© 2005 Foundation for Promotion of Cancer Research
Epidemiology Note |
Trends in Head and Neck Cancer Incidence in Japan during 1965–1999
Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
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
Received September 30, 2004; accepted October 15, 2004
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Abstract |
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The age-standardized incidence rates for cancers of the tongue, oropharynx, hypopharynx, esophagus and lung increased steadily for males during 1965–1999, while for females there has been an increase for oropharynx and lung only.
Key Words: head and neck cancer • oral cavity • pharynx • larynx • incidence rate
Cancer Incidence in Five Continents (CI5) has reported age-standardized incidence rates for the three-character categories of ICD-10 in head and neck cancer: lip (C00, ICD Tenth Revision), tongue (C01–02), mouth (C03–06), salivary glands (C07–08), tonsil (C09), other oropharynx (C10), nasopharynx (C11), hypopharynx (C12–13) and pharynx unspecified (C14) (1). For the same sites, the Research Group for Population-based Cancer Registration in Japan has presented the rates for cancers of the lip, oral cavity and pharynx (C00–14) (2). Therefore, we have tried to clarify trends in the incidence of head and neck cancer categorized as in CI5, using data from the Osaka Cancer Registry. This registry has been operating since December 1962, covering Osaka Prefecture with its population of 8.8 million (2000 census), and reporting cancer incidence data in Osaka in ‘Cancer Incidence in Five Continents’ volume III in 1976 to VIII in 2002 (1).
Data from reported head and neck cancer cases which were diagnosed in 1965–1999 were retrieved from the Osaka Cancer Registry's database: the categories are: tongue (C01–02), salivary glands (C07–08), oropharynx (C09–10), nasopharynx (C11), hypopharynx (C12–13), esophagus (C15), nose/sinuses, etc. (C30–31), larynx (C32) and lung (C33–34).
Figures 1 and 2 illustrate trends in numbers and age-standardized incidence rates (standard: 1985 Japanese standard population) in cancers of the oral cavity, pharynx and esophagus from 1965 to 1999 categorized by sex. In cancers of the oral cavity and pharynx, the total numbers have increased 4.4-fold for males and 3.8-fold for females: the increase was most striking for hypopharyngeal and oropharyngeal cancers among males, and for oropharyngeal cancer among females. The age-standardized incidence rates have also increased in hypopharyngeal (from 0.4 to 1.7) and oropharyngeal cancers (from 0.3 to 1.1) among males, and oropharyngeal cancer (from 0.03 to 0.1) among females. The incidence rates for cancers of the tongue and esophagus have increased steadily for males (from 1.5 to 2.3/3.6 to 15.0, respectively), while the rate for cancer of the esophagus has decreased from 4.7 to 2.3 for females.
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Figures 3 and 4 present trends in the numbers and age-standardized incidence rates for cancers of nose/sinuses, etc., larynx and lung from 1965 to 1999 categorized by sex. The incidence of lung cancer has increased >6.0-fold for both males and females, and that of laryngeal cancer has increased 1.8-fold for males. For the age-standardized incidence rates, only lung cancer has increased among both males (from 28.6 to 65.7) and females (from 8.7 to 19.6).
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In the IARC Monograph on tobacco smoking (3), cancers of the oral cavity (including lip and tongue), pharynx, esophagus, nose and nasal sinuses, larynx and lung were identified as being caused by cigarette smoking. Alcohol drinking also increases the risk for cancers of the oral cavity, pharynx, esophagus and larynx (4). Alcohol consumption tends to be associated with other behaviors (especially cigarette smoking and certain aspects of diet including poor nutrition) which may also influence the risk of developing cancer of these sites. As shown in a prior report (5), the present study indicates that although the incidence rates for cancers of the tongue, pharynx, esophagus and lung have increased from 1965 to 1999 in Japan and generally paralleled the increase in tobacco consumption, the incidence rates for cancers of nose/sinuses, etc. and larynx have in fact decreased.
The incidence rates especially of oropharyngeal, hypopharyngeal and lung cancers have increased steadily in Japan, while there has been a small increase only for esophagus (for males) and lung (for females) in the US-SEER (white) (1) where the prevalence of adult smoking has declined steadily (6). The risks of these cancers increased with increasing duration of smoking and daily cigarette consumption and decreased with increased time since quitting. Smoking cessation among young people will contribute to a reduction in the incidence of these cancers.
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1 Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB, editors. Cancer Incidence in Five Continents, Vol. VIII. IARC Scientific Publication No.155. Lyon, France: International Agency for Research on Cancer 2002.
2 The Research Group for Population-based Cancer Registration in Japan. Cancer incidence and incidence rates in Japan in 1998: estimates based on data from 12 population-based cancer registries. Jpn J Clin Oncol 2003;33:241–5.
3 International Agency for Research on Cancer. IARC Monographs Programme on the Evaluation of Carcinogenic Risks to Humans. Vol. 83. Tobacco Smoke and Involuntary Smoking. Lyon, France: International Agency for Research on Cancer 2002.
4 World Cancer Research Fund: American Institute for Cancer Research. Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington 1997.
5 Wynder EL, Fujita Y, Harris RE, Hirayama T, Hiyama T. Comparative epidemiology of cancer between the United States and Japan. A second look. Cancer 1991;67:746–63.[CrossRef][Web of Science][Medline]
6 Siegel M, Mowery PD, Pechacek TP, Strauss WJ, Schooley MW, Merritt RK, et al. Trends in adult cigarette smoking in California compared with the rest of the United States, 1978–1994. Am J Public Health 2000;90:372–9.
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