© 2007 Foundation for Promotion of Cancer Research
Comparison of Time Trends in Lung Cancer Incidence (1973–97) in East Asia, Europe and 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 lung cancer incidence (ICD-10: C33–C34) were compared among 18 selected cancer registries and ethnic/racial groups in East Asia, Europe and the USA. The data source was the Cancer Incidence in Five Continents Vols IV–VIII (years at diagnosis: 1973–77, 78–82, 83–87, 88–92 and 93–97, respectively). World population was used for age-standardization.
Figure 1 shows the time trends of ASR of lung cancer incidence for males. When all the areas, including Asia, Europe and the USA, were compared, age-adjusted incidence rates from lung cancer were comparatively lower (around 30/100 000) in the three Japanese registries (Miyagi, Nagasaki and Osaka) and among East Asian people in the USA (Hawaii and Los Angeles), and appreciably lower in Sweden. In East Asia, the ASR was highest in Hong Kong (China), which showed rapid increases between 1978–82 and 1983–87 and decreased afterwards. Although three registries of Japan had the lowest ASRs, a steady upward trend was observed, reaching ASRs of over 40/100 000 in 1993–97. Shanghai (China), which had higher ASRs than Japan in 1973–77, showed slower increases throughout the 1970s and 1980s, decreased between 1988–92 and 1993–97, and approached the level of Japan. In the European area, substantial falls in ASRs were observed in two registries in England, and in 1993–97, the ASRs in the two registries were almost same. Varese (Italy) and Denmark showed decreasing trends since 1983–87, while Denmark maintained a lower ASR than Varese. Although Bas-Rhin (France) had similar ASRs to Denmark in 1973–77, the ASRs in Bas-Rhin rapidly increased until 1988–92 and remained much higher than those in Denmark thereafter. Although Sweden had very low ASRs, a further slight fall was observed. In USA, ASRs were appreciably highest among the black population (Surveillance Epidemiology and End Results, SEER), showing a sharp increase until 1983–87 and decreasing by as much as the increase until late 1993–97. The white population in the USA had the second highest lung cancer ASR, which had decreased since 1978–82. Other USA populations, namely, East Asian people in Los Angeles and Hawaii, had ASRs ranging from 20 to 40 per 100 000. A decrease of lung cancer ASR was observed in Hawaii Japanese, Los Angeles Chinese (since 1978–82) and Los Angeles Japanese (since 1978–82). Although Hawaii Chinese showed decreases in ASR and reached the second lowest level following Los Angeles Japanese in 1983–87, the ASR increased afterwards to the highest among East Asians in the USA.
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Figure 2 shows time trends of ASR of lung cancer incidence for females. In East Asia, Europe and USA, lung cancer ASRs for female were lower than those for males. Although differences across registries were not so clear for females as compared with males, Shanghai (China) in Asia and white and black populations (SEER) in the USA tended to have high ASRs. In East Asia, higher ASR was observed in two registries of China than in the three registries of Japan. Hong Kong showed large increases between 1978–82 and 1983–87 and decreased afterwards. A leveling of ASR was observed in Shanghai, and smaller increases were found in the three registries of Japan throughout the period. A steady upward trend in lung cancer ASR was observed in all European countries except for two areas in England; South Thames showed a decrease between 1983–87 and 1988–92, and West Midlands showed a decrease through the latest period. The increase in Denmark was especially large and the ASR rose to the highest in Europe in 1993–97. In the USA, Chinese people in Hawaii had the highest ASRs in 1973–77, which decreased slightly and reached a level as low as for other East Asians in Los Angeles or Hawaii. The ASR in black and white populations in the USA (SEER), which was similar in 1973–77, increased clearly and was the highest in 1993–97. The ASRs for Koreans in Los Angeles, which were significantly low in 1973–77, increased and reached similar levels to the other East Asian populations in USA.
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Note
Data were downloaded from IARC CANCER Mondial Statistical Information System (http://www-dep.iarc.fr/). Data for 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 years 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 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.
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