Table 3.
Joinpoint analysis for KC age-standardized incidence rates in EU15 + countries and WHO regions for years 1990–2019 in males (A), females (B).
| (A) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Country/Region | Trend 1 | Trend 2 | Trend 3 | Trend 4 | ||||||||
| Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-Value” | Years | EAPC (95% CI) | “P-value” | |
| Global | 1990–1994 | 2.6 (2.1–3.2) | < 0.001 | 1994–1997 | 0.8 (− 1–2.5) | 0.371 | 1997–2009 | 1.6 (1.4–1.7) | < 0.001 | 2009–2019 | 0.1 (− 0.1–0.2) | 0.203 |
| Australia | 1990–1999 | 2.4 (2.2–2.7) | < 0.001 | 1999–2003 | − 1.7 (− 3.2–0.2) | 0.025 | 2003–2007 | 3 (1.5–4.6) | 0.001 | 2007–2019 | − 0.3 (− 0.5–0.2) | 0.001 |
| Austria | 1990–1999 | − 1.4 (− 1.8–1.1) | < 0.001 | 1999–2019 | − 0.5 (− 0.6–0.4) | < 0.001 | ||||||
| Belgium | 1990–1996 | − 0.2 (− 1.1–0.7) | 0.645 | 1996–2002 | 4.3 (3–5.6) | < 0.001 | 2002–2019 | − 0.4 (− 0.5–0.2) | 0.001 | |||
| Denmark | 1990–1996 | 9.1 (8–10.2) | < 0.001 | 1996–2009 | 1.5 (1.2–1.9) | < 0.001 | 2009–2019 | − 0.5 (− 1–0) | 0.034 | |||
| Finland | 1990–1998 | 1.7 (1.4–2.1) | < 0.001 | 1998–2002 | − 1.5 (− 3–0.1) | 0.071 | 2002–2011 | 0.3 (0–0.7) | 0.057 | 2011–2019 | − 0.2 (− 0.6–0.1) | 0.239 |
| France | 1990–2007 | 0.9 (0.8–1) | < 0.001 | 2007–2011 | 2.3 (0.7–4) | 0.007 | 2011–2019 | − 0.2 (− 0.5–0.2) | 0.279 | |||
| Germany | 1990–1995 | 4 (3.2–4.7) | < 0.001 | 1995–2019 | 0.1 (0–0.2) | 0.002 | ||||||
| Greece | 1990–1996 | 3.5 (2.8–4.3) | < 0.001 | 1996–2010 | 1.1 (0.9–1.3) | < 0.001 | 2010–2019 | − 0.4 (− 0.8–0.1) | 0.026 | |||
| Ireland | 1990–1996 | 2.4 (1.5–3.3) | < 0.001 | 1996–2000 | 5.6 (3–8.3) | < 0.001 | 2000–2009 | 2.3 (1.7–2.9) | < 0.001 | 2009–2019 | − 0.9 (− 1.3–0.5) | < 0.001 |
| Italy | 1990–2005 | 1.6 (1.5–1.8) | < 0.001 | 2005–2019 | − 0.4 (− 0.6–0.3) | < 0.001 | ||||||
| Luxembourg | 1990–2004 | 1 (0.8–1.1) | < 0.001 | 2004–2013 | − 1 (− 1.4–0.7) | < 0.001 | 2013–2016 | − 3.1 (− 5.9–0.1) | 0.041 | 2016–2019 | 0.1 (− 1.4–1.6) | 0.913 |
| Netherlands | 1990–2000 | 1.8 (1.4–2.3) | < 0.001 | 2000–2003 | − 1.5 (− 7.3–4.7) | 0.612 | 2003–2008 | 4.3 (2.3–6.3) | < 0.001 | 2008–2019 | − 0.5 (− 0.9–0.1) | 0.024 |
| Norway | 1990–2011 | 2.2 (2–2.3) | < 0.001 | 2011–2019 | − 2.1 (− 2.6–1.5) | < 0.001 | ||||||
| Portugal | 1990–1998 | 3.2 (2.5–3.9) | < 0.001 | 1998–2001 | − 4.5 (− 10.3–1.7) | 0.14 | 2001–2006 | 6 (3.9–8.1) | < 0.001 | 2006–2019 | 0 (− 0.3–0.3) | 0.983 |
| Spain | 1990–1996 | 3.4 (3–3.8) | < 0.001 | 1996–2006 | 0.9 (0.6–1.1) | < 0.001 | 2006–2015 | 1.8 (1.6–2.1) | < 0.001 | 2015–2019 | − 0.2 (− 1–0.5) | 0.512 |
| Sweden | 1990–2007 | − 1 (− 1.2–0.9) | < 0.001 | 2007–2019 | 0.1 (− 0.1–0.4) | 0.348 | ||||||
| United Kingdom | 1990–1995 | 2.6 (2–3.2) | < 0.001 | 1995–2006 | 1.3 (1.1–1.5) | < 0.001 | 2006–2019 | 0.6 (0.5–0.7) | < 0.001 | |||
