Death rates from cancer will fall in Australasian countries and Russia in 2018

December 10, 2018

Researchers predict that death rates from cancer will fall in 2018 in Australasian countries and in Russia. However, a greater proportion of the population will die in Russia from the disease than in any of the other countries, mainly because of the large numbers of men who still smoke.

In a study published in the leading cancer journal Annals of Oncology [1] today (Tuesday), researchers led by Carlo La Vecchia (MD), Professor at the Faculty of Medicine, University of Milan (Italy), predict that 158,950 men and 137,810 women will die in 2018 in Russia, representing age-standardised rates of 158.5 men and 84 women per 100,000 of the population [2].

Out of the ten major cancers the researchers investigated, lung cancer accounted for the greatest number of deaths among Russian men (about 40,000), while about 9000 women are predicted to die from it - 39.7 men and 5.3 women per 100,000 of the population.

By contrast, in countries such as Australia, Israel and the Philippines 101, 95 and 84.5 men and 74.7, 76.5 and 70 women respectively per 100,000 of the population will die from any cancer in 2018. In Australia, for example, 4,970 men and 3,600 women are predicted to die from lung cancer in 2018 - 19.7 men and 13.65 women per 100,000 of the population.

Prof La Vecchia said: "There is an urgent need for further improvement in cancer prevention and treatment in Russia. Given the high lung cancer rates among Russian men, stopping smoking remains a priority there. This is particularly important among middle aged and elderly men who started smoking during the Soviet era.

"The comparatively low rates of cancer deaths in Australia are partly, but not only, due to its low lung cancer rates."

Prof La Vecchia and his colleagues from Italy, Switzerland and the USA collected data on total cancer deaths and deaths from ten major cancers (stomach, colorectum, pancreas, lung, breast, uterus and cervix, ovary, prostate, bladder and leukaemias) from the World Health Organization between 1970 and 2015 for the Russian Federation, Israel, Hong Kong, Japan, the Philippines, the Republic of Korea and Australia. They used these figures to make predictions for cancer deaths in 2018. The results of their research have public health implications, and are also relevant for the organisation of cancer management and care.

Although they predict that death rates from cancer will decline in all seven countries, the actual numbers of deaths will continue to rise because of the growing population of elderly people.

By looking at the number of deaths from cancer in 1993 and projecting the number of deaths that would have been expected in 2018 if deaths had continued at the same rate, the researchers estimated that a substantial number of cancer deaths have been avoided over that period: one million in Russia, 40,000 in Israel, 63,000 in Hong Kong, about 650,000 in Japan, 330,000 in Korea and 180,000 in Australia. There was no appreciable reduction observed in the Philippines.

"The Philippines had, and still have, low rates of deaths from cancer. These are partly influenced by under-registration of causes of death, particularly in the past. Even so, the low lung cancer rates in both sexes are probably real, reflecting past low smoking prevalence. Stomach cancer rates are also low," said Prof La Vecchia.

About 17.9 men per 100,000 of the Philippine population will die from lung cancer in 2018, and 2.1 per 100,000 from stomach cancer. Death rates among women are similarly low with 6.3 per 100,000 dying from lung cancer and 1.25 from stomach cancer.

The researchers found there were persistently high rates of deaths from stomach cancer in some of the other countries, despite declines in recent years. In Russia, 13.6 men and 5.8 women per 100,000 will die from stomach cancer; in Japan, 13 men and 4.8 women per 100,000 will die; and in Korea 10 men and 4 women per 100,000 will die.

A rise in cancers of the uterus (womb) and cervix is predicted for 2018 in Russia, Israel, Hong Kong and Japan; only a slight decrease is predicted for the Philippines. "In Russia and the Philippines this is probably due to inadequacies in cervical cancer screening, as these countries have comparatively high rates - 10.2 and 7.4 per 100,000 in Russia and the Philippines respectively versus less than five per 100,000 in the European Union," said Prof La Vecchia. "The other countries that have seen an increase have relatively low rates."

Out of the seven countries considered, the lowest cancer death rates predicted in men in 2018 were in the Philippines (84.6 per 100,000), and the lowest rates among women were in Korea (52.5 per 100,000). The greatest fall in death rates between 2012 and 2018 occurred in Korean men: the researchers predicted a 20% decrease.

Prof La Vecchia concluded: "Overall, we predict falls in death rates from cancer for 2018. However, these are less pronounced and have occurred later compared to the EU and USA. Mortality from lung cancer among women is low in Russia compared to the EU and North America, reflecting the low prevalence of smoking among Russian women, in sharp contrast with figures for Russian men. However, the rise in the lung cancer death rates among women aged 25 to 44 years in Israel is particularly worrisome. This underlines the need for urgent measures on tobacco control, particularly in countries like Russia with exceedingly high lung cancer rates in men."

Editor-in-chief of Annals of Oncology, Professor Fabrice André, Professor in the Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France, commented: "The predictions made in this study by Carlo La Vecchia and his colleagues are important for policy-makers and health providers to help them to make plans for the future prevention and treatment of cancers. This study shows that there is still a lot of work to be done, particularly in Russia, on encouraging people to stop smoking and to prevent them starting in the first place."
[1] "Cancer mortality and predictions for 2018 in selected Australasian countries and Russia", by G. Carioli et al. Annals of Oncology. doi:10.1093/annonc/mdy489
[2] Age-standardised rates per 100,000 of the population are adjusted according to the proportions of people in different age groups in the overall population
[3] The paper contains individual tables of predicted cancer death rates for selected Australasian states and Russia.

European Society for Medical Oncology

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