Skip to main content
Log in

Predicting lung cancer death in Africa and Asia: differences with WHO estimates

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective

Reliable cancer burden estimates are rarely available from most developing countries where cancer registration is lacking. This study provided estimates on the current and future number of lung cancer deaths in Indonesia, Vietnam and Ethiopia, and Sub-Saharan Africa at large.

Methods

The number of lung cancer deaths was estimated from detailed smoking prevalence data (obtained from surveys among 8,726 rural individuals aged 25–74 years in Indonesia, Vietnam, and Ethiopia in 2005–2006) and on lung cancer rate estimates among non-smokers.

Results

Our estimate for lung cancer deaths in Sub-Saharan Africa is 44,076 in 2005, which is 2.6 times the most recent WHO estimate in 2003 (17,000 deaths). A similar ratio is found for the country-specific estimate in Ethiopia. Our estimates are only slightly higher than the WHO’s in Indonesia, and Vietnam. The attributable risk of smoking for lung cancer death among men was 39% in Ethiopia, 80% in Indonesia and 85% in Vietnam. We expect the annual number of lung cancer deaths to double by 2025, even if the smoking prevalence is assumed not to increase further.

Conclusions

WHO estimates on lung cancer deaths in Asia appear to be slightly lower than our study results; however, in Africa, the burden appears to be largely underestimated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. International Agency for Research on Cancer (2007) CANCERMondial—Statistical Information System. International Agency for Research on Cancer [updated 2007; cited 2008 Mar 15]; Available from: http://www-dep.iarc.fr/

  2. Lopez AD, Collishaw NE, Piha T (1994) A descriptive model of the cigarette epidemic in developed countries. Tob Control 3(3):242–247. doi:10.1136/tc.3.3.242

    Article  Google Scholar 

  3. Mackay J, Eriksen M (2005) The tobacco atlas. World Health Organization, Geneva

    Google Scholar 

  4. Danaei G, Vander Hoorn S, Lopez AD, Murray CJ, Ezzati M (2005) Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors. Lancet 366(9499):1784–1793. doi:10.1016/S0140-6736(05)67725-2

    Article  PubMed  Google Scholar 

  5. World Health Organization (2005) Preventing chronic diseases—a vital investment. World Health Organization, Geneva

    Google Scholar 

  6. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367(9524):1747–1757. doi:10.1016/S0140-6736(06)68770-9

    Article  PubMed  Google Scholar 

  7. He J, Gu D, Wu X, Reynolds K, Duan X, Yao C et al (2005) Major causes of death among men and women in China. N Engl J Med 353(11):1124–1134. doi:10.1056/NEJMsa050467

    Article  PubMed  CAS  Google Scholar 

  8. Liu BQ, Peto R, Chen ZM, Boreham J, Wu YP, Li JY et al (1998) Emerging tobacco hazards in China: 1 Retrospective proportional mortality study of one million deaths. BMJ 317(7170):1411–1422

    PubMed  CAS  Google Scholar 

  9. Bach PB, Kattan MW, Thornquist MD, Kris MG, Tate RC, Barnett MJ et al (2003) Variations in lung cancer risk among smokers. J Natl Cancer Inst 95(6):470–478

    PubMed  Google Scholar 

  10. Knoke JD, Shanks TG, Vaughn JW, Thun MJ, Burns DM (2004) Lung cancer mortality is related to age in addition to duration and intensity of cigarette smoking: an analysis of CPS-I data. Cancer Epidemiol Biomarkers Prev 13(6):949–957

    PubMed  Google Scholar 

  11. Marugame T, Sobue T, Satoh H, Komatsu S, Nishino Y, Nakatsuka H et al (2005) Lung cancer death rates by smoking status: comparison of the Three-Prefecture Cohort study in Japan to the Cancer Prevention Study II in the USA. Cancer Sci 96(2):120–126. doi:10.1111/j.1349-7006.2005.00013.x

    Article  PubMed  CAS  Google Scholar 

  12. Lubin JH, Caporaso NE (2006) Cigarette smoking and lung cancer: modeling total exposure and intensity. Cancer Epidemiol Biomarkers Prev 15(3):517–523. doi:10.1158/1055-9965.EPI-05-0863

    Article  PubMed  CAS  Google Scholar 

  13. Ezzati M, Lopez AD (2003) Estimates of global mortality attributable to smoking in 2000. Lancet 362(9387):847. doi:10.1016/S0140-6736(03)14338-3

    Article  PubMed  Google Scholar 

  14. Winkler V, Gbangou A, Kouyate B, Becher H (2006) A simple method to estimate tobacco-related lung cancer deaths based on smoking prevalence data. Methods Inf Med 45(4):397–403

    PubMed  CAS  Google Scholar 

  15. Ng N, Van Minh H, Tesfaye F, Bonita R, Byass P, Stenlund H et al (2006) Combining risk factors and demographic surveillance: potentials of WHO STEPS and INDEPTH methodologies for assessing epidemiological transition. Scand J Public Health 34(2):199–208. doi:10.1080/14034940500204506

    Article  PubMed  Google Scholar 

  16. World Health Organization (2005) WHO STEPS surveillance manual: the WHO STEPwise approach to chronic disease risk factor surveillance. Noncommunicable Diseases and Mental Health, World Health Organization, Geneva