| Canada | 1990–2001 | 1.1 (0.9–1.3) | < 0.001 | 2001–2004 | 5.9 (2.7–9.2) | 0.001 | 2004–2008 | 2.1 (0.5–3.7) | 0.012 | 2008–2019 | − 0.1 (− 0.4–0.1) | 0.164 |
| United States of America | 1990–1994 | 2.6 (1.8–3.4) | < 0.001 | 1994–2002 | 0.5 (0.1–0.8) | 0.006 | 2002–2006 | − 0.9 (− 2–0.3) | 0.138 | 2006–2019 | 0.1 (− 0.1–0.2) | 0.394 |
| African Region | 1990–2013 | 1.5 (1.4–1.5) | < 0.001 | 2013–2019 | 1.2 (1–1.5) | < 0.001 | ||||||
| Region of the Americas | 1990–1994 | 2 (1.4–2.6) | < 0.001 | 1994–2002 | 0.6 (0.3–0.8) | < 0.001 | 2002–2019 | 0.1 (0.1–0.2) | < 0.001 | |||
| South-East Asia Region | 1990–1992 | 2 (− 0.9–5) | 0.16 | 1992–1998 | 5 (4.3–5.7) | < 0.001 | 1998–2006 | 0.3 (− 0.1–0.7) | 0.088 | 2006–2019 | 2.1 (1.9–2.2) | < 0.001 |
| European Region | 1990–1994 | 4.1 (3.3–4.9) | < 0.001 | 1994–1997 | 0.4 (− 2–2.9) | 0.725 | 1997–2008 | 1.5 (1.3–1.7) | < 0.001 | 2008–2019 | 0.2 (0–0.3) | 0.037 |
| Eastern Mediterranean Region | 1990–1996 | 2.3 (2–2.6) | < 0.001 | 1996–2001 | 3.8 (3.3–4.4) | < 0.001 | 2001–2011 | 2.9 (2.7–3) | < 0.001 | 2011–2019 | 3.1 (2.9–3.3) | < 0.001 |
| Western Pacific Region | 1990–1998 | 2.4 (2–2.8) | < 0.001 | 1998–2005 | 6.3 (5.7–6.9) | < 0.001 | 2005–2010 | 3.9 (2.8–5) | < 0.001 | 2010–2019 | 0.6 (0.3–1) | < 0.001 |
| (B) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Country/Region | Trend 1 | Trend 2 | Trend 3 | Trend 4 | ||||||||
| Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | |
| Global | 1990–1993 | 1.5 (0.8–2.3) | < 0.001 | 1993–2009 | 0.7 (0.6–0.7) | < 0.001 | 2009–2014 | − 0.7 (− 1.1–0.2) | 0.008 | 2014–2019 | 0 (− 0.3–0.4) | 0.819 |
| Australia | 1990–1994 | 3.8 (2.5–5) | < 0.001 | 1994–2004 | 0.8 (0.4–1.1) | < 0.001 | 2004–2017 | − 1.4 (− 1.6–1.2) | < 0.001 | 2017–2019 | 1.1 (− 2.6–4.9) | 0.562 |
| Austria | 1990–2019 | − 0.9 (− 1–0.9) | < 0.001 | |||||||||
| Belgium | 1990–1996 | − 1.3 (− 2.2–0.3) | 0.013 | 1996–2001 | 4.5 (2.6–6.4) | < 0.001 | 2001–2019 | − 0.5 (− 0.7–0.3) | < 0.001 | |||
| Denmark | 1990–1992 | 6.5 (2.8–10.3) | 0.001 | 1992–1995 | 14.2 (10.2–18.3) | < 0.001 | 1995–1999 | 4.7 (2.8–6.5) | < 0.001 | 1999–2019 | − 0.5 (− 0.6–0.4) | < 0.001 |
| Finland | 1990–2003 | 2.1 (1.9–2.4) | < 0.001 | 2003–2019 | 0 (− 0.2–0.2) | 0.87 | ||||||
| France | 1990–1999 | 1.2 (1–1.5) | < 0.001 | 1999–2007 | − 0.4 (− 0.8–0.1) | 0.026 | 2007–2014 | 1.5 (1–1.9) | < 0.001 | 2014–2019 | 0.2 (− 0.5–0.8) | 0.586 |
| Germany | 1990–1995 | 2.3 (1.7–3) | < 0.001 | 1995–2019 | − 0.3 (− 0.3–0.2) | < 0.001 | ||||||
| Greece | 1990–1998 | 3.1 (2.7–3.6) | < 0.001 | 1998–2007 | − 0.1 (− 0.5–0.3) | 0.674 | 2007–2011 | − 1.6 (− 3.4–0.3) | 0.095 | 2011–2019 | 0.6 (0.2–1.1) | 0.005 |
