Readers will remember that a few days ago, I published some simple statistics which showed that, despite the fact that smoking has been decreasing greatly in prevalence since before 1970, lung cancer deaths have increased as a proportion of all deaths and of all-cancer deaths over the 12 year period 2000 to 2011 (inclusive).
I don’t want to flood the reader’s eyes with masses of figures, and so I’ll keep it really simple. For the detail, see:
http://boltonsmokersclub.wordpress.com/wp-admin/post.php?post=2972&action=edit
So I’ll just show the percentages of lung cancer deaths as a percentage of total deaths and as a percentage of total cancer deaths.
Year………..LC deaths……….% of total deaths……….% of all cancer deaths.
2000……….29,500……………………5.5………………………………21.9.
2006……….29300……………………5.8………………………………21.0.
2011………..30150……………………6-2………………………………21.0.
So we can see immediately, without quibble, that lung cancer deaths have been increasing in numbers and increasing as a percentage of total deaths, while remaining more or less steady as a percentage of cancer deaths (Note that the 0.9% drop in the ‘% of all cancers’ is not very important since LC deaths are such a large part of all cancer deaths).
When you look at column 1, LC deaths, you should be aware that all deaths have fallen from 535,000 in 2000 to 488,000 in 2011.
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Smoking has been diminishing enormously since before 1970. Should not the ‘delayed effect’ now be petering out? Should not deaths from lung cancer be falling drastically in view of the fact decades have now elapsed since people started to stop smoking in large numbers?
Look at this graph again:
(The first graph is the more important)
Smoking has fallen steadily from about 80% of males in 1950 to about 50% by 1980. Why are LC deaths not falling substantially?
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But there is a problem. The above figures did not distinguish between males and females. It could be that male LC deaths were falling drastically while female LC deaths were increasing drastically. Therefore, I have revisited the ONS statistics and split the males and females.
As I said earlier, I don’t want to overwhelm everyone with lists of figures, so I’ll keep it simple as I did above. I shall publish all the detailed figures at the end.
MALE LUNG CANCER DEATHS.
Year………LC deaths…….% of total deaths……% of all cancer deaths.
2000……..17,700……………6.93……………………………..25.39.
2006……..16,700……………6.93……………………………..23.00.
2011………16,700……………7.11………………………………22.18.
So LC deaths have fallen, but total male deaths have also fallen (from 255,500 in 2000 to 234,700 in 2011). NB. The % of all cancer deaths does not mean much since it could just as easily be explained by either a fall or an increase in other forms of cancer.
FEMALE LUNG CANCER DEATHS.
Year………LC deaths…….% of total deaths……% of all cancer deaths.
2000……..10,850……………3.87……………………………..16.69.
2006……..12,200……………4.66……………………………..18.43.
2011………13,100…………….5.25……………………………..19.31.
Again, note that total deaths fell from 280,100 in 2000 to 249,700 in 2011.
The situation here is beginning to become silly. How big a ‘delayed effect’ do the Zealots want to claim? Female smoking peaked in 1970 and has been falling ever since. In fact, prior to 1970, smoking was not very prevalent among women. The 1970 peak was a blip.
The fact of the matter is that ‘the delayed effect’ has always been an artificial construct. It was invented by Doll et al, entirely on a whim, since there is no scientific/biological reason for such a lengthy incubation period, to justify their claim that smoking causes lung cancer.
Let us describe the situation.
In 1970, the female smoking prevalence is 50%: in 2000, the female LC rate is 3.87% of all female deaths.
In 1976, the prevalence is, say, 45%: in 2006, the LC rate is 4.66%.
In 1981, the prevalence is about 40%: in 2011, the LC rate is 5.25%.
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What we should note overall is that it is not true that male LC deaths decreased drastically and female LC death increased drastically. As a percentage of total deaths, BOTH increased, although females increased more.
Is this difference in the rate of increase due to the fact that female smoking grew from 40% to 50% between 1950 and 1970? That is what the Zealots would claim, but………… Is it not true that a middle aged female smoker in 1950 would almost certainly be dead by the year 2000 anyway? Without going into detail (which I do not have anyway, and have no wish to investigate), is it not likely that it is the younger people, who either never started smoking or gave up from 1970 onwards, who are now suffering increasing incidence of LC? Why is it that the more of them that never started or gave up has caused an increase in LC between 2000 and 2012?
