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Japanese Journal of Clinical Oncology Pages 450-453

Cancer Incidence in Japan in 1990: Estimates Based on Data from Population-based Cancer Registries
Acknowledgments
References
Cancer Incidence in Japan in 1990: Estimates Based on Data from Population-based Cancer Registries

Cancer Incidence in Japan in 1990: Estimates Based on Data from Population-based Cancer Registries

The Research Group for Population-based Cancer Registration in Japan*

Key words: cancer incidence - incidence estimates - cancer registry - Japan

It is essential that the Japanese national government sets up a comprehensive cancer program and establish an agenda for the future based on accurate Japanese cancer incidence statistics. To provide cancer incidence statistics is one of the fundamental aims of a population-based cancer registry. The Research Group for Population-based Cancer Registration in Japan has been making efforts to prepare national cancer incidence estimates since it was established in 1975.

In a 1994 study, the Group estimated 1990 incidence in Japan, based on data from eight eligible population-based cancer registries: Miyagi, Yamagata, Chiba, Kanagawa, Fukui, Osaka and Nagasaki prefectural cancer registries and the Hiroshima City Cancer Registry. The incidence for 1990 was estimated as 388 640 (Table 1). Of all the incident cases, 14.5% were unreported death certificate only cases. The stomach, lung and liver were the three leading cancer sites for males and for females the stomach, breast and uterus. Yearly estimation methods and limitations are explained in other reports (1,2). Fig. 1 shows the time trends in age-standardized incidence rates for major sites. Cancer incidence has been continuously increasing in most sites except the stomach and cervix. Number of incidence, incidence rates, age-standardized rates for two standard populations, completeness of reporting and accuracy of diagnosis are shown in Table 1. Age-specific number of incidence and incidence rates are shown in Table 2 and 3 according to gender and primary site.


Figure 1. Trends of age-standardized cancer incidence rates (world population) in Japan for major sites according to gender, 1975-90.

Incidence estimates in Japan for every calendar year from 1975 to 1990 are now available according to gender, site and 5-year age-group, through correspondence with the present principal investigator of the Research Group, with the support of a grant-in-aid for cancer research from the Ministry of Health and Welfare: (8-2).

