Cigarette smoking and changing trends of lung cancer incidence by histological subtype among Chinese male population

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 66; no. 1; pp. 22 - 27
• Main Authors: Tse, Lap Ah, Mang, Oscar Wai-Kong, Yu, Ignatius Tak-Sun, Wu, Fan, Au, Joseph Siu-Kie, Law, Stephen Chun-Key
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ireland Ltd 01.10.2009; Elsevier
• Subjects: Adolescent; Adult; Age-period-cohort models; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - classification; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - ethnology; Forecasting; Hematology, Oncology and Palliative Medicine; Histology; Hong Kong - epidemiology; Humans; Incidence; Lung neoplasm; Lung Neoplasms - classification; Lung Neoplasms - epidemiology; Lung Neoplasms - ethnology; Male; Medical sciences; Middle Aged; Pneumology; Pulmonary/Respiratory; Risk Factors; Smoking; Smoking - adverse effects; Smoking - trends; Time trends; Tobacco, tobacco smoking; Toxicology; Tumors; Tumors of the respiratory system and mediastinum; Young Adult; Hong Kong; ADC; RR; Hong Kong Cancer Registry; Incidence; HKCR; UTT; SQCC; Time trends; OSC; WHO; World Health Organization; other specified and/or unspecified histological subtypes; CI; adenocarcinoma; Histology; LCC; unknown tumour type; relative risk; SCC; annual percentage change; APC; Lung neoplasm; Age-period-cohort models; small cell carcinoma; confidence interval; large cell carcinoma; squamous cell carcinoma; Smoking; Lung disease; Respiratory disease; Lung cancer; Tobacco smoking; Male; Period; Malignant tumor; Epidemiology; Cigarette; Cancerology; Bronchus disease; Chinese; Population; Models; Subtype; Cancer; Pneumology
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2008.12.023

Abstract We analyzed the time trends of lung cancer by histological subtype in Hong Kong during 1991–2005, and examined how the time trends were influenced by the effects of birth cohort and calendar period of diagnosis. Cancer incidence data were obtained from Hong Kong Cancer Registry and population data from Census and Statistics Department. Age-standardized incidence rates were computed by the direct method using WHO 1966 standard population as reference. Period and cohort effects were assessed by using two separate Poisson regression models adjusting for age. From 1991 to 2005, the incidence rates in Hong Kong Chinese males decreased steadily. The decline in overall lung cancer incidence rates was limited primarily to the decrease in squamous cell carcinoma, which could be explained by the decreasing trend of cigarette smoking. Adenocarcinoma had been the most predominant histological subtype all along. The relatively horizontal trend of adenocarcinoma and the lack of cohort effect implied the important roles of gene-environment interaction and/or the use of low-tar and filter tip cigarettes. Our study suggests that different histological subtypes may represent different disease entities with perhaps some distinct risk factors. The hypotheses generated from this ecological study will need confirmation by subsequent analytic studies.