Japanese Journal of Clinical Oncology 2005 35(4):224-227; doi:10.1093/jjco/hyi063
© 2005 Foundation for Promotion of Cancer Research
Comparison of Cancer Mortality (Rectal Cancer) in Five Countries: France, Italy, Japan, UK and USA from WHO Mortality Database (1960–2000)
Itsuro Yoshimi and
Satoshi Kaneko
Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center
Overall males have higher age-standardized mortality rates (ASRs) compared with females, although long-term trends in ASRs differ substantially between countries. In males from France and the UK a steady decreasing trend is observed, while Italy and the USA exhibit a bottoming out after a decreasing trend over the study period. Japan exhibits an increasing trend, although this is moderating. In females, a similar trend is observed, although in Japan ASRs have decreased slightly after a mild increase until the middle of the 1970s (Fig. 1).
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Figure 1. Age-standardized mortality rates (ASRs) for rectal cancer in males and females: age-standardized with 1985 Japanese standard population, rates per 100 000.
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For age-specific rates (
Figs 2 and
3), similar trends to ASRs
are observed, although these trends tend to be more dramatic.
In France, Italy and the UK, steadily decreasing trends are
observed in most age groups during these decades. Italian middle-aged
males and females (45–59 years) show leveling trends.
In the USA, mortality trends are bottoming out, although more
recently they are on the increase among those under 60 years
of age for both genders. In Japan, after the 1970s, decreasing
trends are observed among younger age groups (30-year-old age
group for males and 30 and 40-year-old age groups for females),
while leveling trends are observed for older age groups. There
is a birth cohort effect in the data for Japan between 1920
and 1930 (
1,
2), as is apparent in
Figs 4 and
5. Also in the
UK, birth cohorts after 1930 seem to have lower mortality than
previous successive birth cohorts, especially in males, although
there may also be a period effect.
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Figure 2. Age-specific rates for males over 30 years of age by year of death for rectal cancer in five countries, rates per 100 000.
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Figure 3. Age-specific rates for males over 30 years of age by birth cohort for rectal cancer in five countries, rates per 100 000.
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Figure 4. Age-specific rates for females over 30 years of age by year of death for rectal cancer in five countries, rates per 100 000.
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Figure 5. Age-specific rates for females over 30 years of age by birth cohort for rectal cancer in five countries, rates per 100 000.
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Conversely, the ICD code for colon cancer is not consistent
for international comparison, although comparisons can be made
for Japan, UK and the USA (
Fig. 6). ASRs in Japan can be seen
to be steeply increasing and approaching levels found in the
UK and USA. When considering all colorectal cancers, Japan has
taken over the UK and USA in males. With these increasing trends
in mind, a more cautions attitude has to be taken towards these
intestinal neoplasms.
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Figure 6. Age-standardized mortality rates (ASRs) for colon cancer for Japan, UK and USA in males and females: age-standardized with 1985 Japanese standard population, rates per 100 000.
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Note: Original data was downloaded from WHO Mortality Database
(version as of August 2004). The data was then tabulated by
I. Yoshimi with 154 (ICD-7,8,9), and C19-C21 (ICD-10). Responsibility
for this presentation and interpretation lies with the authors,
not the WHO Mortality Database. For colon cancer in Japan, UK
and the USA, data was tabulated from 153 (ICD-7,8,9) and C18
(ICD-10).
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References
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1 Imamura Y, Mizuno S. Mortality trends of rectal cancer in Japan: 1960–2000.
Jpn J Clin Oncol 2004;34:107–11.
[Medline]
2 Imamura Y, Sobue T. Mortality trend of colon, rectal, liver, "gallbladder and biliary tract" and pancreas cancer in Japan by birth cohort. Jpn J Clin Oncol 2004;34:491–3.[Free Full Text]
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