| Ireland | 1990–1995 | 1.6 (0.5–2.6) | 0.006 | 1995–2006 | 3.8 (3.5–4.2) | < 0.001 | 2006–2019 | 0.1 (− 0.2–0.3) | 0.501 | |||
| Italy | 1990–2003 | 1.4 (1.2–1.5) | < 0.001 | 2003–2019 | − 0.2 (− 0.3–0.1) | 0.001 | ||||||
| Luxembourg | 1990–2000 | 1.3 (1.1–1.5) | < 0.001 | 2000–2013 | 0.1 (− 0.1–0.2) | 0.465 | 2013–2016 | − 3.4 (− 6.1–0.6) | 0.019 | 2016–2019 | − 0.5 (− 1.9–0.9) | 0.459 |
| Netherlands | 1990–2007 | 1.5 (1.2–1.8) | < 0.001 | 2007–2019 | − 0.4 (− 0.9–0.1) | 0.153 | ||||||
| Norway | 1990–2002 | 2.8 (2.6–3) | < 0.001 | 2002–2011 | 1.2 (0.9–1.6) | < 0.001 | 2011–2017 | − 2.5 (− 3.2–1.7) | < 0.001 | 2017–2019 | 0.4 (− 3–3.9) | 0.809 |
| Portugal | 1990–1998 | 1.4 (1–1.8) | < 0.001 | 1998–2001 | − 5.3 (− 8.9–1.6) | 0.008 | 2001–2004 | 4.8 (0.9–8.9) | 0.019 | 2004–2019 | 0.5 (0.3–0.6) | < 0.001 |
| Spain | 1990–1995 | 2.5 (1.9–3.1) | < 0.001 | 1995–2008 | 1.9 (1.7–2) | < 0.001 | 2008–2014 | − 0.2 (− 0.7–0.4) | 0.557 | 2014–2019 | 0.9 (0.4–1.5) | 0.002 |
| Sweden | 1990–1999 | − 0.6 (− 0.9–0.3) | 0.001 | 1999–2002 | − 3.1 (− 6.5–0.5) | 0.084 | 2002–2019 | − 0.8 (− 0.9–0.7) | < 0.001 | |||
| United Kingdom | 1990–1995 | 2.2 (1.9–2.6) | < 0.001 | 1995–2008 | 1.4 (1.3–1.5) | < 0.001 | 2008–2019 | 0.3 (0.2–0.4) | < 0.001 | |||
| Canada | 1990–1998 | 1.1 (0.6–1.6) | < 0.001 | 1998–2006 | 4.4 (3.7–5) | < 0.001 | 2006–2015 | − 1.6 (− 2.1–1.2) | < 0.001 | 2015–2019 | 0.3 (− 1.2–1.8) | 0.675 |
| United States of America | 1990–1995 | 1.9 (1.6–2.3) | < 0.001 | 1995–2003 | 0 (− 0.2–0.2) | 0.89 | 2003–2016 | − 0.9 (− 1–0.8) | < 0.001 | 2016–2019 | 0 (− 0.7–0.8) | 0.909 |
| African Region | 1990–2003 | 0.9 (0.8–0.9) | < 0.001 | 2003–2009 | 1.6 (1.3–1.9) | < 0.001 | 2009–2013 | 2.4 (1.8–3.1) | < 0.001 | 2013–2019 | 1.5 (1.3–1.8) | < 0.001 |
| Region of the Americas | 1990–1995 | 0.9 (0.6–1.3) | < 0.001 | 1995–1999 | − 1.5 (− 2.3–0.7) | 0.001 | 1999–2003 | 0.2 (− 0.6–1) | 0.632 | 2003–2019 | − 0.5 (− 0.5–0.4) | < 0.001 |
| South-East Asia Region | 1990–1998 | 2.5 (2.3–2.8) | < 0.001 | 1998–2005 | − 0.1 (− 0.4–0.3) | 0.776 | 2005–2012 | 0.9 (0.5–1.3) | < 0.001 | 2012–2019 | 2.2 (1.9–2.5) | < 0.001 |
| European Region | 1990–1993 | 2.9 (1.9–3.9) | < 0.001 | 1993–2008 | 1.3 (1.2–1.4) | < 0.001 | 2008–2019 | 0.1 (− 0.1–0.2) | 0.347 | |||
| Eastern Mediterranean Region | 1990–1996 | 2.3 (2–2.6) | < 0.001 | 1996–1999 | 1.5 (− 0.2–3.3) | 0.09 | 1999–2019 | 2.6 (2.5–2.6) | < 0.001 | |||
| Western Pacific Region | 1990–1997 | 1.2 (0.8–1.7) | < 0.001 | 1997–2004 | 4.4 (3.8–5) | < 0.001 | 2004–2008 | 2.5 (0.9–4.3) | 0.005 | 2008–2019 | 0.2 (0–0.4) | 0.118 |
EAPC indicates estimated annual percentage change, with 95% confidence intervals in brackets. *Significantly different from 0 (P < 0.05). AAPC (Average annual percentage change) indicates summary measure of the trend over 1990–2019.