Lung cancer mortality rates in birth cohorts in the United States from 1960 to 1994

We sought to describe the changing death rates from lung cancer in the US w hite population ill sequential birth cohorts, adjusting for cohort smoking prevalence and duration. We starched the US mortality database (1960 1994) fur all deaths among whites in which lung cancer was listed as the underlyi ng cause of death. To determine the population at risk for lung cancer, we used the 1970. 1978-1980, and 1992 National Health Interview Surveys to est imate the annual number of current and recent smokers (those who had quit w ithin 5 years) in 11 5-year birth cohorts. starting in 1901. We then determ ined annual lung cancer mortality rates, for each birth cohort, stratified by sex and adjusting fur the prevalence and duration of smoking. The popula tion-based rates of lung cancer mortality were much higher among men than a mong women across all ages and birth cohorts. reflecting higher smoking rat es among men. These differences decreased after we controlled for current a nd recent smoking within the cohorts and were slightly increased in women a fter we controlled for duration of smoking. Differences in lung cancer deat h rates across birth cohorts of US men and women primarily reflect differen ces in the prevalence and duration of smoking in these birth cohorts. Chang es in cigarette design that have greatly reduced tar yields have a relative ly small effect compared with that of people's smoking status, and duration of smoking. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.