Breast cancer mortality in Spain: has it really declined for all age groups?

OBJECTIVES: In recent years, the incidence of breast cancer has increased in Spain but mortality has decreased, particularly since 1992. Despite the general decrease in mortality, the intensity of this disease differs between age groups. The main objective of this study was to examine mortality due to breast cancer for different age groups in Spain from 1981 to 2007, and to forecast the mortality rate in 2023. STUDY DESIGN: Ecological study. METHODS: Trends in mortality due to breast cancer were analysed using the Lee-Carter model, which is the typical analysis for mortality in the general population but is rarely used to analyse specific causes of death. RESULTS: This study found a decreasing trend in mortality due to breast cancer from 1993 to 2007, and it is predicted that this trend will continue. However, mortality rates varied between age groups: a decreasing trend was seen in younger and middle-aged women, whereas mortality rates remained stable in older women. CONCLUSIONS: Preventive breast cancer practices should differ by patient age.

A comparison of models for dynamic life tables. Application to mortality data from the Valencia Region (Spain).

The graduation of mortality data aims to estimate the probabilities of death at age x, q ( x ), by means of an age-dependent function, whose parameters are adjusted from the crude probabilities that are directly obtainable from the data. However, current life tables have a problem, the need for periodic updates due to changes in mortality over short periods of time. The table containing mortality rates for different ages in different years, q ( xt ), is called a dynamic life table, which captures mortality variation over time. This paper proposes a review of the most commonly used dynamic models and compares the results obtained by each of them when applied to mortality data from the Valencia Region (Spain). The result of the comparison leads us to the conclusion that the Lee-Carter method offers the best results for both sexes, while that based on Heligman and Pollard functions provides the best fit for men alone. Our working method is of additional interest as it may be applied to mortality data for a wide range of ages in any geographical location, allowing the most appropriate dynamic life table to be selected for the case at hand.