Recent decline in cancer mortality in Catalonia (Spain). A joinpoint regression analysis

The aim of this paper was to analyse recent changes in cancer mortality in Catalonia (Spain) between 1975 and 1998 using join-point regression models. Mortality data were obtained from the Mortality Registry of Catalonia. For each sex, age-standardised (standard world population) mortality rates wer e computed by the direct method. and join-point analysis was used to identi fy tile best fitting points where a statistically significant change in the rates had occurred. In men, the overall cancer mortality (except skin non- melanoma) was highest in 1991 and decreased thereafter. Lung cancer was the main Cause of cancer mortality, with an increase until 1989, and a subsequ ent levelling off (-0.8% annual between 1989 and 1998). Colorectal cancer w as the second cause of cancer death, both in men and women, with a levellin g-off of the rates since 1991 and 1989, respectively. In women, tile mortal ity rate decreased for total cancer (except skin non-melanoma) since 1991 ( -0.9% annually). Breast cancer increased until 1975, levelled-off and begun to decline since 1992 (-3.8% annual). Lung cancer increased since 1988 ( 2.1%) and became the third cancer cause of death among women in 1998. Thes e changes are mainly due to the decline of smoking prevalence in males, but not in females, and to the introduction of new diagnostic techniques and i mproved therapies for female breast cancer. (C) 2001 Elsevier Science Ltd. All rights reserved.