© The Author (2008). Published by Oxford University Press. All rights reserved
Comparison of Time Trends in Bladder Cancer Incidence (1973-1997) in East Asia, Europe and USA, from Cancer Incidence in Five Continents Vol. IV-VIII
Cancer Information Services and Surveillance Division
Center for Cancer Control and Information Services National Cancer Center
Tokyo, Japan
Time trends of age-standardized rate (ASR) of bladder cancer incidence (ICD-10: C67) were compared among 18 selected cancer registries and ethnic/racial groups in East Asia, Europe, and USA. Data source was the Cancer Incidence in Five Continents Vol. 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 time trends of ASR of bladder cancer incidence for males. In East Asia no clear difference was seen between the three regions of Japan (Miyagi, Nagasaki, and Osaka) and the two regions of China (Hong Kong and Shanghai). Nagasaki and Hong Kong showed high ASRs compared with the other regions. The increasing tendency of ASR was recognized for all regions between the period of 1973–77 and 78–82, then it leveled-off to the last period of the surveillance except for Hong Kong where the ASR was continuously decreasing through all periods. The variance of ASR at the first period seemed to converge at the end. ASR in Europe was about twice higher than those in East Asia. The ASRs of Varese (Italy) and Denmark were higher than those in the other four regions. In addition, a rapid increasing tendency was seen in Varese. Sweden and South Thames (England) showed leveling-off or slightly rising incidence rate. The ASRs in Bas-Rhin (France) and West Midlands (England) increased in the first two periods, and then leveled-off as East Asian regions. The incidence rate of white (SEER) was remarkably high compared with the other races in the United States, and it increased moderately. The ASRs in other races were of similar level, and the transitions were also comparable though the rates increased and decreased repeatedly during the period covered.
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Figure 2 shows the transition of age-standardized bladder cancer incidence rate for female. The ASR for female was a half to quarter of that for male. Note that the scale in Figure 2 is different from the Figure 1 for that reason. Solely Hong Kong had a decreasing ASR in East Asia as for male. The ASR in Nagasaki increased between the periods of 1973-77 and 88-92, and it decreased afterwards. The variance of ASRs at the first period of the surveillance converged due to the high incidence rate in Hong Kong having decreased at the end. In Europe, Denmark showed the highest ASR in the 18 regions, and it stayed consistently in uptrend except for the period between 1988-92 and 93-97. The ASR in West Midlands (England) also showed a similar transition though the rate was not as high as Denmark. A continuous increasing tendency of ASRs was observed in Varese (Italy) and Sweden, and no clear tendency was seen in rest of the regions. Only white (SEER) had a high incidence rate in the United States, and the rates in Black (SEER) and Asian races were similar to those in East Asia. Black had a stable transition of the ASR for all periods. The variance of ASRs in the Asian races at the first period converged at the end as in East Asian countries though the sharp fluctuation of rates was observed.
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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 Vol. 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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