© The Author (2008). Published by Oxford University Press. All rights reserved
Comparison of Time Trends in Gallbladder Cancer Incidence (1973–1997) in East Asia, Europe and the USA, from Cancer Incidence in Five Continents Vols IV–VIII
Cancer Information Services and Surveillance Division
Center for Cancer Control and Information Services
National Cancer Center
Time trends of age-standardized rate (ASR) of gallbladder cancer incidence (ICD-10: C23–C24) were compared among 18 selected cancer registries and ethnic/racial groups in East Asia, Europe and the USA. Data source was the Cancer Incidence in Five Continents Vols IV–VIII (years at diagnosis: 1973–77, 1978–82, 1983–87, 1988–92 and 1993–97, respectively). World population was used for age-standardization.
Figure 1 shows time trends of ASR of gallbladder cancer incidence for males. When all the areas including Asia, Europe and the USA were compared, age-adjusted incidence rates (ASRs) of gallbladder cancer were comparatively higher in three Japanese registries (Miyagi, Nagasaki and Osaka) followed by that in Hong Kong (China) and that among Korean people in Los Angels (USA). In East Asia, ASR was higher in three Japanese registries than that in two Chinese registries (Hong Kong and Shanghai). In terms of time trends, ASRs in Japan increased, and that in Hong Kong (China) rapidly increased like those in Japan from 1973–77 to 1983–87 and decreased afterward. Gradual increase of ASR of gallbladder cancer incidence in Shanghai (China) from 1973–77 to 1988–92 and a mild decrease afterward was observed. In European area, little difference of ASRs across registries is shown over the all periods. ASR in Varese (Italy) was the highest in 1978–82 and it was increasing since 1983–87. Although ASR in Denmark decreased consistently, that in Bas-Rhin (France), which was similar to that in Denmark in 1973–77 and 1978–82, decreased after increasing until 1983–87. ASR in Sweden which was the highest in 1973–77 decreased since 1983–87 and got to almost the same ASR in Bas-Rhin (France) in 1993–97. Although both English registries (South Thames and West Midlands) had the lowest ASR in 1973–77, as a result of increase between 1983–87 and 1988–92, South Thames kept the lowest ASR and West Midlands surpassed South Thames and Denmark in ASR. In USA, ASR was comparatively high among Korean in Los Angels and ASRs among both black and white population (SEER) were low. White population in USA showed a slow decrease from 1973–77 to 1993–97 and USA black kept leveling off for the period. In East Asian people in USA, ASR among Japanese in Hawaii which was the highest in 1973–77 decreased slowly and ASR in Hawaii Chinese, which was second highest following Hawaii Japanese, repeatedly decreased and increased. Los Angels Japanese in which ASR was the third highest in 1973–77 once was low in 1978–82, increased in 1983–87 and decreased afterward. ASR in Los Angels Chinese was the lowest in 1973–77, but they showed the second highest ASR following Los Angels Korean in 1983–87 and 1993–97.
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Figure 2 shows time trends of ASR of gallbladder cancer incidence for females. When all the areas including Asia, Europe and USA were compared, ASRs from gallbladder cancer were comparatively higher in Japanese three registries (Miyagi, Nagasaki and Osaka) like that in males. Following ASR in Japan, Sweden and Korean people in Los Angels had high ASRs of gallbladder cancer incidence. In East Asia, ASRs in three Japanese registries (Miyagi, Nagasaki and Osaka) had higher than that in two Chinese registries (Shanghai and Hong Kong). ASR in Shanghai (China) increased all over the period, that in Nagasaki (Japan) increased slowly since 1978–82 and that in any other East Asian registries showed decrease since 1983–87. In Europe, two English registries (South Thames and West Midlands) kept the lower ASR than any other registries. ASR in South Thames showed a slow decrease and that in West Midlands had been leveling off since 1983–87 after increasing from 1978–82 to 1983–87. Although both ASRs in Denmark and in Bas-Rhin (France) were almost same in 1973–77 and decreased all over the period, ASR in Bas-Rhin was higher than that in Denmark in 1993–97 resulting in the difference across the two registries. Sweden which had the highest ASR of gallbladder cancer incidence in Europe decreased since 1983–87. Varese (Italy) showed the highest ASR in 1993–97 after increasing from 1978–82 to 1988–92 and decreasing slightly from 1988–92 to 1993–97. In USA, Korean in Los Angels had the highest ASR all over the period and the difference between the registries became small in 1993–1997. Black and white population (SEER) got to the lowest ASRs after a slight decrease in white and a slight increase in black without remarkable change compared with other ethnic/racial groups in USA. After showing low ASRs in 1978–82, Los Angels Japanese and Hawaii Chinese kept leveled off ASRs since 1983–87 and showed high ASRs once and decreased afterward. ASR in Los Angels Chinese which had been the lowest rose up to higher than ASRs in black, white and Hawaii Japanese, which decreased continuously all over the period.
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Note: Data were downloaded from IARC CANCER Mondial Statistical Information System (http://www-dep.iarc.fr/). Data of number of incidence and population for Vols IV –VIII were extracted from the file named CI5I-VIII_September_2005.ZIP and tabulated by the authors of this article. Periods of year at diagnosis were representative, and they included the following exceptions: the first period was 1975 for Shanghai (China), 1974–77 for Hong Kong (China), 1975–77 for Bas-Rhin (France), 1973–76 for West Midlands (England); the second period was 1979–82 for West Midlands (England); the first period (1976–77) of Varese (Italy) was excluded because there were no data for several age groups. Note that calculated incidence rates were values averaged across five years, which could have rounded rapid annual changes (a spike or drop). Responsibility for this presentation and interpretation lies with the authors of this article. LA, Los Angeles; SEER, Surveillance Epidemiology and End Results.
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