Changing epidemiology and trends in incidence of smoking-related cancers in England, 1971-2020
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Brighton and Sussex Medical School, United Kingdom
Publication date: 2023-04-25
Corresponding author
Emma T Taylor-Gallardo
Brighton and Sussex Medical School, United Kingdom
Tob. Prev. Cessation 2023;9(Supplement):A163
Tobacco smoking is causally associated with 15 different types of cancer and is the single most preventable cause of morbidity and mortality in the world. The prevalence of smoking in most European countries has steadily declined over the past six decades – for example, in the UK, it declined from about 60% in males and 45% in females in the 1960s to 15.3% and 13.7%, respectively in 2020. We conducted a retrospective population-based cohort study to examine whether there has been a stabilisation or decline in the incidence of smoking-related cancers in England over the past five decades.

Material and Methods:
Aggregate data for patients diagnosed with eight smoking-related cancers (lip, oral cavity, and pharynx, larynx, lung, oesophagus, kidney and bladder) in England during 1971-2020 were obtained from GLOBOCAN and NHS Digital. Data on smoking prevalence and denominator population were obtained from the Office for National Statistics (ONS). Average annual incidence rates (AAIR) were calculated by two age categories (0-49, 50+ years) and all ages combined during the 10 five-year time periods (1971-75 to 2016-20). The percentage change in incidence was calculated as change in the AAIR from the first (1971-75) to the last time period (2016-20).

During the 50-year study period, a total of 2,983,239 smoking-related cancers were registered in England. Overall, the incidence rates of laryngeal, lung and bladder cancer stabilized over this period – the largest decline in the incidence of laryngeal (-30%), lung (-63%) and bladder (-64%) cancer was observed in young males (aged 0-49). In contrast, the incidence rates of cancer of the lip, oral cavity and pharynx (combined) increased by 145% (from 5.8/100,000 in 1971-75 to 14.2/100,000 in 2016-20), oesophagus by 116% (from 6.3/100,000 in 1971-75 to 13.6/100,000 in 2016-20), and kidney by 355% (from 3.8/100,000 in 1971-75 to 17.3/100,000 in 2016-20).

These findings confirm that public health interventions and tobacco control legislation have substantially reduced the burden of smoking-related cancers (i.e. larynx, lung and bladder). As for the increasing burden of other cancers (lip, oral cavity and pharynx, oesophagus and kidney) further research is needed to quantify the attributable risk from lifestyle/environmental factors other than smoking.

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