Female mortality trends in Spain due to tumors associated with tobacco smoking.

Age- and period-specific mortality rates for esophageal, laryngeal, lung, and bladder cancers in Spanish women from 1952 to 1986 were analyzed using an age-period-cohort model for each location. The four sites exhibit a similar pattern, characterized by a decline in mortality (cohort effect) in post-1900 generations. In the case of cancers of the esophagus and larynx, the model and curvature analysis show a slight rise in mortality in post-1932 generations. In cancers of the esophagus and lung, the period effect parallels the trend traced by the cohort effect. Prevalence estimates of smoking among women in Spain would seem to suggest that the degree of exposure in cohorts studied has been very low. The study indicates that smoking in Spanish women is relatively frequent only in recent generations and that this exposure has not produced, as yet, relevant variations in time trends. Special attention should be paid to the well known synergistic effect of smoking and alcohol consumption, which might already have determined changes in esophageal and laryngeal mortality.