Table 4.
Joinpoint analysis for KC age-standardized mortality rates in EU15 + countries and WHO regions for years 1990–2019 in males (A), females (B) and both sexes (C).
| (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 | 1990–1993 | 1.9 (1–2.8) | < 0.001 | 1993–2009 | 0.9 (0.8–0.9) | < 0.001 | 2009–2019 | − 0.2 (− 0.3–0) | 0.018 | |||
| Australia | 1990–1999 | 0.6 (0.3–0.8) | < 0.001 | 1999–2003 | − 3.1 (− 4.4–1.8) | < 0.001 | 2003–2006 | 2.9 (0.1–5.6) | 0.041 | 2006–2019 | − 0.5 (− 0.6–0.3) | < 0.001 |
| Austria | 1990–2000 | − 2.8 (− 2.9–2.6) | < 0.001 | 2000–2003 | 0.4 (− 1.9–2.8) | 0.721 | 2003–2012 | − 1.4 (− 1.6–1.1) | < 0.001 | 2012–2019 | − 0.4 (− 0.8–0.1) | 0.008 |
| Belgium | 1990–1993 | 1.9 (− 1.5–5.4) | 0.261 | 1993–1996 | − 4.5 (− 10.7–2.1) | 0.168 | 1996–1999 | 6.9 (0–14.4) | 0.051 | 1999–2019 | − 0.6 (− 0.8–0.4) | < 0.001 |
| Denmark | 1990–1996 | 8.2 (7.4–9.1) | < 0.001 | 1996–2009 | 0 (− 0.3–0.3) | 0.881 | 2009–2019 | − 1.1 (− 1.5–0.8) | < 0.001 | |||
| Finland | 1990–1998 | 0.4 (0.2–0.6) | < 0.001 | 1998–2008 | − 1.6 (− 1.8–1.5) | < 0.001 | 2008–2011 | 1.2 (− 0.2–2.6) | 0.098 | 2011–2019 | − 0.6 (− 0.8–0.5) | < 0.001 |
| France | 1990–2007 | − 0.5 (− 0.5–0.4) | < 0.001 | 2007–2011 | 1.7 (0.7–2.7) | 0.001 | 2011–2019 | − 0.5 (− 0.7–0.3) | < 0.001 | |||
| Germany | 1990–1996 | 2.3 (1.9–2.7) | < 0.001 | 1996–2007 | − 1.3 (− 1.5–1.1) | < 0.001 | 2007–2013 | 1.2 (0.7–1.8) | < 0.001 | 2013–2019 | − 0.3 (− 0.7–0.1) | 0.147 |
| Greece | 1990–1992 | 4.1 (2.1–6.1) | < 0.001 | 1992–1998 | 1.8 (1.3–2.2) | < 0.001 | 1998–2019 | − 0.3 (− 0.3–0.2) | < 0.001 | |||
| Ireland | 1990–1996 | 1.7 (1.1–2.2) | < 0.001 | 1996–2001 | 3.5 (2.4–4.6) | < 0.001 | 2001–2009 | 0.3 (− 0.1–0.7) | 0.172 | 2009–2019 | − 1.3 (− 1.5–1) | < 0.001 |
| Italy | 1990–1994 | 0.8 (0.2–1.3) | 0.009 | 1994–2001 | − 0.1 (− 0.4–0.2) | 0.614 | 2001–2005 | 0.6 (− 0.2–1.5) | 0.14 | 2005–2019 | − 0.6 (− 0.7–0.5) | < 0.001 |
| Luxembourg | 1990–2004 | − 0.5 (− 0.6–0.4) | < 0.001 | 2004–2013 | − 1.4 (− 1.7–1.2) | < 0.001 | 2013–2016 | − 3.3 (− 5.6–1) | 0.008 | 2016–2019 | 0.1 (− 1.1–1.3) | 0.915 |