Table 1. Incidence in Japan, complenetess of reporting and accuracy of diagnosis according to gender and primary site, 1990
Gender Primary site ICD-9th No. of incidence Crude rate Age-standardized rate Completeness of reporting Accuracy of diagnosis:
World population Japanese 1985 model population DCO/I (%) I/D HV/I (%)
Male All sites (incl. CIS) 140-208, 233 220750 364.1 257.6 360.6 14.8 1.69 68.2
All sites 140-208 220750 364.1 257.6 360.6 14.8 1.69 68.2
Lip, oral cavity & pharynx 140-149 4290 7.0 5.1 6.9 7.8 2.30 84.2
Esophagus 150 8040 13.2 9.3 13.0 13.2 1.34 75.8
Stomach 151 62860 105.2 73.0 102.3 11.4 2.10 81.5
Colon 153 20180 33.0 23.4 32.7 10.3 2.59 80.3
Rectum 154 13060 21.7 15.3 21.1 9.5 2.35 82.7
Liver 155 21760 34.9 25.6 34.5 24.3 1.22 28.6
Gallbladder 156 5790 9.7 6.5 9.6 22.0 1.14 44.1
Pancreas 157 7830 13.0 9.0 12.9 26.7 1.07 34.3
Larynx 161 2760 4.5 3.2 4.5 3.8 3.58 88.6
Lung 162 31770 52.5 36.0 52.8 20.9 1.18 52.8
Skin 172, 173 2280 3.7 2.6 3.8 3.8 5.98 90.4
Prostate 185 7770 12.8 8.3 13.3 12.6 2.25 76.4
Bladder 188 7470 12.3 8.5 12.3 8.1 3.54 83.9
Kidney 189 4610 7.5 5.4 7.5 10.3 2.29 73.6
Brain & nervous system 191-192 1900 3.1 2.7 3.1 14.6 2.77 70.6
Thyroid 193 1210 2.0 1.5 1.9 7.2 3.95 86.9
Malignant lymphoma 200-202 5270 8.6 6.4 8.6 14.9 1.66 77.7
Multiple myeloma 203 1430 2.3 1.6 2.3 26.5 1.31 56.1
Haematopoietic tissue 204-208 3500 5.7 4.9 5.7 19.6 1.08 62.1
Female All sites (incl. CIS) 140-208, 233 167730 267.4 162.6 219.8 13.9 1.93 71.1
All sites 140-208 162560 259.2 156.1 211.7 14.3 1.87 70.4
Lip, oral cavity & pharynx 140-149 1670 2.7 1.6 2.2 11.9 2.26 80.3
Esophagus 150 1620 2.6 1.3 1.9 17.8 1.27 68.3
Stomach 151 33390 54.1 30.5 42.6 13.3 1.90 79.1
Colon 153 16560 26.5 14.7 20.7 13.0 2.15 76.5
Rectum 154 8910 14.3 8.3 11.4 9.9 2.41 81.5
Liver 155 8080 12.6 7.1 9.9 29.9 1.25 24.4
Gallbladder 156 7770 12.7 6.2 9.2 26.0 1.14 39.6
Pancreas 157 6180 9.8 5.0 7.4 29.8 1.03 29.7
Larynx 161 180 0.3 0.2 0.2 9.0 2.36 83.7
Lung 162 11200 17.7 9.5 13.7 23.3 1.16 48.7
Skin 172, 173 2500 4.0 2.1 3.0 4.2 8.23 89.2
Breast 174-175, 2330 23400 36.9 26.1 33.6 4.4 4.00 87.8
Uterus (incl. CIS) 179-182, 2331 17050 26.9 19.0 24.6 5.3 3.71 84.8
Uterus (only invasive) 179-182 12420 19.6 13.1 17.2 6.8 2.70 82.3
Cervix uteri 180 7700 12.2 8.3 10.8 3.0 4.11 87.5
Corpus uteri 182 3180 5.0 3.4 4.4 3.3 5.60 89.4
Ovary 183 5280 8.3 5.9 7.4 14.0 1.61 70.3
Bladder 188 2360 3.7 2.0 2.8 12.6 2.51 77.7
Kidney 189 2040 3.2 1.9 2.6 16.1 2.05 61.9
Brain & nervous system 191-192 1410 2.3 1.9 2.1 15.2 2.60 70.6
Thyroid 193 5760 9.1 6.6 8.4 3.2 8.38 87.4
Malignant lymphoma 200-202 3750 5.9 3.7 4.9 14.0 1.79 79.2
Multiple myeloma 203 1260 2.0 1.0 1.5 30.5 1.25 53.4
Haematopoietic tissue 204-208 2610 4.1 3.3 3.7 25.0 1.08 62.5
Incidence figures in this table have been rounded off to the second digit, since these are only estimated values.

