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Japanese Journal of Clinical Oncology Advance Access originally published online on July 29, 2008
Japanese Journal of Clinical Oncology 2008 38(8):571-576; doi:10.1093/jjco/hyn061
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© The Author (2008). Published by Oxford University Press. All rights reserved

Lifetime and Age-Conditional Probabilities of Developing or Dying of Cancer in Japan

Ken-ichi Kamo1, Kota Katanoda2, Tomohiro Matsuda2, Tomomi Marugame2, Wakiko Ajiki2 and Tomotaka Sobue2

1 Division of Mathematics, School of Medicine Liberal Arts and Sciences, Sapporo Medical University, Sapporo
2 Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

For reprints and all correspondence: Ken-ichi Kamo, Division of Mathematics, School of Medicine Liberal Arts and Sciences, Sapporo Medical University, S1 W16, Chuo-ku, Sapporo 060-8543, Japan. E-mail: kamo{at}sapmed.ac.jp

Received April 3, 2008; accepted June 18, 2008


   Abstract
TOP
 Abstract
BACKGROUND
 PATIENTS AND METHODS
 RESULTS AND CONCLUSION
 Funding
 Acknowledgements
 References
 
The concepts of lifetime and age-conditional probabilities of developing and dying of cancer are introduced as indexes to understand the risk of cancer. In this paper, we estimated the lifetime and age-conditional probabilities of developing and dying of cancer in 2001 and 2005, respectively, in Japan. It is estimated that one in two Japanese males and one in three females will develop cancer, and one in four Japanese males and one in six females will die of cancer. Moreover, the probabilities of developing cancer within specific decades of age are obtained as the short-term risks.

Key Words: lifetime probability • age-conditional probability • developing cancer • dying of cancer • life table.


   BACKGROUND
TOP
 Abstract
 BACKGROUND
PATIENTS AND METHODS
 RESULTS AND CONCLUSION
 Funding
 Acknowledgements
 References
 
Recently, lifetime and age-conditional probabilities of developing or dying of cancer were introduced as indexes to understand the risk of cancer (1,2). Lifetime probability of developing cancer is defined as the percentage of the population developing cancer at least once in a lifetime. Age-conditional probability of developing cancer is the percentage of the population developing cancer before a specific age, given that the individuals are cancer-free at the current age. Lifetime and age-conditional probabilities of dying of cancer are defined in the same manner as the probability of developing cancer. These indexes are useful for planning, monitoring and evaluating cancer control programs. The details of the mathematical derivation of these probabilities have been previously published by Wun et al. (1) Using the same procedure, the probabilities for the development of cancer in the Japanese population in 1999 were also published by Kamo et al. (2) The purpose of this paper is to update previous estimates by our research group for the development of cancer in 2001 and for dying of cancer in 2005.


   PATIENTS AND METHODS
TOP
 Abstract
 BACKGROUND
 PATIENTS AND METHODS
RESULTS AND CONCLUSION
 Funding
 Acknowledgements
 References
 
Cross-sectional age-stratified incidence, mortality and population are needed to estimate lifetime and age-conditional probabilities of developing cancer. Cancer incidence data were provided by the National Cancer Center (3,4). Mortality and population data were originated from National Vital Statistics provided by the Ministry of Health, Labor and Welfare. These data are stratified by 5-year age intervals 0–4, 5–9, ..., 80–84 and the final open interval 85+. Incidence and mortality rates stratified these intervals were converted to the probabilities using an exponential model and were applied to a cohort of 100 000 live births. Using these probabilities, we estimate the number of cancer incidence, mortality, cancer free and survivor in life table. Then, lifetime probability of developing cancer is calculated dividing the number of incidence in life table by 100 000. Similarly, age-conditional probability of developing cancer is calculated dividing the number of incidence during the considered age interval by the number of cancer free at the beginning of age interval in life table. In the estimation of cancer mortality, we used an ordinary life table, whereas for developing cancer, we used multiple life tables, as proposed by Wun et al. (1) and Kamo et al. (2) Note that our estimates for the probability were based on the assumption that the age-specific incidence or mortality rates will be the same in the future as observed in the calendar year of our source data (2001 for incidence, 2005 for mortality).


