Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 143 No. 2324 (2013)

Tobacco-related cancer mortality: projections for different geographical regions in Switzerland

  • Verena Jürgens
  • Silvia Ess
  • Harish C. Phuleria
  • Martin Früh
  • Matthias Schwenkglenks
  • Harald Frick
  • Thomas Cerny
  • Penelope Vounatsou
Cite this as:
Swiss Med Wkly. 2013;143:w13771


PRINCIPLES: Switzerland is divided into 26 cantons of variable population size and cultural characteristics. Although a federal law to protect against passive smoking and a national tobacco control programme exist, details of tobacco-related policies are canton-specific. This study aimed to project gender-specific tobacco-related cancer mortality in Switzerland at different geographical levels for the periods 2009–2013 and 2014–2018.

METHODS: In this analysis, data on Swiss tobacco-related cancer mortality from 1984 until 2008 were used. Bayesian age-period-cohort models were formulated to assess past trends of gender-specific tobacco-related cancer mortality and to project them up to 2018 at cantonal and language region levels. Furthermore, estimates are provided on a national scale by age categories of 50–69 and ≥70 years.

RESULTS: Model-based estimates at cantonal level identified regions with low and high tobacco-related cancer mortality rates for the observed and projected periods. Our analysis based on language regions showed the lowest mortality in the German-speaking part. Projections at national level, between younger (age 50–69) and older (age ≥70) males, indicated an ongoing decreasing trend for males but an upward trend for females. The gap in tobacco-related cancer mortality rates between younger and older males seems to be shrinking. In females, a stronger rise was obtained for the younger age group.

CONCLUSION: Our findings indicate region-, sex- and age-related differences in tobacco-related cancer mortality in Switzerland and this could be useful for healthcare planning and for evaluating the impact of canton-specific tobacco-related policies and interventions.


  1. Boyle P. Cancer, cigarette smoking and premature deaths in Europe: a review including the Recommendations of European Cancer Experts Consensus Meeting, Helsinki, October 1996. Lung Cancer. 1997;17(1):1–60.
  2. Chaturvedi P. Tobacco is a “weapon of mass destruction”. Should western countries be invaded for that? Postgrad Med J. 2004;80:477.
  3. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328:1519.
  4. Marques-Vidal P, Cerveira J, Paccaud F, Cornuz J. Smoking trends in Switzerland, 1992–2007: a time for optimism? J Epidemiol Commun H. 2011;65:281–6.
  5. Flandorfer P, Wegner C, Buber I. Gender Roles and Smoking Behaviour. Vienna Institute of Demographic. Working Papers, 2010.
  6. Heishman S. Behavioral and cognitive effects of smoking relationship to nicotine addiction. Nicotine Tob Res. 1999;1:143–7.
  7. Lee Y, Boffetta P, Sturgis E, Wei Q, Zhang Z, Muscat J, et al. Involuntary smoking and head and neck cancer risk: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidem Biomar. 2008;17(8):1974–81.
  8. Taylor R, Najafi F, Dobson A. Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent. Int J Epidemiol. 2007;36(5):1048–59.
  9. Doll R, Peto R: Mortality in relation to smoking: 20 years observations on male British doctors. BMJ. 1976;2:1525–36.
  10. Clèries R, Ribes J, Esteban L, Martinez J, Borràs J. Time trends of breast cancer mortality in Spain during the period 1977–2001 and Bayesian approach for projections during 2002–2016. Ann Oncol. 2006;17(12):1783–91.
  11. Eilstein D, Uhry Z, Lim T, Bloch J. Lung cancer mortality in France. Trend analysis and projection between 1975 and 2012, using a Bayesian age-period-cohort model. Lung cancer. 2008;59(3):282–90.
  12. Knorr-Held L, Rainer E. Projections of lung cancer mortality in West Germany: a case study in Bayesian prediction. Biostatistics. 2001;2:109–29.
  13. Berrut S, Junker J. Von Generation zu Generation: Entwicklung der Todesursachen 1970 bis 2004. Bundesamt für Statistik (BFS), Neuchâtel. Schweiz, 2008.
  14. Segi M. Cancer mortality for selected sites in 24 countries (1950–57). Department of Public Health, Tohoku University of Medicine, Sendai, Japan, 1960.
  15. Bernardinelli L, Montomoli C. Empirical Bayes versus fully Bayesian analysis of geographical variation in disease risk. Stat Med. 1992;11:983–1007.
  16. Clayton D, Kaldor J. Empirical Bayes estimates of age-standardized relative risks for use in disease mapping. Biometrics. 1987;43:671–81.
  17. Negri E, LaVecchia C, Levi F, Randriamiharisoa A, Decarli A, Boyle P. The application of age, period and cohort models to predict Swiss cancer mortality. J Cancer Res Clin. 1990;116(2):207–14.
  18. Lopez AD, Collishaw NE, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tobacco Control. 1995;3:242–7.
  19. Malvezzi M, Bertuccio P, Levi F, LaVecchia C, Negri E. European cancer mortality predictions for the year 2012. Ann Oncol. 2012;23(4):1044–52.
  20. Kohler B, Ward E, McCarthy B, Schymura M, Ries L, Eheman C, et al. Annual Report to the Nation on the Status of Cancer, 1975–2007, Featuring tumors of the brain and other nervous system. J Natl Cancer I. 2011;103:1–23.

Most read articles by the same author(s)

1 2 > >>