Trend in esophageal cancer mortality in Serbia, 1991-2015 (a population-based study): an age-period-cohort analysis and a joinpoint regression analysis

Purpose: Esophageal cancer mortality trends vary substantially across the world. This study assessed the trend of esophageal cancer mortality in Serbia. Methods: A population-based study analyzing esophageal cancer mortality in Serbia in the period 1991-2015 was carried out based on official data. The annual percentage of change (APC), with the 95% confidence interval (CI), was computed using the joinpoint regression analysis. The age, period and birth cohort effects on the mortality from esophageal cancer were examined using the age-period-cohort analysis. Results: In Serbia, esophageal cancer mortality trend significantly increased from 1991 to 2015 in men (APC=+0.9%, 95%CI=0.3 to 1.4), but nonsignificantly increased in women (APC=+0.4%, 95%CI=-0.6 to 1.4). The age-specific mortality rates were increasing with age, but this trend has only been significant in men in the 50-59 years age group (APC=+1.5%, 95%CI= 0.8 to 2.3). The age-period-cohort analysis suggested statistically non-significant period and cohort effects, and local drifts for both genders (p>0.05 for all). Conclusions: The trend of esophageal cancer mortality should be elucidated in future analytical epidemiological studies in Serbia.