Japanese Journal of Clinical Oncology 33:645-646 (2003)
© 2003 Foundation for Promotion of Cancer Research
Trends in Uterine Cancer Incidence in Japan 1975–98
Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
National cancer incidence in Japan has been estimated by the Research Group for Population-based Cancer Registration in Japan since 1975, based on the data from 5–12 population-based cancer registries that fulfil the standard requirements for data quality. The methods of estimation and their limitations were explained in our previous reports (1–3); the most recent three-year incidence was calculated for each eligible registry. Cancer incidence rates in Japan before correction are estimated as the arithmetic mean of incidence rates of all eligible registries according to site, gender and five-year age group. Since using data from only a limited number of registries may introduce some biases into estimating the overall incidence in Japan, correction coefficients are calculated as the ratio of actual cancer deaths in the country to those estimated from eligible registries’ mortality data. Final estimates of the rates are obtained by multiplying the estimated incidence rates before correction by the correction coefficients. The estimated national cancer incidence by site, gender, five-year age group and calendar year during the period 1975–98 is now available on a Web site (http://www.mc.pref.osaka.jp/ocr/).
We investigated trends in uterine cancer (WHO: International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, code C53–C55) incidence in Japan, according to the following subcategories: invasive cervical cancer (C53), corpus cancer (C54), uterine cancer NOS (C55) and carcinoma in situ (D06).
Fig. 1 illustrates trends in age-standardized incidence rates (standard: world population) of uterine cancer in Japan from 1975 to 1998, including those of invasive cervical cancer and corpus cancer. Uterine cancer incidence decreased steadily from 21.4 to 12.4 per 100 000 women. Invasive cervical cancer incidence also decreased by approximately half from 13.4 to 7.2 per 100 000 women; conversely, corpus cancer incidence increased from 1.4 to 4.5 per 100 000 women. The standardized incidence rate ratio of invasive cervical to uterine cancer decreased during this period, whereas the rate ratio of corpus to uterine cancer increased substantially (Fig. 2). Age-standardized incidence rates of carcinoma in situ also increased and approximated to the rates of invasive cervical cancer in the 1990s (Fig. 1).
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Fig. 3 illustrates the trends in incidence rates by age group: <30 and 30+ years old. Among those aged <30 years, incidence rates of both uterine cancer and invasive cervical cancer decreased until 1984, but increased thereafter. These rates, however, have decreased again during the last few years. Among those aged 30+ years, the rates have steadily decreased since 1975. For corpus cancer, the rates increased slightly among those aged 30+ years, but not among those aged <30 years. For carcinoma in situ, the rates have increased substantially among those aged <30 years (approximately seven-fold, from 0.3 to 2.0 per 100 000 women), whereas the rates increased slightly among those aged 30+ years (less than twofold, from 7.2 to 10.3 per 100 000 women).
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The present study indicates that the incidence rates of invasive cervical cancer have steadily decreased in Japan, whereas the rates of carcinoma in situ have increased, especially among those aged <30 years, in the period 1975–98. The Japanese Ministry of Health, Labor and Welfare recommends cervical cancer screening to be carried out every year for those aged 30+ years. However, the Japan Association of Obstetricians and Gynecologists recommends that even women aged <30 years should undergo cervical cancer screening. The US Preventive Task Force recommends that the screening should begin with the onset of sexual activity (4). Hence it is becoming common for pregnant women of all ages to have cervical cancer screening at their first antenatal visit in Japan. Cervical cancer screening among pregnant women might contribute to a reduction in the incidence of invasive cervical cancer among those aged <30 years.
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FOOTNOTES |
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+ For reprints and all correspondence: Akiko Ioka, Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1–3–3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. E-mail: akiko3{at}gol.com
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REFERENCES |
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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, 1985–89: re-estimation based on data from eight population-based cancer registries. Jpn J Clin Oncol 1998;28:54–67.
3 The Research Group for Population-based Cancer Registration in Japan. Cancer incidence in Japan. In: Tominaga S, Oshima A, editors. Cancer Mortality and Morbidity Statistics Japan and the World – 1999. Monograph on Cancer Research No. 47. Tokyo: Japanese Scientific Societies Press 1999;83–143.
4 US Preventive Services Task Force. Guide to Clinical Preventive Services, 2nd ed. Baltimore: Williams & Wilkins 1996;105–17.
Received October 16, 2003; accepted October 30, 2003
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