Lung and breast cancer mortality among women in France: future trends.

Estimates of mortality in future years are crucial for communication, prevention and anticipation related to the burden of diseases and for developing scenarios studying the effects of reducing environmental exposure. The aim of this study is to project observed trends of mortality in France for lung and breast cancer among females to 2021. Projections of mortality rates are based on a Bayesian age-period-cohort model and a Poisson distribution. We used cancer mortality data from the French mortality register (period 1977-2006) and population data from population registers (estimated for 1977-2006 and projected for period 2007-2021 using five scenarios: largest, smallest, youngest, older, average population). Alternative models were tested (generalized additive model, negative binomial distribution). For the average population scenario, lung and breast cancer mortality rates age-standardized to the world population, are respectively: 11.5 per 10(5) women (Credibility interval: 10.3-12.8) and 15.9 (14.4-17.6) in 2007-2011, 14.6 (11.7-18.1) and 14.5 (11.6-18.0) in 2012-2016, 18.2 (12.6-26.0) and 13.3 (9.1-18.9) in 2017-2021. Projections show an ongoing increase for lung cancer and decrease for breast cancer mortality rates, which are expected to be equal in 2012-2016. Compared projections of these two cancers using a similar method had not been done before. Aggressive prevention strategies targeting smoking among women are needed to control this fast growing epidemic of avoidable cancer. Planning of health care capacity for diagnosis and treatment of cancer among females is also necessary.