German Cancer Research Center: Epidemiologists have predicted it for years, and now the moment has come: For the first time ever, lung cancer will replace breast cancer as the leading cause of death from cancer in women. On the occasion of Word Cancer Day 2015, the German Cancer Research Center (DKFZ) reports that this change in the rankings of cancer mortality, originally determined for all of Europe, has also been observed in Germany.
Cancer death rates have been declining
throughout Europe – by approximately 6 percent for women and by 7.5
percent for men compared to 2009, as epidemiologists from Italy have
recently reported*. However, while death rates from almost all types of
cancer are declining, the death toll from lung cancer amongst women is
predicted to be nine percent higher in 2015 than it was in 2009.
“This change in the leading causes of death
from cancer in women is also observable in Germany,” says epidemiologist
Professor Nikolaus Becker of the German Cancer Research Center
(Deutsches Krebsforschungszentrum, DKFZ). Since 1984, Nikolaus Becker
has edited and made available data on cancer mortality in Germany for
the “Krebsatlas” (Cancer Atlas). Although figures for 2013 and 2014 are
not yet available, scientists can extrapolate certain long-term, stable
trends. “The dropping curve of the death rate for breast cancer and the
steeply rising one for lung cancer in women have been running for many
years toward an intersection point by about 2015,” Becker explains.
The absolute figures for breast cancer are still
higher than those for lung cancer: In 2012, breast cancer claimed the
lives of 15,000 women, whereas lung cancer accounted for 12,800 deaths
in women. However, the age-adjusted death rates for both types of cancer
in women have now become equal for the first time. In 2012, for every
100,000 German women, the age-adjusted death rates for breast cancer and
lung cancer were 16.5 percent and 15.5 percent, respectively. By 2015,
these figures are expected to be equal.
Dr. Martina Pötschke-Langer, who leads DKFZ’s
Cancer Prevention Unit, calls this change in the leading causes of death
from cancer a “predicted catastrophe.” “The significant rise in lung
cancer deaths among women started more than ten years ago,” says
Pötschke-Langer, “and now this trend has appeared to reach a peak. We
have kept warning about this disastrous development. It is tragic that a
mostly preventable disease is now reaching the highest [cancer]
mortality rate and taking an increasing toll on women.” Eighty-five to
90 percent of all cases of lung cancer are considered to be
tobacco-related and, therefore, preventable.
The consumption of cigarettes continues to be high
among women between 25 and 69 years of age. It had even been
continuously on the rise until 2003, when it started to drop slightly.
“Therefore, we cannot expect the trend for lung cancer mortality to
change very soon,” says Pötschke-Langer. To illustrate this, she cites
the famous British epidemiologist Richard Peto, who once said: “If women
smoke like men, they die like men.”
Until about two decades ago, the rate of new cases
of lung cancer was more than three times higher for men than for women.
However, the smoking rate among men has been on the decline since the
late 1970s. This was reflected by a drop in lung cancer mortality that
started around 1990.
Professor Otmar D. Wiestler, Chairman of the
Management Board and Scientific Director of DKFZ, also sees some good
news in this development: “Breast cancer has been regarded as a dreadful
killer among women for decades. But although ever more women develop
breast cancer, fewer of them die from it now than they did about ten
years ago. Cancer treatment is developing at an extremely rapid pace and
we are now seeing the first fruits of success in the positive trend
towards declining death rates from breast cancer."
For the short term, oncologists are hoping that
new, highly effective immunotherapies may for the first time also
achieve better treatment outcomes in some cases of lung cancer.
*M. Malvezzi, P. Bertuccio1, T. Rosso, M. Rota1,
F. Levi, C. La Vecchia & E. Negri: European cancer mortality
predictions for the year 2015: does lung cancer have the highest death
rate in EU women? Annals of Oncology 2015, DOI: 10.1093/annonc/mdv001