| Netherlands | 1990–2000 | 1 (0.6–1.5) | < 0.001 | 2000–2003 | − 3.5 (− 9–2.2) | 0.209 | 2003–2006 | 5.8 (− 0.1–12.2) | 0.055 | 2006–2019 | − 0.6 (− 0.9–0.3) | 0.001 |
| Norway | 1990–2012 | 0.6 (0.5–0.7) | < 0.001 | 2012–2019 | − 2.2 (− 2.6–1.8) | < 0.001 | ||||||
| Portugal | 1990–1998 | 1.3 (0.7–2) | 0.001 | 1998–2001 | − 6.8 (− 12.3–0.8) | 0.028 | 2001–2004 | 7 (0.6–13.8) | 0.033 | 2004–2019 | − 0.1 (− 0.3–0.2) | 0.571 |
| Spain | 1990–1995 | 1.9 (1.6–2.2) | < 0.001 | 1995–2005 | 0.4 (0.2–0.5) | < 0.001 | 2005–2015 | 1.6 (1.5–1.7) | < 0.001 | 2015–2019 | − 0.6 (− 1–0.2) | 0.01 |
| Sweden | 1990–1998 | − 0.8 (− 1.1–0.6) | < 0.001 | 1998–2001 | − 2.6 (− 4.8–0.3) | 0.029 | 2001–2008 | − 1.5 (− 1.9–1.1) | < 0.001 | 2008–2019 | − 0.1 (− 0.3–0) | 0.078 |
| United Kingdom | 1990–1995 | 1.3 (0.9–1.7) | < 0.001 | 1995–2006 | 0.3 (0.1–0.4) | < 0.001 | 2006–2010 | − 0.5 (− 1.3–0.3) | 0.232 | 2010–2019 | 0.3 (0.2–0.5) | < 0.001 |
| Canada | 1990–2001 | 0.4 (0.2–0.6) | 0.001 | 2001–2004 | 5.7 (2.3–9.3) | 0.002 | 2004–2008 | 1.2 (− 0.5–2.8) | 0.167 | 2008–2019 | − 0.4 (− 0.6–0.2) | 0.001 |
| United States of America | 1990–1995 | 1 (0.5–1.4) | < 0.001 | 1995–2014 | − 0.5 (− 0.6–0.4) | < 0.001 | 2014–2019 | 0.7 (0.2–1.1) | 0.006 | |||
| African Region | 1990–1998 | 1.5 (1.3–1.6) | < 0.001 | 1998–2019 | 1 (1–1.1) | < 0.001 | ||||||
| Region of the Americas | 1990–1994 | 0.8 (0.4–1.2) | < 0.001 | 1994–2002 | 0.3 (0.1–0.4) | 0.002 | 2002–2015 | 0.1 (0–0.1) | 0.063 | 2015–2019 | 0.5 (0.2–0.9) | 0.005 |
| South-East Asia Region | 1990–1993 | 2.3 (0.7–4) | 0.007 | 1993–1998 | 4.4 (3.4–5.5) | < 0.001 | 1998–2011 | 0.4 (0.2–0.6) | < 0.001 | 2011–2019 | 1.8 (1.5–2.2) | < 0.001 |
| European Region | 1990–1994 | 3.5 (2.8–4.2) | < 0.001 | 1994–1997 | − 0.4 (− 2.4–1.7) | 0.686 | 1997–2005 | 0.8 (0.5–1.1) | < 0.001 | 2005–2019 | 0 (− 0.1–0.1) | 0.55 |
| Eastern Mediterranean Region | 1990–1996 | 1.9 (1.6–2.1) | < 0.001 | 1996–2001 | 3.2 (2.7–3.7) | < 0.001 | 2001–2011 | 2 (1.8–2.1) | < 0.001 | 2011–2019 | 2.3 (2.1–2.4) | < 0.001 |
| Western Pacific Region | 1990–1998 | 1.8 (1.5–2) | < 0.001 | 1998–2005 | 4.8 (4.4–5.3) | < 0.001 | 2005–2011 | 2 (1.4–2.6) | < 0.001 | 2011–2019 | − 0.4 (− 0.7–0.2) | 0.003 |
