Lung cancer in France: will women's mortality levels ever reach those of men?

France Meslé, Institut National d'Études Démographiques (INED)
Jacques Vallin, Institut National d'Études Démographiques (INED)

For several decades, highly contrasting trends in male and female lung cancer mortality have been observed in most developed countries. The decrease in lung cancer mortality has contributed significantly to male life expectancy improvement, while its increase among women has prevented female life expectancy from improving as far as expected. First observed in England, and then in the USA, the phenomenon has spread to European countries. In France, the reversal of male mortality occurred at the turn of the 1990s, while female mortality is still increasing and has even accelerated recently. Is it reasonable to predict that female lung cancer mortality will overtake male mortality within a few decades? Thanks to the cause-of-death time series reconstructed under a constant medical definition, it is possible to analyse long-term trends in age-specific mortality rates by cause, both by period and by cohort. To forecast female lung cancer mortality, taking account of cohort trajectories, different hypotheses will be discussed. The first one relies on the fact that 1956-1960 female cohorts are rather close to the level reached by 1906-1911 male cohorts with the same slope by age. These cohorts and the next ones could experience the same trajectories as successive male cohorts. Such a hypothesis is probably unrealistic since for the three previous groups of female cohorts the rise in mortality with age had already been slowed down by the anti-smoking policies, at levels of consumption much lower than male ones. A second extreme hypothesis is given by modelling female trajectories decelerating at younger ages than those of males, considering that the initial cohort effects among females will be counterbalanced by the period effect sooner and sooner across cohorts. Finally, on the basis of this range of hypotheses, the impact of lung cancer on life expectancy will be estimated for the coming decades.