Smoking and lung cancer mortality in Italian men and women: 2003-2019

BackgroundIn Italy, progress in lung cancer mortality in men is not paralleled by similar trends in women, though exposure to tobacco smoking is well known to be the key driver of lung cancer incidence and mortality. This study aimed to compare recent trends in lung cancer mortality rates in Italian men and women.MethodsMortality data for 2003-2019 were retrieved from death certificates compiled by the Italian National Institute for Statistics. These data were used to compute, separately in men and women, age-standardized mortality rates (/105/year) for lung cancer (ICD-10: C33-C34.9). Furthermore, we estimated the absolute number of prevented lung cancer deaths in 2007-2019 in Italy, as the difference between the observed and expected (based on the 2003-2006 mortality rates) number of lung cancer deaths. Data on the prevalence of tobacco smoking in men and women were collected from national surveys.ResultsIn Italian men, the use of tobacco smoking strongly declined from 60% in the 1960s to 27.7% in 2021, whereas it tended to increase in women – particularly in the two last decades from 16.6% in 2004 to 20.7% in 2021. In men, a decline from 2007 to 2019 in lung cancer mortality rates was documented in all geographic areas (e.g., from 121.2/105 to 92.6/105 in northern Italy; and from 98.5/105 to 91.4/105 in southern Italy). Conversely, upward trends were registered for women: from 30.3/105 to 33.8/105 in the North; and from 16.3/105 to 20.3/105 in the South. From 2007 to 2019, there was an 18.7% reduction in the expected number of lung cancer deaths in men (-73.397) and an increase of 16.0% in expected deaths in women (+16.036).ConclusionsStudy findings strengthen the persistent need for tailoring interventions to reduce smoking among females to invert lung cancer mortality trends in Italian women.Legal entity responsible for the studyThe authors.FundingItalian Ministry of Health, Ricerca Corrente IRCCS CRO, Aviano.DisclosureAll authors have declared no conflicts of interest.