Trends in lung cancer mortality in South Africa: 1995-2006

BACKGROUND: Cancer remains a major cause of morbidity and mortality worldwide. In developing countries, data on lung cancer mortality are scarce. METHODS: Using South Africa's annual mortality and population estimates data, we calculated lung cancer age-standardised mortality rates for the period 1995 to 2006. The WHO world standard population was used as the reference population. Scatter plots and regression models were used to assess linear trends in mortality rates. To better characterise emerging trends, regression models were also partitioned for defined periods. RESULTS: Lung cancer caused 52,217 deaths during the study period. There were 4,525 deaths for the most recent year (2006), with men accounting for 67% of deaths. For the entire South African population, the age-standardised mortality rate of 24.3 per 100,000 persons in 1995 was similar to the rate of 23.8 per 100,000 persons in 2006. Overall, there was no significant decline in lung cancer mortality in South Africa from 1995 to 2006 (slope = -0.15, p = 0.923). In men, there was a statistically non-significant annual decline of 0.21 deaths per 100,000 persons (p = 0.433) for the study period. However, from 2001 to 2006, the annual decline of 1.29 deaths per 100,000 persons was statistically significant (p = 0.009). In women, the mortality rate increased significantly at an annual rate of 0.19 per 100,000 persons (p = 0.043) for the study period, and at a higher rate of 0.34 per 100,000 persons (p = 0.007) from 1999 to 2006. CONCLUSION: The more recent declining lung cancer mortality rate in men is welcome but the increasing rate in women is a public health concern that warrants intervention. Smoking intervention policies and programmes need to be strengthened to further reduce lung cancer mortality in men and to address the increasing rates in women.