Abstract
BACKGROUND: A decrease in lung cancer mortality among females below 50 years of age has been reported for countries with significant tobacco control efforts. The aim of this study was to describe the lung cancer deaths, including the mortality rates and proportions among total deaths, for females and males by age at death in a country with a high smoking prevalence (Germany) over a time period of 62 years. METHODS: The vital statistics data were analyzed using a joinpoint regression analysis stratified by age and sex. An age-period-cohort analysis was used to estimate the potential effects of sex and school education on mortality. RESULTS: After an increase, lung cancer mortality among women aged 35-44 years remained stable from 1989 to 2009 and decreased by 10.8% per year from 2009 to 2013. CONCLUSIONS: Lung cancer mortality among females aged 35-44 years has decreased. The potential reasons include an increase in the number of never smokers, following significant increases in school education since 1950, particularly among females.