QUESTION: Would it be correct, in epidemiological terms, to plot this increase forward? Would it be correct to say that the continuing diminishing of smoking will produce even more lung cancer deaths in the future?
The ONS have given me some useful help in deriving similar figures for 1980 and 1990. I hope to be able to extract the appropriate information during the next few days.
Can I say again that it is not for us to explain these things. It is for TOBACCO CONTROL to explain why it is that decades of smoking reduction has produced increases in lung cancers.
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THE DETAILED FIGURES
[NB. Because I have to extract information regarding 1980 and 1990 myself, I have decided to change from ALL lung cancer deaths, including the trachea and other marginal sites, to only 'bronchus or lung'. Those are by far the greatest sites numerically - the trachea etc are very small by comparison. It will be far easier for me to extract data about 'bronchus or lung' only from the metadata than for all lung cancer sites. Thus, I have gone back and re-defined 'lung cancer' for these figures. Thus, small differences in those numbers will appear from the figures in the previous posts]
Deaths are rounded to the nearest 100 generally.
THE YEAR 2000.
All male deaths…………………………..255,500.
All female deaths………………………..280,100.
All male cancer deaths………………….69,500.
All female cancer deaths………………65,000.
Bronchus or lung males………………..17,700.
Bronchus or lung females…………….10,850.
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THE YEAR 2006.
All male deaths…………………………..240,900.
All female deaths………………………..261,700.
All male cancer deaths………………….72,600.
All female cancer deaths………………66,200.
Bronchus or lung males………………..16,700.
Bronchus or lung females…………….12,200.
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THE YEAR 2011.
All male deaths…………………………..234,700.
All female deaths………………………..249,700.
All male cancer deaths………………….75,300.
All female cancer deaths……………….67,850.
Bronchus or lung males………………..16,700.
Bronchus or lung females……………..13,100.
30/01/2013 at 18:27
Just a thought to confound matters a bit.
Lung cancer,as are all of the diseases ’caused’ by smoking, is a disease of old age.
In America, from 1960 to 2000,the percentage of people over the age of 65 increased from 9.2% to 12.4%.
That is a 35% increase.
An increase in the lung cancer rate might be no more than a factor of the increase in the percentage of old geezers running around.
30/01/2013 at 19:59
Just a bit more.
In America, during the 20th century,the percentage of the population over the age of 65 increased from 4% to 12%.
That is a 3 fold increase.
Over that same time period, the lung cancer death rate increased from about 15/100,000 to about 60/100,000.
That is a 4 fold increase.
Most of the increase in lung cancer deaths can be associated with the increase in the over 65 population.
31/01/2013 at 00:42
Hi Gary.
The important point is that Doll et al did not allow for the effects of aging in their cogitations about the cause of lung cancer. Therefore, as far as they were concerned, aging is irrelevant. For Doll et al, aging became ‘the delayed effect’ of smoking.
If everyone stopped smoking, then there would be no ‘delayed effect’, and therefore fewer people would contract lung cancer, regardless of age.
There was never any proof at all of a ‘delayed effect’. It was always a hypothesis.
The fact that MORE lung cancer deaths are being reported, year on year, despite the decades long reduction in smoking prevalence, must surely indicate that there is no ‘delayed effect’.
If there is no ‘delayed effect’, then the ‘smoking causes lung cancer’ hypothesis fails. That is not to say that could not be some ‘delayed effect’, but that would be over a comparatively short period – say, seven years. Certainly, the idea of a thirty-year incubation period would clearly be nonsensical.
And that is what the figures seems to show:
a) There is no evidence of a short incubation period.
b) The evidence of a long incubation period has failed to appear since the occurrence of the effect has failed to diminish despite the decades-long reduction of the putative cause.
therefore, on the evidence presented, smoking cannot be claimed to be the cause lung cancer.
What we see is that the healthist zealots have had the emotional upper-hand with their simplistic mantras. The question is: How can we turn the failure of historical proof of the hypothesis that lung cancer (etc) is caused by smoking into a ‘stop persecuting us and leave us alone’.