Table 2. Age-specific incidence in Japan according to gender and primary site, 1990
Primary site ICD-9th All ages Age group
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Male
All sites (incl. CIS) 140-208, 233 220751 546 263 347 451 494 731 1315 2938 6318 9267 14925 25945 35037 33092 30063 29003 19351 10664
All sites 140-208 220748 546 263 347 451 494 731 1315 2938 6318 9267 14925 25945 35037 33091 30061 29003 19351 10664
Lip, oral cavity & pharynx 140-149 4285 7 1 4 21 25 18 36 94 170 231 424 672 772 662 439 380 222 108
Esophagus 150 8040 0 0 0 0 0 0 2 42 83 302 707 1045 1537 1330 1148 1016 591 236
Stomach 151 62862 10 0 0 7 42 120 348 1058 2239 3172 4974 7605 9898 9525 8487 7817 4968 2592
Colon 153 20181 0 3 7 4 13 50 92 230 603 987 1780 2423 3503 3067 2447 2499 1628 846
Rectum 154 13063 0 0 0 5 12 27 46 148 487 739 1188 1748 2152 1992 1777 1356 890 497
Liver 155 21764 14 1 6 0 6 14 56 141 489 870 1766 4420 4826 3402 2346 1639 1149 622
Gallbladder 156 5786 0 0 0 0 0 2 6 39 96 136 271 482 731 858 930 1044 734 457
Pancreas 157 7833 1 3 0 0 1 0 6 62 181 297 437 821 1211 1273 1133 1177 759 472
Larynx 161 2756 0 0 0 0 0 0 2 7 51 106 137 411 529 556 378 329 176 74
Lung 162 31769 4 0 0 1 10 10 77 176 445 815 1159 2597 4559 5336 5433 5534 3643 1970
Skin 172, 173 2278 2 0 16 9 6 11 13 52 83 81 109 178 288 283 285 348 292 223
Prostate 185 7773 1 0 0 0 0 5 0 0 5 14 73 236 735 917 1443 1878 1593 874
Bladder 188 7471 0 0 0 1 4 11 44 96 205 216 322 758 1034 1091 1115 1187 822 565
Kidney 189 4608 17 5 0 0 0 0 24 82 137 246 388 577 776 732 594 547 312 171
Brain & nervous system 191-192 1896 65 55 87 67 56 56 53 84 105 130 148 182 234 147 149 150 95 31
Thyroid 193 1207 0 7 0 13 23 29 37 54 159 123 96 128 163 124 123 68 37 24
Malignant lymphoma 200-202 5267 44 46 61 38 61 86 115 128 245 229 360 600 754 652 536 624 460 227
Multiple myeloma 203 1427 0 0 0 0 0 0 5 7 24 54 45 174 221 209 205 222 157 103
Haematopoietic tissue 204-208 3498 164 85 107 127 97 58 86 151 187 209 198 368 414 285 330 328 174 131
Female
All sites (incl. CIS) 140-208, 233 167732 442 219 320 436 656 1291 2787 5811 10916 11936 12372 15398 18254 20044 20076 19705 15612 11458
All sites 140-208 162560 442 219 320 433 616 1093 2191 5008 9613 11161 11919 15155 17953 19821 19966 19614 15601 11436
Lip, oral cavity & pharynx 140-149 1672 0 1 3 13 1 20 27 47 82 83 133 157 195 203 228 212 170 99
Esophagus 150 1619 0 0 0 0 0 0 0 8 30 38 71 110 146 198 247 328 234 207
Stomach 151 33386 0 0 2 11 48 165 344 988 1731 1750 2080 2984 3756 4364 4492 4551 3648 2473
Colon 153 16564 0 0 0 4 30 24 64 230 504 730 1096 1614 1937 2342 2269 2357 1959 1405
Rectum 154 8906 0 0 0 0 3 4 33 182 398 510 712 1063 1097 1304 1209 1054 726 611
Liver 155 8081 12 3 0 5 15 5 19 39 95 187 315 707 1216 1343 1378 1143 882 718
Gallbladder 156 7771 2 0 0 0 4 5 14 32 90 140 277 472 677 1035 1248 1477 1264 1034
Pancreas 157 6184 3 1 0 0 11 5 6 62 77 160 253 365 582 830 1043 1140 922 725
Larynx 161 182 0 0 1 0 0 0 5 4 0 10 20 19 25 25 15 23 19 17
Lung 162 11197 0 0 5 5 5 28 33 97 219 391 538 893 1100 1544 1886 1930 1569 954
Skin 172173 2503 0 3 10 14 3 19 29 29 86 93 135 150 182 222 330 391 338 470
Breast 174-175, 2330 23397 0 0 0 5 26 196 636 1535 3424 3830 2824 2613 2543 2157 1490 1112 598 407
Uterus (incl. CIS) 179-182, 2331 17051 0 0 0 2 68 391 991 1560 2441 1878 1661 1675 1725 1401 1112 945 655 547
Uterus (only invasive) 179-182 12424 0 0 0 1 31 199 402 774 1200 1216 1293 1475 1460 1266 1021 905 649 534
Cervix uteri 180 7698 0 0 0 0 26 144 333 664 934 740 634 668 857 816 643 602 369 265
Corpus uteri 182 3175 0 0 0 0 0 30 31 77 189 376 530 661 467 327 224 144 71 50
Ovary 183 5282 4 12 21 62 77 123 119 252 488 641 642 605 579 527 377 326 247 180
Bladder 188 2358 0 0 0 0 7 1 17 17 39 71 77 152 250 301 413 400 344 270
Kidney 189 2044 28 4 8 1 5 10 16 23 53 80 108 186 248 257 338 260 273 147
Brain & nervous system 191-192 1409 85 57 73 43 54 27 62 43 50 87 96 110 115 148 147 88 85 40
Thyroid 193 5763 0 3 11 58 139 135 232 412 745 761 638 645 625 444 355 282 185 93
Malignant lymphoma 200-202 3753 28 18 34 42 47 54 66 132 145 200 219 322 381 473 488 489 398 217
Multiple myeloma 203 1257 0 0 0 0 4 0 0 8 12 16 59 87 176 208 158 224 193 113
Haematopoietic tissue 204-208 2605 134 77 88 103 72 42 62 107 120 118 200 205 224 205 259 263 212 113
The incidence figures given in this table are estimated values. However, these values have not been rounded off, as age-specific incidence figures are often single-digit numbers.