    Google Scholar 

  17. Jha P, Ranson MK, Nguyen SN, Yach D (2002) Estimates of global and regional smoking prevalence in 1995, by age and sex. Am J Public Health 92(6):1002–1006. doi:10.2105/AJPH.92.6.1002

    Article  PubMed  Google Scholar 

  18. World Population Prospects [database on the Internet]. United Nations. 2006 [cited June 15, 2007]. Available from: http://esa.un.org/unpp/index.asp?panel=2

  19. World Health Organization (2003) World Health Report 2003: shaping the future. World Health Organization, Geneva

    Google Scholar 

  20. INDEPTH Network (2002) Population and health in developing countries. INDEPTH Network, IDRC, Ottawa

    Google Scholar 

  21. Wakelee HA, Chang ET, Gomez SL, Keegan TH, Feskanich D, Clarke CA et al (2007) Lung cancer incidence in never smokers. J Clin Oncol 25(5):472–478. doi:10.1200/JCO.2006.07.2983

    Article  PubMed  Google Scholar 

  22. Thun MJ, Henley SJ, Burns D, Jemal A, Shanks TG, Calle EE (2006) Lung cancer death rates in lifelong nonsmokers. J Natl Cancer Inst 98(10):691–699

    Article  PubMed  Google Scholar 

  23. Ando M, Wakai K, Seki N, Tamakoshi A, Suzuki K, Ito Y et al (2003) Attributable and absolute risk of lung cancer death by smoking status: findings from the Japan Collaborative Cohort Study. Int J Cancer 105(2):249–254. doi:10.1002/ijc.11043

    Article  PubMed  CAS  Google Scholar 

  24. Haiman CA, Stram DO, Wilkens LR, Pike MC, Kolonel LN, Henderson BE et al (2006) Ethnic and racial differences in the smoking-related risk of lung cancer. N Engl J Med 354(4):333–342. doi:10.1056/NEJMoa033250

    Article  PubMed  CAS  Google Scholar 

  25. Pinsky PF (2006) Racial and ethnic differences in lung cancer incidence: how much is explained by differences in smoking patterns? (United States). Cancer Causes Control 17(8):1017–1024. doi:10.1007/s10552-006-0038-2

    Article  PubMed  Google Scholar 

  26. McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF Jr (1995) Smoking and cancer mortality among U.S. veterans: a 26-year follow-up. Int J Cancer 60(2):190–193. doi:10.1002/ijc.2910600211

    Article  PubMed  CAS  Google Scholar 

  27. Prescott E, Osler M, Andersen PK, Hein HO, Borch-Johnsen K, Lange P et al (1998) Mortality in women and men in relation to smoking. Int J Epidemiol 27(1):27–32. doi:10.1093/ije/27.1.27

    Article  PubMed  CAS  Google Scholar 

  28. Engeland A, Haldorsen T, Andersen A, Tretli S (1996) The impact of smoking habits on lung cancer risk: 28 years’ observation of 26, 000 Norwegian men and women. Cancer Causes Control 7(3):366–376. doi:10.1007/BF00052943

    Article  PubMed  CAS  Google Scholar 

  29. Nordlund LA, Carstensen JM, Pershagen G (1999) Are male and female smokers at equal risk of smoking-related cancer: evidence from a Swedish prospective study. Scand J Public Health 27(1):56–62. doi:10.1177/14034948990270010301

    Article  PubMed  CAS  Google Scholar 

  30. Speizer FE, Colditz GA, Hunter DJ, Rosner B, Hennekens C (1999) Prospective study of smoking, antioxidant intake, and lung cancer in middle-aged women (USA). Cancer Causes Control 10(5):475–482. doi:10.1023/A:1008931526525

    Article  PubMed  CAS  Google Scholar 

  31. Bray F, Sankila R, Ferlay J, Parkin DM (2002) Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer 38(1):99–166. doi:10.1016/S0959-8049(01)00350-1

    Article  PubMed  CAS  Google Scholar 

  32. Levy DT, Bales S, Lam NT, Nikolayev L (2006) The role of public policies in reducing smoking and deaths caused by smoking in Vietnam: results from the Vietnam tobacco policy simulation model. Soc Sci Med 62(7):1819–1830. doi:10.1016/j.socscimed.2005.08.043

    Article  PubMed  Google Scholar 

  33. World Health Organization. WHO Global NCD Infobase (2005) [updated 2005; cited]; Available from: http://www.who.int/ncd_surveillance/infobase/en/

Download references

Acknowledgments

This study was undertaken within the Centre for Global Health at Umeå University, with support from FAS, the Swedish Council for Working Life and Social Research (grant no. 2006-1512). The research of Volker Winkler was supported by the German Research Foundation (DFG).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Heiko Becher.

Additional information

Nawi Ng and Volker Winkler have equal contribution to this paper.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 132 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ng, N., Winkler, V., Minh, H.V. et al. Predicting lung cancer death in Africa and Asia: differences with WHO estimates. Cancer Causes Control 20, 721–730 (2009). https://doi.org/10.1007/s10552-008-9285-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-008-9285-8

Keywords

Navigation