   RESULTS AND CONCLUSION
TOP
 Abstract
 BACKGROUND
 PATIENTS AND METHODS
 RESULTS AND CONCLUSION
Funding
 Acknowledgements
 References
 
The lifetime probability of developing cancer in 2001 was estimated to be 49.01% for men and 37.36% for women (Tables 1, 2 and 3). The lifetime probability of dying of cancer in 2005 was estimated to be 26.59% for men and 16.17% for women (Table 4). These probabilities mean that one in two males and one in three females will develop cancer during their lifetime, and one in four males and one in six females will die of cancer. Since the lifetime probability of developing cancer in 1999 was reported to be 46.35% for males and 34.81% for females (2), the increase in incidence was about 3% over 2 years. Furthermore, the lifetime probability of dying of cancer in 1999 was reported to be 29.44% for males and 20.52% for females, so there was a decrease of about 3% during those 6 years. We have reported that since 1975 the lifetime probability of dying of cancer increases and it becomes stable around 1995 (2). The decreasing trend for the lifetime probability of dying in comparison with 1999 and 2005, which is obtained in this paper, may be reflected in the slight decreasing trend of age-adjusted mortality rate. The reason why the lifetime probability corresponding to the age adjusted rate is that the numbers in life table are regarded as the rate per 100 000 adjusted by age distribution.


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  		Table 1. Percent developing cancer before a specific age, for males and females who were cancer-free at current age in Japan in 2001

 

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  		Table 2. Probability of developing cancer in Japan in 2001

 

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  		Table 3. Lifetime probability of developing and dying from cancer and probability of developing cancer, by age, in Japan

 

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  		Table 4. Percent dying from cancer by a specific age, for males and females who were alive at current age in Japan in 2005

 
Age-conditional probabilities of developing and dying of cancer in 2001 and dying of cancer in 2005 are also shown in Tables 1 and 4, respectively. In these tables, ‘Eventually’ means the lifetime probability of those who were cancer-free in Table 1 (or alive in Table 4) at ‘Current age’. For example, a male who was cancer free at 50-year old has 16.42% chance of developing cancer before 70, and such male (cancer free at 50) saddled with 49.79% chance of developing cancer during his lifetime. Table 2 shows the composite life table in 2001, which includes the results for both cancer mortality and incidence in 2001.

Table 3 shows the lifetime probability of developing cancer in 2001 and of dying of cancer in 2005, stratified by primary site. It also illustrates the probability of developing cancer within the following 10 years, which is a useful indication of the short-term risk of cancer (5,6). For example, a 60-year-old man has 2.85% (1 in 35) chance of developing stomach cancer before age 70. This table is ordered by lifetime probability of developing cancer in 2001. The cancer site with the highest lifetime probability in 2001 was stomach for both sexes (males, 10.77%; females, 5.79%). The cancer site with the highest dying probability in 2005 was lung for males (6.23%) and stomach for females (2.21%). The following are the comparisons of the five sites with the highest probability of incidence between 1999 and 2001 and of mortality between 1999 and 2005. The probability of developing cancer for males in 1999 was highest for stomach (10.46%), followed by lung (7.44%), colon (5.25%), liver (3.76%) and prostate (3.26%), and for females, the probability was highest for stomach (5.59%), followed by breast (4.54%), colon (4.40%), lung (3.09%) and uterus (2.39%) (2). So, the sites with the highest probabilities were the same (stomach) between 1999 and 2001. The probability of developing prostate cancer became higher than that of liver cancer for men, and the probability of developing liver cancer became higher than that of uterine cancer for women in 2001. The probability of dying cancer for males in 1999 was highest for lung (6.59%), followed by stomach (5.55%), liver (3.42%), colon (2.04%) and pancreas (1.66%), and for female the probability was highest for stomach (3.37%), followed by lung (2.61%), colon (2.18%), liver (1.76%) and gallbladder (1.60%) (2). Thus, the sites and their order did not change between 1999 and 2005. Here, we must note that the probability is not necessarily in proportion to the number, because the number depends on the current age distribution of population. Actually, the site with the largest number of incidence is breast for female in 2001, but it is the second highest in our estimate of probability of developing cancer (Table 3).