| (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 | 1990–1994 | 0.9 (0.5–1.2) | < 0.001 | 1994–1997 | − 0.4 (− 1.5–0.6) | 0.409 | 1997–2006 | 0.3 (0.1–0.4) | < 0.001 | 2006–2019 | − 0.6 (− 0.6–0.5) | < 0.001 |
| Australia | 1990–1993 | 2.6 (1.8–3.4) | < 0.001 | 1993–2008 | − 1 (− 1.1–0.9) | < 0.001 | 2008–2016 | − 2.1 (− 2.3–1.9) | < 0.001 | 2016–2019 | 0.8 (0–1.6) | 0.046 |
| Austria | 1990–1992 | − 0.3 (− 2.8–2.2) | 0.793 | 1992–2000 | − 2.3 (− 2.6–2) | < 0.001 | 2000–2017 | − 1.5 (− 1.6–1.4) | < 0.001 | 2017–2019 | 0.2 (− 2.2–2.7) | 0.851 |
| Belgium | 1990–1993 | 1.3 (− 2.8–5.7) | 0.513 | 1993–1996 | − 6 (− 13.6–2.2) | 0.14 | 1996–1999 | 7.1 (− 1.5–16.5) | 0.104 | 1999–2019 | − 1.1 (− 1.3–0.8) | < 0.001 |
| Denmark | 1990–1992 | 6.4 (1.4–11.6) | 0.014 | 1992–1995 | 12.8 (7.5–18.3) | < 0.001 | 1995–1998 | 4.7 (− 0.2–9.8) | 0.059 | 1998–2019 | − 1.6 (− 1.7–1.5) | < 0.001 |
| Finland | 1990–2003 | 0.9 (0.8–1) | < 0.001 | 2003–2006 | − 1.6 (− 4.2–1.1) | 0.229 | 2006–2019 | − 0.3 (− 0.5–0.2) | < 0.001 | |||
| France | 1990–1999 | − 0.2 (− 0.3–0) | 0.017 | 1999–2007 | − 1.8 (− 2–1.6) | < 0.001 | 2007–2012 | 1.2 (0.8–1.7) | < 0.001 | 2012–2019 | 0 (− 0.2–0.2) | 0.934 |
| Germany | 1990–1994 | 1.4 (1–1.8) | < 0.001 | 1994–1998 | 0.1 (− 0.5–0.7) | 0.638 | 1998–2005 | − 1.7 (− 1.9–1.5) | < 0.001 | 2005–2019 | 0 (− 0.1–0) | 0.227 |
| Greece | 1990–1999 | 2.3 (2.1–2.5) | < 0.001 | 1999–2008 | − 1.6 (− 1.8–1.3) | < 0.001 | 2008–2011 | − 3.5 (− 5.9–1) | 0.008 | 2011–2019 | 0.5 (0.2–0.8) | 0.001 |
| Ireland | 1990–1994 | 0.8 (− 0.2–1.7) | 0.1 | 1994–2006 | 2 (1.8–2.2) | < 0.001 | 2006–2011 | − 1.3 (− 2.2–0.4) | 0.007 | 2011–2019 | − 0.2 (− 0.5–0.1) | 0.265 |
| Italy | 1990–1992 | 1 (− 0.1–2.1) | 0.071 | 1992–2003 | − 0.1 (− 0.2–0) | 0.091 | 2003–2014 | − 0.4 (− 0.5–0.3) | < 0.001 | 2014–2019 | 0.1 (− 0.2–0.3) | 0.445 |
| Luxembourg | 1990–2000 | − 0.3 (− 0.4–0.1) | 0.005 | 2000–2019 | − 1.1 (− 1.2–1.1) | < 0.001 | ||||||
| Netherlands | 1990–2007 | 0.4 (0.1–0.8) | 0.016 | 2007–2019 | − 0.8 (− 1.4–0.2) | 0.011 | ||||||
