How Can Age Patterns of Cancer Incidence and Mortality Rates Be Explained?

Anatoli Yashin, Max Planck Institute for Demographic Research
Svetlana V. Ukraintseva, Max Planck Institute for Demographic Research
Konstantin Arbeev, Max Planck Institute for Demographic Research
Serge I. Boiko, Max Planck Institute for Demographic Research

The analysis of epidemiological data on cancer presented in the IARC monographs shows that overall cancer incidence and mortality rates increase, level off and then decline at old ages. In addition, male and female cross-sectional cancer incidence rates intersect near the age of female climacterics. In this paper we discuss the contribution of different factors to the age pattern of cancer incidence and mortality rates. To explain these phenomena we suggest the model of cancer initiation and development. In this model cancer incidence rate is composed of time-dependent, age-related, and ontogenetic components. The latter component determines the wave-like age-profile of individual vulnerability to diseases, which has different shape for males and females. We show that this difference is responsible for the intersection of the male and female cancer incidence curves. The ontogenetic component makes also an important contribution to the decline of incidence and mortality rates at old ages.