Table 3. Age-specific incidence rates per 100,000 population in Japan according to gender and primary site 1990

Primary site ICD-9th Crude rate Age group
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Male
All sites (incl. CIS) 140-208, 233 364.1 16.4 6.9 7.9 8.8 11.0 17.8 33.4 64.7 117.7 206.0 372.0 683.3 1078.9 1502.7 1920.8 2414.0 2843.2 2977.5
All sites 140-208 364.1 16.4 6.9 7.9 8.8 11.0 17.8 33.4 64.7 117.7 206.0 372.0 683.3 1078.9 1502.7 1920.7 2414.0 2843.2 2977.5
Lip, oral cavity & pharynx 140-149 7.0 0.2 0.0 0.1 0.4 0.6 0.4 0.9 2.1 3.2 5.1 10.6 17.7 23.8 30.0 28.0 31.6 32.7 30.0
Esophagus 150 13.2 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.9 1.5 6.7 17.6 27.5 47.3 60.4 73.4 84.6 86.9 65.9
Stomach 151 105.2 0.3 0.0 0.0 0.1 0.9 2.9 8.8 23.3 41.7 70.5 124.0 200.3 304.8 432.6 542.2 650.6 729.9 723.8
Colon 153 33.0 0.0 0.1 0.2 0.1 0.3 1.2 2.3 5.1 11.2 22.0 44.4 63.8 107.9 139.3 156.3 208.0 239.3 236.0
Rectum 154 21.7 0.0 0.0 0.0 0.1 0.3 0.7 1.2 3.2 9.1 16.4 29.6 46.0 66.3 90.5 113.5 112.9 130.8 138.8
Liver 155 34.9 0.4 0.0 0.1 0.0 0.1 0.3 1.4 3.1 9.1 19.3 44.0 116.4 148.6 154.5 149.9 136.4 168.8 173.5
Gallbladder 156 9.7 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.9 1.8 3.0 6.8 12.7 22.5 39.0 59.5 86.9 107.9 127.6
Pancreas 157 13.0 0.0 0.1 0.0 0.0 0.0 0.0 0.1 1.4 3.4 6.6 10.9 21.6 37.3 57.8 72.4 98.0 111.6 131.7
Larynx 161 4.5 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.2 1.0 2.4 3.4 10.8 16.3 25.3 24.2 27.4 26.0 20.6
Lung 162 52.5 0.1 0.0 0.0 0.0 0.2 0.2 2.0 3.9 8.3 18.1 28.9 68.4 140.4 242.3 347.2 460.7 535.3 549.8
Skin 172, 173 3.7 0.1 0.0 0.3 0.2 0.1 0.3 0.3 1.1 1.5 1.8 2.7 4.7 8.9 12.9 18.2 29.0 42.9 62.3
Prostate 185 12.8 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.1 0.3 1.8 6.2 22.6 41.6 92.2 156.4 234.1 244.1
Bladder 188 12.3 0.0 0.0 0.0 0.0 0.1 0.3 1.1 2.1 3.8 4.8 8.0 20.0 31.8 49.5 71.2 98.8 120.7 157.8
Kidney 189 7.5 0.5 0.1 0.0 0.0 0.0 0.0 0.6 1.8 2.5 5.5 9.7 15.2 23.9 33.3 38.0 45.5 45.9 47.5
Brain & nervous system 191-192 3.1 2.0 1.4 2.0 1.3 1.2 1.4 1.3 1.9 2.0 2.9 3.7 4.8 7.2 6.7 9.6 12.5 14.0 8.7
Thyroid 193 2.0 0.0 0.2 0.0 0.3 0.5 0.7 0.9 1.2 2.9 2.7 2.4 3.3 5.0 5.6 7.8 5.6 5.3 6.8
Malignant lymphoma 200-202 8.6 1.3 1.2 1.4 0.7 1.4 2.1 2.9 2.8 4.6 5.1 9.0 15.8 23.2 29.6 34.3 52.0 67.6 63.2
Multiple myeloma 203 2.3 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.2 0.4 1.2 1.1 4.6 6.8 9.5 13.1 18.5 23.1 28.9
Haematopoietic tissue 204-208 5.7 4.9 2.2 2.4 2.5 2.2 1.4 2.2 3.3 3.5 4.6 4.9 9.7 12.7 13.0 21.0 27.3 25.5 36.5
Female
All sites (incl. CIS) 140-208, 233 267.4 13.9 6.0 7.7 8.9 15.1 32.3 72.0 129.5 205.3 262.7 301.9 390.1 519.5 688.0 887.9 1080.6 1350.2 1494.8
