Clustering Trend Changes of Lung Cancer Incidence in Europe via the Growth Mixture Model during 1990-2016

Abstract

Background: Lung cancer accounts for half of all deaths from cancer in Europe and has the highest incidence in Southern Europe. The current study aimed to cluster trend changes of lung cancer incidence in Europe via the growth mixture model.

Methods: The dataset included incidence rates of female and male lung cancer per 100,000 for 42 European countries during 1990-2016 compiled from the Gapminder database. The growth mixture model was implemented to recognize different longitudinal patterns and estimate the linear trend of each pattern in Mplus 7.4 software.

Results: The observed overall trend of incidence for female and male lung cancer was raising and falling, respectively, and Iceland was the only country with higher incidence of female versus male lung cancer in 2016. The growth mixture model suggests 3 main patterns for the trend of lung cancer incidence both for males and females. In male lung cancer, a sharp decreasing pattern was detected for 6 countries including Belarus, Estonia, Russia, Slovenia, Ukraine, and the United Kingdom; also, a moderately decreasing pattern was observed among the other countries. In female lung cancer, a moderate increasing trend was observed for 8 countries including the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway; the other patterns were categorized into two clusters with slow increasing trends.

Conclusion: Given the raising patterns in the incidence of lung cancer among European females, especially in the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway, urgent effective measures are recommended to be taken.

Figure 1

Bar chart of male lung cancer incidence among European countries.

Figure 2

Bar chart of female lung cancer incidence among European countries.

Figure 3

The trend changes of tobacco smoking prevalence in European countries.

Figure 4

The overall mean (top) and estimated linear trend (bottom) for male lung cancer. Cluster 1, Andorra, Croatia, Hungary, Lithuania, Norway, Slovak Republic, Spain, and Turkey. Cluster 2, Belarus, Estonia, Russia, Slovenia, Ukraine, and the United Kingdom. Cluster 3, other European countries.

Figure 5

The overall mean (top) and estimated linear trend (bottom) for female lung cancer. Cluster 1, Bulgaria, Georgia, Latvia, Macedonia, Malta, Portugal, and Romania. Cluster 2, the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway. Cluster 3, other European countries.