Lung cancer incidence in the Czech Republic: a time-trend study.

Background: Analysis of cancer incidence trends is one of the prerequisites for cancer prevention. It is possible to set up priorities and assess current development of morbidity.

Methods: All lung cancer incidences in the Moravia region of the Czech Republic (4,000,000 inhabitants) in the years 1984-1998 have been assessed concerning incidence, anatomical subsites, stage, and morphology. Age and sex distribution have been taken into consideration.

Results: There has been a continuous increase in the incidence of lung cancer in females and a mild decrease in males. In both sexes the most affected anatomical subsites were upper and lower lobe of the lung. Stage III and IV predominated. Main morphological type was squamous cell carcinoma in males (39.3%) and in females (22.2%), the second most frequent type in males was small cell carcinoma (13.6%) and in females adenocarcinoma (21.8%). The highest incidence was observed in the age group of 55-75 in males and 60-80 in females.

Conclusion: Lung cancer epidemiology and prevention is one of the top-priority health problems in the Czech Republic. The incidence is one of the highest in the world especially for males; in females it is continuously increasing. Primary prevention is available but difficult to implement, particularly non-smoking. Secondary prevention is not available due to lack of suitable screening tests and a short lead time.