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Over the past 20 years, breast cancer mortality trends have decreased in several Western countries because of early detection through mammography, improved treatment, and reduced use of post menopausal hormone [66], [67], [68].
Infectious disease mortality trends have been described by review of International Classification of Diseases (ICD) –coded death certificate data (2 ).
Incidence and mortality trends have been diverging since the mid-1980s, importantg improvementsprovements in the prognosis of the disease.
Female breast cancer mortality trends have remained stable in the country since 1994, this finding being in agreement with reports from another study (APC = 0.4%) [ 3].
Screening programmes have been less well organised in most other countries (British Columbia being a notable exception) and the benefits in terms of national mortality trends have been less clear.
Ischeamic heart disease (IHD) mortality trends have fallen in developed countries over recent decades; this is mainly due to a decrease in disease incidence through improved primary prevention measures and to a drop in case fatality reflecting advances in diagnosis, treatment and secondary prevention[ 1].
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The detection of such structural changes in mortality trends has been analyzed recently (Vallin and Meslé 2009; van Berkum et al. 2013) and poses additional obstacles to forecast mortality accurately.
The influence of cerebrovascular and cardiovascular disease mortality trends on cancer mortality trends has been analysed in various studies.
In Sweden, mortality trends had steadily decreased since 1972 2 and screening implementation did not lead to a new inflexion in trends after 1972.
Joinpoint regression analyses were performed to ascertain whether changes in gastric cancer mortality trends had occurred, and to estimate the annual percent change by sex and geographic area.
When comparing our trends with western countries, a reduction in mortality trends has been observed in the younger age group (<50 years) in countries where screening of young women is rare (Denmark, Finland, Netherlands, Norway, UK) but also in those where screening is common (France, Germany, Sweden) (Autier et al, 2010).
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