Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.
Cancer Sci. 2012 Feb;103(2):360-8. doi: 10.1111/j.1349-7006.2011.02145.x. Epub 2011 Dec 15.
Population-based cancer registries are operated by over 80% of prefectures in Japan. However, only a limited proportion of the registries can provide long-term incidence data. Here, we aimed to establish a method for monitoring cancer incidence trends in Japan using data from selected prefectures. Based on the availability of long-term (≥ 20 years) high-quality data, we collected incidence data from five prefectures (Miyagi, Yamagata, Fukui, Osaka, and Nagasaki), which included an annual average of 54,539 primary cancer cases diagnosed between 1985 and 2004. Cancer mortality data for 1995-2004 were obtained from the vital statistics. Representativeness and homogeneity of the trends were examined by funnel plot analysis of log-linear regression coefficients calculated for the most recent 10 years of data (1995-2004) of age-standardized rates (ASR). The ASR of incidence for five prefectures in total (5-pref total) showed a significant decrease, with an annual percent change (APC) of -1.0 (95% confidence interval [CI] -1.4: -0.6) for males and -0.4 (95% CI -0.8: -0.1) for females. Excluding data from Osaka (4-pref total) reversed the decreasing trend; the corresponding APC was +0.4 (95% CI -0.2: +1.0) for males and +0.7 (95% CI +0.5: +0.9) for females. The APCs for the ASR of mortality for the 4-pref total (males, -1.5; females, -1.3) were more representative of nationwide data (males, -1.4 [95% CI -1.7: -1.2]; females, -1.1 [95% CI -1.4: -0.9]) than those for the 5-pref total (males, -1.7; females, -1.4). We conclude that using data from Miyagi, Yamagata, Fukui, and Nagasaki prefectures, with continuous monitoring of the representativeness of the data, is a provisionally relevant way to evaluate cancer incidence trends in Japan.
基于人群的癌症登记由日本超过 80%的县运营。然而，只有有限比例的登记处能够提供长期发病率数据。在这里，我们旨在建立一种使用选定县的数据监测日本癌症发病率趋势的方法。基于长期（≥ 20 年）高质量数据的可用性，我们从五个县（宫城、山形、福井、大阪和长崎）收集了发病率数据，其中包括 1985 年至 2004 年期间每年平均诊断的 54539 例原发性癌症病例。1995-2004 年的癌症死亡率数据来自生命统计数据。通过对最近 10 年（1995-2004 年）年龄标准化率（ASR）的对数线性回归系数进行漏斗图分析，检查了趋势的代表性和同质性。五个县的总发病率 ASR（5 县总）显示出显著下降，男性的年变化百分比（APC）为-1.0（95%置信区间[CI]为-1.4：-0.6），女性为-0.4（95% CI -0.8：-0.1）。排除大阪的数据（4 县总）改变了下降趋势；男性对应的 APC 为+0.4（95% CI -0.2：+1.0），女性为+0.7（95% CI +0.5：+0.9）。4 县总死亡率 ASR 的 APC（男性，-1.5；女性，-1.3）比全国数据（男性，-1.4 [95% CI -1.7：-1.2]；女性，-1.1 [95% CI -1.4：-0.9]）更具代表性。我们得出的结论是，使用宫城、山形、福井和长崎县的数据，并持续监测数据的代表性，是评估日本癌症发病率趋势的一种临时相关方法。