The primary aim of this paper was to estimate lifetime and age-conditional probabilities of developing and dying of cancer. Although the method for deriving these probabilities requires several assumptions (1), these probabilities express the current risk of cancer well. Lifetime or age-conditional probability is a very familiar index for nations, because the risk of cancer can be converted to a percentage for each situation. Especially, the interpretation using the reciprocal number of this probability, for example, one in two males will develop cancer and one in four males will die of cancer during their lifetime, makes the risk for cancer to an intuitively comprehensible form.

In many other countries, these indexes are reported as a useful summary of the cancer risk, for example (5) in Canada and (6) in USA, and quoted in popular press. Moreover by extending the method for estimating probability, we will be able to include several factors which influence on cancer risk, for example smoking status (7). So it is necessary to introduce these useful indexes in Japan, which will contribute Japanese cancer control program and prevention.


   Funding
TOP
 Abstract
 BACKGROUND
 PATIENTS AND METHODS
 RESULTS AND CONCLUSION
 Funding
Acknowledgements
 References
 
This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare, Japan (8–2), and the Foundation for the Promotion of Cancer Research for the Third-Term Comprehensive 10-Year Strategy for Cancer Control. K.K.’s research was supported by the Ministry of Education, Culture, Sports, Science and Technology of Japan, Grant-in-Aid for Young Scientists (B), No. 18790398, 2006–2008.

Conflict of interest statement None declared.


   Acknowledgements
TOP
 Abstract
 BACKGROUND
 PATIENTS AND METHODS
 RESULTS AND CONCLUSION
 Funding
 Acknowledgements
References
 
The authors give thanks to the Research Group for Population-Based Cancer Registration in Japan.


   References
TOP
 Abstract
 BACKGROUND
 PATIENTS AND METHODS
 RESULTS AND CONCLUSION
 Funding
 Acknowledgements
 References
 
1 Wun LM, Merrill RM, Feuer EJ. Estimating lifetime and age-conditional probability of developing cancer. Lifetime Data Anal (1998) 4:169–86.[CrossRef][Web of Science][Medline]

2 Kamo K, Kaneko S, Yoshimura K, Sobue T. Estimating lifetime cancer risk in Japan. Kosei no Sihyou (2005) 52:21–6. (in Japanese).

3 National Cancer Center’s Home Page. Japan: Center for Cancer Control and Information Services, National Cancer Center. (Last updated in 2007). http://ganjoho.ncc.go.jp/professional/statistics/statistics.html.

4 Marugame T, Matsuda T, Kamo K, Katanoda K, Ajiki W, Sobue T, The Japan Cancer Surveillance Research Group. Cancer incidence and incidence rates in Japan in 2001 based on the data from 10 population-based cancer registries. Jpn J Clin Oncol (2007) 37:884–91.[Free Full Text]

5 Canadian Cancer Society/National Cancer Institute of Canada. Canadian Cancer Statistics 2007 (2007) Toronto, Canada.

6 Jemal A, Siegel R, Ward E, Murray T, Xu J Thun M. Cancer statistics, 2007. CA Cancer J Clin (2007) 57:43–66.[Abstract/Free Full Text]

7 Villeneuve PJ, Mao Y. Lifetime probability of developing lung cancer, by smoking status, Canada. Can J Public Health (1994) 85:385–8.[Web of Science][Medline]


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