Time trends in ovarian cancer mortality in Europe (1955-1993): Effect of age, birth cohort and period of death

The time trend in ovarian cancer mortality in the European Union over the p eriod 1955-1993, and the age, period-of-death and birth cohort components u nderlying the trend's evolution were analysed using log-linear Poisson mode ls to quantify risk of dying from ovarian cancer in the different countries and regions of Europe, and ascertain the relative annual trend for each co untry. Furthermore, age-period-cohort models were fitted for each country i n order to ascertain the effect an time trend exerted by the respective age , period-of-death and birth cohort components. Ovarian cancer mortality pro ved 2.77-fold (95% confidence interval (CI) 2.60-2.95) higher in northern v ersus southern Europe over the period 1955-1993. Denmark registered the hig hest adjusted rates, namely, 14.3 per 100 000 person-years for the 1989-199 3 5-year period, the last studied, with Portugal (4.5 per 100 000) and Gree ce (4.5 per 100 000) bring the countries with the lowest rates. Spain and G reece, with annual rises of 5.8% (95% CI 5.3-6.3) and 5.1% (95% CI 4.2-6.0) respectively, were the countries that displayed the greatest increase in o varian cancer mortality. Risk of death associated with the birth cohort eff ect declined in all northern countries from 1920 to 1930. In the south, Ita ly and France recorded a decline in risk from 1930. Women in Spain and Gree ce registered an increase in birth cohort-associated mortality, which becam e less pronounced after 1930. Ovarian cancer mortality in Europe evinces a south-north distribution pattern. The mortality risk for women cohorts born in northern Europe witnessed a gradual decline from 1920 to 1930. In the s outhern region: (1) Italy and France display a cohort effect of decreased r isk from 1930. and (2 Greece and Spain show a cohort effect of increased ri sk among the different generations of women, though this became less pronou nced from 1930 onwards. (C) 2000 Elsevier Science Ltd. All rights reserved.