Journal of Community Health

, Volume 34, Issue 3, pp 188–194 | Cite as

Trends in Lung Cancer Death Rates in Belgium and The Netherlands: a Systematic Analysis of Temporal Patterns

  • Mieke J. J. Van Hemelrijck
  • Zubair Kabir
  • Gregory N. Connolly
Original Paper


Belgium and The Netherlands have fairly similar smoking prevalence patterns, but distinct tobacco control policies. It is our aim to use lung cancer death rates, especially among the youngest age groups (30–39 years), as indicators of past smoking behavioral patterns to evaluate recent tobacco control efforts in both countries. Lung cancer mortality rates from 1954 to 1997 and from 1950 to 2000 were investigated in Belgium and The Netherlands, respectively, using the joinpoint regression modeling technique (log-linear Poisson models) to calculate annual percent change in death rate. In the most recent period (1984–2000) overall male lung cancer death rates have been declining at a faster rate in The Netherlands than in Belgium. In contrast, overall female lung cancer death rates (between 1950 and 2000) have been increasing at a faster rate in The Netherlands than in Belgium. Since 1988, however, APCs in death rates among Dutch females have begun to level off. Interestingly, during this same period, a significant annual decline of 7.7% among the youngest Dutch women (30–39 years) has been observed. Tobacco use prevention and interventions seem to have an impact on smoking prevalence, especially among younger age groups. In The Netherlands, where aggressive anti-tobacco campaigns were introduced a few years earlier than in Belgium, male lung cancer mortality rates have been declining more rapidly, and female lung cancer mortality rates have begun to level off.


Lung cancer Temporal pattern Belgium The Netherlands 



The authors want to thank Jacob Sattelmair for his language support.


  1. 1.
    Office for Official Publications of the European Communities. (2004). The ASPECT consortium. Tobacco or health in the European union: Past, present and future. Luxembourg.Google Scholar
  2. 2.
    Gallus, S. S., La Vecchia, C., Townsend, J., & Fernandez, E. (2006). Price and cigarette consumption in Europe. Tobacco control, 15, 114–119.PubMedCrossRefGoogle Scholar
  3. 3.
    Bosetti, C. L., Lucchini, F., Negri, E., & La Vecchia, C. (2005). Lung cancer mortality in European women: Recent trends and perspectives. Annals of Oncology, 16, 1597–1604.PubMedCrossRefGoogle Scholar
  4. 4.
    Skov, T., Sprøgel, P., Engholm, G., & Frølund, C. (1991). Cancer of the lung and urinary bladder in Denmark, 1943–87: A cohort analysis. Cancer Causes and Control, 2, 365–369.PubMedCrossRefGoogle Scholar
  5. 5.
    Michaud, D. S., Clinton, S. K., Rimm, E. B., Willett, W. C., & Giovannucci, E. (2001). Risk of bladder cancer by geographic region in a US cohort of male health professionals. Epidemiology, 12, 719–726.PubMedCrossRefGoogle Scholar
  6. 6.
    Thyrian, J. R., & John, U. (2006). Measuring activities in tobacco control across the EU. The MAToC. Substance Abuse Treatment, Prevention, and Policy, 1, 9.PubMedCrossRefGoogle Scholar
  7. 7.
    World Health Organization (1997). Tobacco or health: A global status report. Geneva: World Health Organization.Google Scholar
  8. 8.
    Cayuela, A., Rodriguez-Dominguez, S., Lopez-Campos, J. L., Otero Candelera, R., & Rodriguez Matutes, C. (2004). Joinpoint regression analysis of lung cancer mortality, Andalusia 1975–2000. Annals of Oncology, 15, 793–796.PubMedCrossRefGoogle Scholar
  9. 9.
    Kabir, Z., Connolly, G. N., & Clancy, L. (2007). Temporal patterns in lung cancer death rates in Ireland. Irish Journal of Medical Science, 176, 81–85.PubMedCrossRefGoogle Scholar
  10. 10.
    Levi, F., Bosetti, C., Fernandez, E., Hill, C., Lucchini, F., Negri, E., et al. (2007). Trends in lung cancer among young European women: The rising epidemic in France and Spain. International Journal of Cancer, 121, 462–465.CrossRefGoogle Scholar
  11. 11.
    Jemal, A., Cokkinides, V. E., Shafey, O., & Thun, M. J. (2003). Lung cancer trends in young adults: An early indicator of progress in tobacco control (United States). Cancer Causes and Control, 14, 579–585.PubMedCrossRefGoogle Scholar
  12. 12.
    World Health Organization’s Mortality Database. Descriptive Epidemiology Group, Biostatistics and Epidemiology Cluster International Agency for Research on Cancer. Retrieved from
  13. 13.
    Forey, B., Lee, P., & Wald, N. (2002). International smoking statistics. London: Oxford University Press.Google Scholar
  14. 14.
    WHO Regional Office for Europe. Tobacco control database. Retrieved from
  15. 15.
    Regents of the University of California. Legacy tobacco documents library. Retrieved from
  16. 16.
    Hublet, A., Maes, L., & Csincsak, M. (2002). Predictors of participation in two different smoking cessation interventions at school. Health education & behavior, 29, 585–595.CrossRefGoogle Scholar
  17. 17.
    Mackay, J., Eriksen, M., & Shafey, O. (2006). The tobacco atlas. Georgia: American Cancer Society.Google Scholar
  18. 18.
    Montes, A., & Villalbí, J. R. (2001). The price of cigarettes in the European union. Tobacco Control, 10, 135–136.PubMedCrossRefGoogle Scholar
  19. 19.
    Osler, M., Prescott, E., Godtfredsen, N., Hein, H. O., & Schnohr, P. (1999). Gender and determinants of smoking cessation: A longitudinal study. Preventive Medicine, 29, 57–62.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Mieke J. J. Van Hemelrijck
    • 1
  • Zubair Kabir
    • 2
  • Gregory N. Connolly
    • 1
  1. 1.Division of Public Health PracticeHarvard School of Public HealthBostonUSA
  2. 2.The Digital DepotResearch Institute for a Tobacco Free SocietyDublinIreland

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