Cancer mortality trends in Lithuania 1978–2005: a joinpoint regression analysis

The aim of this study was to analyse changes in cancer mortality in Lithuania from 1978 to 2005. Materials and methods. Age-standardised mortality (World standard) rates were calculated for all the malignant neoplasms as well as for stomach, colorectal, lung, prostate, breast and cervical cancers. A joinpoint regression methodology was used to provide estimated annual percentage changes (EAPCs) and to detect points in time where significant changes in the trends occurred. Results. Analysis showed a trend toward mortality reduction for some cancer sites. In males, mortality reduction for all cancer sites combined started from 1995, while in females no significant decrease in mortality trend was revealed for all cancer sites. Colorectal and lung cancer mortality in both sexes as well as female breast cancer mortality rates were increasing and, after a change in trend, started to decrease or levelled off. An increasing trend was observed for female cervical and male prostate cancers, whereas a decreasing one was seen for stomach cancer in both sexes. Conclusion. In Lithuania, reduction and stabilisation in mortality rates occurred during recent years because of causes amenable to primary prevention through reduction of exposures (stomach and lung cancers) and tertiary prevention owing to improved treatment and medical care (breast cancer). Recent introduction of population-based screening interventions for cervix and breast cancers will probably contribute to the downward mortality trends in females over the next years. There is also a need for organized colorectal cancer screening programme in Lithuania.