| Norway | 1990–2001 | 1.6 (1.4–1.7) | < 0.001 | 2001–2012 | 0 (− 0.1–0.2) | 0.598 | 2012–2017 | − 2.4 (− 3.1–1.7) | < 0.001 | 2017–2019 | 0.7 (− 1.6–2.9) | 0.539 |
| Portugal | 1990–1998 | 0 (− 0.3–0.4) | 0.817 | 1998–2001 | − 6.4 (− 9.3–3.5) | < 0.001 | 2001–2005 | 2.5 (0.9–4.1) | 0.004 | 2005–2019 | − 0.1 (− 0.3–0) | 0.058 |
| Spain | 1990–2008 | 0.5 (0.5–0.6) | < 0.001 | 2008–2015 | − 0.2 (− 0.5–0.1) | 0.167 | 2015–2019 | 0.8 (0.2–1.4) | 0.009 | |||
| Sweden | 1990–1998 | − 0.9 (− 1–0.7) | < 0.001 | 1998–2002 | − 2.8 (− 3.5–2) | < 0.001 | 2002–2009 | − 1.7 (− 2–1.5) | < 0.001 | 2009–2019 | − 0.6 (− 0.7–0.5) | < 0.001 |
| United Kingdom | 1990–1998 | 1.1 (1–1.2) | < 0.001 | 1998–2008 | 0.5 (0.4–0.5) | < 0.001 | 2008–2019 | 0 (− 0.1–0.1) | 0.708 | |||
| Canada | 1990–1998 | 0 (− 0.5–0.6) | 0.883 | 1998–2006 | 4.1 (3.5–4.8) | < 0.001 | 2006–2016 | − 1.9 (− 2.4–1.5) | < 0.001 | 2016–2019 | 0.3 (− 2–2.7) | 0.764 |
| United States of America | 1990–1995 | 0.8 (0.5–1) | < 0.001 | 1995–2003 | − 0.5 (− 0.6–0.4) | < 0.001 | 2003–2017 | − 1 (− 1–0.9) | < 0.001 | 2017–2019 | 1 (0–2) | 0.056 |
| African Region | 1990–2004 | 0.5 (0.5–0.6) | < 0.001 | 2004–2008 | 1.2 (0.5–1.9) | 0.002 | 2008–2014 | 1.9 (1.6–2.2) | < 0.001 | 2014–2019 | 1 (0.7–1.3) | < 0.001 |
| Region of the Americas | 1990–1994 | − 0.1 (− 0.4–0.2) | 0.585 | 1994–1999 | − 2.1 (− 2.4–1.7) | < 0.001 | 1999–2017 | − 0.4 (− 0.5–0.4) | < 0.001 | 2017–2019 | 0.3 (− 0.7–1.3) | 0.586 |
| South-East Asia Region | 1990–1999 | 1.8 (1.6–2) | < 0.001 | 1999–2004 | − 0.5 (− 1.2–0.2) | 0.13 | 2004–2012 | 0 (− 0.3–0.3) | 0.81 | 2012–2019 | 1.5 (1.2–1.8) | < 0.001 |
| European Region | 1990–1994 | 2.2 (1.7–2.7) | < 0.001 | 1994–2005 | 0.6 (0.5–0.8) | < 0.001 | 2005–2019 | − 0.2 (− 0.3–0.2) | < 0.001 | |||
| Eastern Mediterranean Region | 1990–1995 | 1.3 (1.1–1.6) | < 0.001 | 1995–2000 | 0.3 (0–0.7) | 0.077 | 2000–2016 | 1.6 (1.5–1.6) | < 0.001 | 2016–2019 | 0.9 (0.3–1.4) | 0.006 |
| Western Pacific Region | 1990–1997 | 0.5 (0.2–0.7) | 0.001 | 1997–2006 | 2.7 (2.4–2.9) | < 0.001 | 2006–2017 | − 0.7 (− 0.9–0.6) | < 0.001 | 2017–2019 | 0.7 (− 1.2–2.7) | 0.444 |
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.