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      Lung cancer: a nationwide analysis of sex and age incidence trends from 1980 to 2022

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          Abstract

          Background

          Lung cancer, once rare, has evolved into the global leading cause of cancer-related mortality, primarily driven by widespread cigarette smoking in the 20th century. This study explores the historical trends of lung cancer incidence in Denmark over four decades, emphasizing the impact of smoking prevalence, age, and gender on the observed patterns.

          Materials and methods

          Drawing upon data from the Danish National Patient Register and information on smoking habits provided by the Danish Health Authority, this study investigates lung cancer incidence rates, demographic shifts, and smoking prevalence from 1980 to 2022.

          Results

          Smoking prevalence exhibited a consistent decline in males from 1950 to 2022, whereas female smoking prevalence maintained a stable level from 1950 to 1987, followed by a subsequent decline from 1987 to 2022. A peak in lung cancer crude incidence rates was identified during 2014–2017, with no significant difference observed before and after this period. Over the period, the gender distribution transitioned from a male majority to an equal male-female ratio, and age-specific disparities indicated declines in patients aged 50–59 and increases in those above 80 years.

          Interpretation

          The certainty of a decline in lung cancer incidence in the coming years remains unclear. Based on smoking prevalence, it might still be a decade away. To ensure a sustained decline in lung cancer incidence, targeted interventions are imperative, including customized smoking cessation programs that could be designed favorably for females. Given the modest decline in smoking prevalence over the last decade, legislation aimed at discouraging young individuals from smoking is pivotal. As of now, these efforts have not been implemented in Denmark.

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          Most cited references27

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          The Danish National Patient Registry: a review of content, data quality, and research potential

          Background The Danish National Patient Registry (DNPR) is one of the world’s oldest nationwide hospital registries and is used extensively for research. Many studies have validated algorithms for identifying health events in the DNPR, but the reports are fragmented and no overview exists. Objectives To review the content, data quality, and research potential of the DNPR. Methods We examined the setting, history, aims, content, and classification systems of the DNPR. We searched PubMed and the Danish Medical Journal to create a bibliography of validation studies. We included also studies that were referenced in retrieved papers or known to us beforehand. Methodological considerations related to DNPR data were reviewed. Results During 1977–2012, the DNPR registered 8,085,603 persons, accounting for 7,268,857 inpatient, 5,953,405 outpatient, and 5,097,300 emergency department contacts. The DNPR provides nationwide longitudinal registration of detailed administrative and clinical data. It has recorded information on all patients discharged from Danish nonpsychiatric hospitals since 1977 and on psychiatric inpatients and emergency department and outpatient specialty clinic contacts since 1995. For each patient contact, one primary and optional secondary diagnoses are recorded according to the International Classification of Diseases. The DNPR provides a data source to identify diseases, examinations, certain in-hospital medical treatments, and surgical procedures. Long-term temporal trends in hospitalization and treatment rates can be studied. The positive predictive values of diseases and treatments vary widely (<15%–100%). The DNPR data are linkable at the patient level with data from other Danish administrative registries, clinical registries, randomized controlled trials, population surveys, and epidemiologic field studies – enabling researchers to reconstruct individual life and health trajectories for an entire population. Conclusion The DNPR is a valuable tool for epidemiological research. However, both its strengths and limitations must be considered when interpreting research results, and continuous validation of its clinical data is essential.
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            The Danish National Patient Register.

            The Danish National Patient Register (NPR) was established in 1977, and it is considered to be the finest of its kind internationally. At the onset the register included information on inpatient in somatic wards. The content of the register has gradually been expanded, and since 2007 the register has included information on all patients in Danish hospitals. Although the NPR is overall a sound data source, both the content and the definitions of single variables have changed over time. Changes in the organisation and provision of health services may affect both the type and the completeness of registrations. The NPR is a unique data source. Researchers using the data should carefully consider potential fallacies in the data before drawing conclusions.
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              Current Cancer Epidemiology

              In this brief report, we offer a concise overview on current cancer epidemiology garnered from the official databases of World Health Organization and American Cancer Society and provide recent information on frequency, mortality, and survival expectancy of the 15 leading types of cancers worldwide. Overall, cancer poses the highest clinical, social, and economic burden in terms of cause-specific Disability-Adjusted Life Years (DALYs) among all human diseases. The overall 0–74 years risk of developing cancer is 20.2% (22.4% in men and 18.2% in women, respectively). A total number of 18 million new cases have been diagnosed in 2018, the most frequent of which are lung (2.09 million cases), breast (2.09 million cases), and prostate (1.28 million cases) cancers. Beside sex-specific malignancies, the ratio of frequency between men and women is >1 for all cancers, except thyroid (i.e., 0.30). As concerns mortality, cancer is the second worldwide cause of death (8.97 million deaths) after ischemic heart disease, but will likely become the first in 2060 (~18.63 million deaths). Lung, liver, and stomach are the three most deadly cancers in the general population, while lung and breast cancers are the leading causes of cancer related-mortality in men and women, respectively. Prostate and thyroid cancers have the best prognosis, with 5-year survival ~100%, while esophagus, liver, and especially pancreas cancers have the worst prognosis, typically <20% at 5 years. We hope that this report will provide fertile ground for addressing health-care interventions aimed at preventing, diagnosing, and managing cancer around the world.
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                Author and article information

                Journal
                Acta Oncol
                Acta Oncol
                AO
                Acta Oncologica
                MJS Publishing on behalf of Acta Oncologica
                0284-186X
                1651-226X
                30 June 2024
                2024
                : 63
                : 34876
                Affiliations
                [a ]Department of Medicine, Lillebaelt Hospital Vejle, Beriderbakken, Denmark
                [b ]WHO-CC, the Parker Institute, Bispebjerg-Frederiksberg Hospital, Copenhagen University, Copenhagen, Denmark
                [c ]I2Minds, Aarhus, Denmark
                [d ]Department of Medicine, Lillebaelt Hospital Vejle, Vejle, Denmark
                Author notes
                CONTACT Morten Borg morten.hornemann.borg@ 123456rsyd.dk Department of Medicine, Lillebaelt Hospital Vejle, Beriderbakken 4, DK-7100 Denmark
                Author information
                https://orcid.org/0000-0002-6204-2623
                https://orcid.org/0000-0002-7161-3416
                https://orcid.org/0000-0002-3075-3463
                https://orcid.org/0000-0002-6905-4141
                Article
                AO-63-34876
                10.2340/1651-226X.2024.34876
                11332477
                38946288
                e33e7362-1a09-45f5-81c4-1988a3f1bbb8
                © 2024 The Author(s)

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work.

                History
                : 11 December 2023
                : 14 May 2024
                Funding
                Funding details This study did not require funding.
                Categories
                Original Article

                Oncology & Radiotherapy
                lung cancer,incidence,epidemiology,female,male,incidence forecasting
                Oncology & Radiotherapy
                lung cancer, incidence, epidemiology, female, male, incidence forecasting

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