Cancer mortality in the United States and Germany

Purpose: The USA and Germany are currently; two of the world's leading indu strial nations with comparable standards of living and considerable similar ities in lifestyle. Fifty years ago, i.e., in the years following the Secon d World War, the living conditions in the two countries were completely dif ferent. Tf it is true that the major part of cancer occurrence is lifestyle -related, we should see corresponding discrepancies and assimilations on th e level of cancer occurrence, Methods: As an exercise in descriptive epidem iology, we compare the time trends in German and US cancer mortality in ord er to examine whether they parallel indeed the differences and changes in l ifestyle factors of the two countries. Results: Overall, we found the cance r mortality of the two countries converging to rather similar rates. Howeve r, in detail, the data indicate various inconsistencies between the pattern s of lifestyle factors and cancer mortality in the two countries: similar l ung cancer rates, despite rather different patterns of cigarette consumptio n, or decreasing rectal cancer mortality, despite increasing prevalence of risk factors, are examples. Conclusions: Promising changes with regard to r elevant risk factors indicate that the recent decline of cancer mortality i n both countries will continue, Nevertheless, vigorous action towards prima ry prevention in German!: and more effective screening programs in both cou ntries appear recommendable.