Trend Analysis of Lung Cancer Incidence Rates in Ninawa Province, Iraq, from 2000 to 2010 - Decrease and Recent Stability

Background: Lung cancer is the most frequent malignancy of men worldwide. In Ninawa in Iraq, lung cancerranks first among cancers diagnosed in men. Since no prior studies have been conducted on incidence trendsin our population the present investigation of rates during 2000-2010 was therefore performed. Materials and
Methods: Registy data for lung cancer cases were collected from the Directorate of Health in Ninawa-MosulContinuing Medical Education Center. We restricted our analyses to men categorized according to the age groupsof 0- 39, 40-49, 50-59, 60-69 and 70+ years. The significance of incidence rate trends during 2000-2010 was testedusing Poisson regression. Age-standardized rates (ASR), and age-specific rates per 100,000 population werecalculated.
Results: A total of 1,206 incident lung cancer were registered among males, accounting for 15.5%of all male cancers registered during 2000-2010. It ranked first throughout the period. Median age at diagnosiswas 69 (mean 66.8± 11.0) years. The incidence rate of all male lung cancers in Ninawa (all ages) decreased from26.4 per 100,000 in 2000 to 12.7 in 2010 (APC=-6.55%, p<.0001). The incidences in age groups 40-49, 50-59,60-69 and 70+ decreased in earlier years and recently appeared (2007-2010) stable. The incidence in age group(0-39) remained stable between 2000-2010. Squamous cell carcinoma (SCC)was the most common type of lungcancer, while adenocarcinoma was relatively rare.
Conclusions: With the data from Directorate of Health inNinawa during the period 2000-2010, lung cancer is the most common cancer but generally declining. Amongall age groups, the recent incidence of lung cancer remained stable. The SCC predominance suggests change intobacco habits as an important factor in the trends observed.