Lung cancer mortality

The main articles are:

• Lung cancer
• Fertility and mortality in Russia

2024: More than 4,800 deaths a day or 1.8 million a year worldwide

According to WHO, as of September 24, 2024, lung cancer is a key cause of cancer mortality in the world. Every year, the disease claims the lives of about 1.8 million people; that's more than 4,800 deaths every day.

2020: The number of deaths from respiratory cancer in the Russian Federation over 10 years decreased by 15%

The number of deaths from respiratory cancer in Russia over 10 years has decreased by 15%. This is stated in an article by the scientific journal Lancet Respiratory Medicine, published in August 2021. Read more here.

2018

50 thousand people a year die from lung cancer in Russia

In Russia, in 2018, lung cancer accounts for 15 percent of all deaths from oncology: more than 50 thousand patients a year with an average incidence of 60 thousand^[1].

Women's lung cancer deaths to rise by half by 2030

On August 1, 2018, a study was published in the Journal of the American Association for Cancer Research, according to which mortality rates from lung cancer in women between 2015 and 2030 will increase by almost half - by 43%. Researchers suggest more women will die of lung cancer than breast cancer by the end of this period.

The use of computed tomography at a low dose of radiation (LDCT) to screen for lung cancer reduces the mortality rate by 20%, but this examination method is not used as effectively as its potential allows, said a team of researchers led by Juan Carlos Martín-Sánchez, professor at the International University of Catalonia in Barcelona (Spain).

More women will die from lung cancer than breast cancer, researchers predict

Lung cancer deaths have already surpassed breast cancer deaths in several countries, according to the study authors. In fact, breast cancer deaths (age-standardized) are projected to decline by 9% from 2015 to 2030, while lung cancer deaths will increase.

Previous studies have shown that prevention and treatment of breast cancer has led to a clear decrease in mortality rates. Historically, lung cancer incidence per 100,000 women has been lower than breast cancer incidence - from 0.8 in equatorial Africa to 33.8 in North America - but the five-year survival rate for this disease is very low - less than 20% in developed countries. Since 60% of deaths in lung cancer in women are associated with smoking, mortality varies depending on the level of tobacco consumption in different regions.

Martin-Sanchez and colleagues used information from the 2008-2014 WHO mortality database to estimate deaths from lung cancer and breast cancer in women worldwide. The team assessed lung and breast cancer deaths by country, year and age group of patients in 52 countries. They compared current mortality rates (age-standardized) with the projected mortality rate for both diseases and established that by 2030, more women would die from lung cancer: if in 2015 lung cancer deaths were 11.2 cases per 100,000 women and breast cancer deaths were 16.1, then the predicted mortality values in 2030 are 16 and 14.7 cases, respectively.

By 2030, lung cancer deaths in women will be higher than breast cancer in 26 of the 52 countries analyzed, the researchers report, with 24 belonging to a group of countries with high per capita GNP - apparently due to the wider prevalence of tobacco smoking in those countries.

For prevention, LDCT can be used to screen for lung cancer, however, its implementation is still limited despite recommendations from the U.S. Preventive Services Task Force. Some experts attribute this to low compensation from the national health insurance fund, some - lack of awareness of patients and doctors about the existence of such a research method.

Lung cancer screening programs could be implemented in the near future, which would subsequently reduce projected mortality rates, the researchers note. In the meantime, CT screening is not available, the efforts of specialists should be aimed at preventing smoking in women and helping smokers to combat this addiction, since this is the main risk factor for lung cancer.^[2]

2015: Reduced mortality in men and growth in women

People per 100 thousand population

1985: How did the USSR manage to reduce lung cancer mortality if the proportion of smokers was only growing?

The direct link between smoking and cancer has been proven by numerous studies. World statistics show that a decrease in the proportion of smokers leads to a pronounced decrease in deaths from lung cancer and laryngeal cancer. However, in Russia, the decline in mortality from these diseases began in the mid-1990s just when cigarette sales began to grow rapidly.

The proportion of smokers peaked in 2009, but deaths from cancers caused by smoking have been steadily declining for more than a decade. What explains the Russian statistical anomaly, in June 2020, the famous Russian oncologist, president of the Anti-Cancer Society of Russia, visiting professor at Oxford University David Zaridze spoke in one of the lectures held as part of the Scientific and Educational Program of the Anti-Cancer Society of Russia.

Studies proving a direct relationship between rising lung cancer rates and smoking emerged in the early 1950s. Later it became known that smoking leads to an increased risk of developing malignant tumors of other organs. The scientific community was forced to admit that this common habit leads to dangerous oncological diseases. The translation of this knowledge in society, the active promotion of smoking cessation led to a steady decrease in the popularity of this habit among the population of developed countries, which naturally led to a decrease in mortality from many forms of cancer. As an illustration, Professor Zaridze suggests looking at data on deaths from malignant tumours associated with smoking among men aged 35 to 69 in the UK. Since the early 1970s, by 2005, this figure has decreased by more than 2.5 times, while mortality from other forms of cancer has remained approximately the same.

Another situation was developing in Russia. Cigarette sales grew steadily and peaked in the mid-2000s. If in the early 1990s, according to official data, more than 200 billion cigarettes were sold in the country per year, then by the beginning of the 2010s more than 400 billion cigarettes were sold in Russia per year. This explosive rise in cigarette sales would seem to have been followed by an increase in deaths from lung cancer and other smoking-associated tumors. However, statistics do not record this. Although until the early 1990s in the RSFSR and Russia, mortality from lung cancer among men steadily increased. However, then a steady decline began, although smoking became no less, and even more. In other countries, deaths from smoking-associated cancers have generally declined following a decrease in cigarette consumption. In Russia, with a sharp increase in cigarette consumption, mortality from lung cancer declined. Moreover, similar dynamics were demonstrated by statistics for others cancer related to, smoking such as laryngeal cancer. A similar dynamic, however less pronounced, was observed among women.

In 2009, the prevalence of smoking reached a historic maximum - 60% of men and 22% of women smoked. However, lung cancer deaths declined from 1993 to 2016 by 40%. How to explain such a Russian anomaly?

As David Zaridze said, this is the merit of scientists. In 1985, the International Conference "Tobacco is the Main International Threat to Health" was held in Moscow at the Cancer Research Center under the auspices of the International Agency for the Study of Cancer. The recommendations of this conference gave rise to the prevention of smoking in the USSR and Russia. According to Professor Zaridze, the list of recommendations was huge, but the key role in reducing mortality was not they, but an additional measure - to introduce an upper limit for the content of resins in tobacco smoke to 15 mg per cigarette. At that time, the tar content in cigarettes sold in the USSR was not regulated in any way. As a result, it reached extremely high rates - 30 mg or more per cigarette. Most of the carcinogenic substances are in the resin. The state listened to the recommendations of doctors and in 1988 the Ministry of Health of the USSR introduced MPC for the content of tar in cigarettes - no more than 15 mg/whitefish. According to Zaridze, this led to a decrease in morbidity and mortality from lung cancer since 1993 and saved more than 400 thousand lives in Russia alone.

In fact, this decision was nothing new. Back in the mid-1970s, British psychiatrist and active anti-smoking fighter Professor Michael Russell formulated the concept of smoking harm reduction (Tobacco Harm Reduction). He was the first to formulate the main problem, saying that people smoke for nicotine, and die because of resins. Later, the British Richard Doll and Richard Peto explained the decrease in mortality from lung cancer in young British men by switching to filtered cigarettes, which were passed into the lungs much less resins, and therefore carcinogenic substances.

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