All sites 140-208 259.2 13.9 6.0 7.7 8.9 14.2 27.3 56.6 111.6 180.8 245.6 290.8 383.9 510.9 680.4 883.1 1075.6 1349.3 1491.9
Lip, oral cavity & pharynx 140-149 2.7 0.0 0.0 0.1 0.3 0.0 0.5 0.7 1.0 1.5 1.8 3.2 4.0 5.5 7.0 10.1 11.6 14.7 12.9
Esophagus 150 2.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.6 0.8 1.7 2.8 4.2 6.8 10.9 18.0 20.2 27.1
Stomach 151 54.1 0.0 0.0 0.0 0.2 1.1 4.1 8.9 22.0 32.6 38.5 50.8 75.6 106.9 149.8 198.7 249.5 315.5 322.6
Colon 153 26.5 0.0 0.0 0.0 0.1 0.7 0.6 1.7 5.1 9.5 16.1 26.8 40.9 55.1 80.4 100.3 129.2 169.4 183.4
Rectum 154 14.3 0.0 0.0 0.0 0.0 0.1 0.1 0.9 4.0 7.5 11.2 17.4 26.9 31.2 44.8 53.5 57.8 62.7 79.7
Liver 155 12.6 0.4 0.1 0.0 0.1 0.3 0.1 0.5 0.9 1.8 4.1 7.7 17.9 34.6 46.1 61.0 62.7 76.3 93.7
Gallbladder 156 12.7 0.1 0.0 0.0 0.0 0.1 0.1 0.4 0.7 1.7 3.1 6.8 12.0 19.3 35.5 55.2 81.0 109.4 134.8
Pancreas 157 9.8 0.1 0.0 0.0 0.0 0.3 0.1 0.2 1.4 1.4 3.5 6.2 9.2 16.6 28.5 46.1 62.5 79.7 94.6
Larynx 161 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.0 0.2 0.5 0.5 0.7 0.9 0.6 1.3 1.6 2.2
Lung 162 17.7 0.0 0.0 0.1 0.1 0.1 0.7 0.9 2.2 4.1 8.6 13.1 22.6 31.3 53.0 83.4 105.9 135.7 124.5
Skin 172173 4.0 0.0 0.1 0.2 0.3 0.1 0.5 0.7 0.6 1.6 2.1 3.3 3.8 5.2 7.6 14.6 21.4 29.2 61.3
Breast 174-175, 2330 36.9 0.0 0.0 0.0 0.1 0.6 4.9 16.4 34.2 64.4 84.3 68.9 66.2 72.4 74.0 65.9 61.0 51.8 53.2
Uterus (incl. CIS) 179-182, 2331 26.9 0.0 0.0 0.0 0.1 1.6 9.8 25.6 34.8 45.9 41.3 40.5 42.4 49.1 48.1 49.2 51.8 56.6 71.3
Uterus (only invasive) 179-182 19.6 0.0 0.0 0.0 0.0 0.7 5.0 10.4 17.3 22.6 26.8 31.5 37.4 41.5 43.5 45.2 49.6 56.1 69.6
Cervix uteri 180 12.2 0.0 0.0 0.0 0.0 0.6 3.6 8.6 14.8 17.6 16.3 15.5 16.9 24.4 28.0 28.5 33.0 32.0 34.5
Corpus uteri 182 5.0 0.0 0.0 0.0 0.0 0.0 0.7 0.8 1.7 3.5 8.3 12.9 16.7 13.3 11.2 9.9 7.9 6.2 6.5
Ovary 183 8.3 0.1 0.3 0.5 1.3 1.8 3.1 3.1 5.6 9.2 14.1 15.7 15.3 16.5 18.1 16.6 17.9 21.3 23.6
Bladder 188 3.7 0.0 0.0 0.0 0.0 0.1 0.0 0.4 0.4 0.7 1.5 1.9 3.9 7.1 10.3 18.3 21.9 29.7 35.2
Kidney 189 3.2 0.9 0.1 0.2 0.0 0.1 0.3 0.4 0.5 1.0 1.8 2.6 4.7 7.0 8.8 15.0 14.2 23.6 19.2
Brain & nervous system 191-192 2.3 2.7 1.6 1.7 0.9 1.3 0.7 1.6 0.9 0.9 1.9 2.4 2.8 3.3 5.1 6.5 4.8 7.4 5.2
Thyroid 193 9.1 0.0 0.1 0.3 1.2 3.2 3.4 6.0 9.2 14.0 16.8 15.6 16.3 17.8 15.2 15.7 15.5 15.9 12.1
Malignant lymphoma 200-202 5.9 0.9 0.5 0.8 0.9 1.1 1.3 1.7 3.0 2.7 4.4 5.4 8.2 10.8 16.3 21.6 26.8 34.4 28.3
Multiple myeloma 203 2.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.2 0.2 0.3 1.4 2.2 5.0 7.2 7.0 12.3 16.7 14.7
Haematopoietic tissue 204-208 4.1 4.2 2.1 2.1 2.1 0.7 1.1 1.6 2.4 2.3 2.6 4.9 5.2 6.4 7.0 11.5 14.4 18.3 14.8

Acknowledgments

In 1994, the Research Group conducted the 21st survey on cancer incidence and cancer medical care with the cooperation of 13 researchers from 11 cancer registries and the Aichi Cancer Center: A. Takano (Miyagi Tumor Registry), Y. Sato (Yamagata Cancer Registry), M. Murata (Chiba), N. Okamoto (Kanagawa), S. Yamasaki (Fukui), S. Hattori (Aichi), A. Hanai (Osaka), T. Ishida (Hyogo), K. Mabuchi (Hiroshima City), T. Ikeda and M. Soda (Nagasaki) and T. Kabo (Kochi) and T. Kuroishi (Aichi Cancer Center). The Group estimated incidence in Japan in 1990 using the above survey data. The authors thank all the researchers and registries for their participation in the 21st survey. The study was supported by a grant-in-aid for cancer research from the Japanese Ministry of Health and Welfare: (5-3).

References

1. The Research Group for Population-based Cancer Registration in Japan. Cancer incidence and incidence rates in Japan in 1988: estimates based on data from ten population-based cancer registries. Jpn J Clin Oncol. 1994;24:299-304.

2. The Research Group for Population-based Cancer Registration in Japan. Cancer incidence in Japan, 1985-1989: re-estimation based on data from eight population-based cancer registries. Jpn J Clin Oncol. 1998;28:54-67.

Received April 27, 1998; accepted May 6, 1998
*This report was prepared by Aya Hanai, Japanese Association of Cancer Registries, Takako Kitagawa, Wakiko Ajiki, Hideaki Tsukuma and Akira Oshima, Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
For reprints and all correspondence: Aya Hanai, JACR, c/o Osaka Medical Center for Cancer and Cardiovascular Diseases, Nakamichi 1-3-3, Higashinari-ku, Osaka 537-8511, Japan
Abbreviations: ICD-9th, International Classification of Diseases, 9th Revision; rate, per 100 000 population; DCO/I, proportion of cases registered with death certificate only to incident cases; I/D, ratio of number of incidence to number of deaths in 1990; HV/I, proportion of histologically verified cases to incident cases

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