Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
Jpn J Clin Oncol. 2013 May;43(5):492-507. doi: 10.1093/jjco/hyt038. Epub 2013 Mar 14.
The analysis of cancer trends in Japan has only been sporadically reported. We present a comprehensive report on the trends in cancer incidence and mortality in Japan using the most recent population-based data.
National cancer mortality data between 1958 and 2011 were obtained from published vital statistics. Cancer incidence data between 1985 and 2007 were obtained from high-quality population-based cancer registries of four prefectures (Miyagi, Yamagata, Fukui and Nagasaki). Joinpoint regression analysis was performed to examine the trends in age-standardized rates of cancer incidence and mortality.
All-cancer mortality decreased from the mid-1990s, with an annual percent change of -1.3% (95% confidence interval: -1.4, -1.3), while all-cancer incidence continually increased from 1985, with an annual percent change of 0.7% (95% confidence interval: 0.6, 0.8). Major cancer sites, particularly the liver, colorectum and lung (males), showed a pattern of increasing incidence and mortality rates until the mid-1990s, stabilizing or decreasing thereafter. Stomach cancer showed a long-term decreasing trend for both incidence and mortality, while female breast cancer showed a continuously increasing trend. The incidence of prostate cancer, particularly at the localized stage, increased rapidly between 2000 and 2003, while that of mortality decreased from 2004. No changes were detected in the incidence or mortality for colorectal, female breast or cervical cancers after the establishment of national screening programs for these cancers.
The analysis of cancer trends in Japan revealed a recent decrease in mortality and a continuous increase in incidence, which are considered to reflect changes in the underlying risk factors such as tobacco smoking and infection, and are partially explained by early detection and improved treatment.
日本的癌症趋势分析仅零星报道过。我们利用最新的基于人群的数据，全面报告日本癌症发病率和死亡率的趋势。
从已公布的生命统计数据中获取 1958 年至 2011 年全国癌症死亡率数据。从四个县（宫城、山形、福井和长崎）高质量的基于人群的癌症登记处获取 1985 年至 2007 年的癌症发病率数据。采用 Joinpoint 回归分析，检验癌症发病率和死亡率的年龄标准化率的变化趋势。
所有癌症的死亡率从 20 世纪 90 年代中期开始下降，年变化百分比为-1.3%（95%置信区间：-1.4，-1.3），而所有癌症的发病率从 1985 年开始持续上升，年变化百分比为 0.7%（95%置信区间：0.6，0.8）。主要癌症部位，特别是肝脏、结直肠和肺（男性），在 20 世纪 90 年代中期之前呈现出发病率和死亡率上升的趋势，此后稳定或下降。胃癌的发病率和死亡率呈长期下降趋势，而女性乳腺癌则呈持续上升趋势。前列腺癌的发病率，特别是局部阶段的发病率，在 2000 年至 2003 年间迅速上升，而死亡率从 2004 年开始下降。在这些癌症的国家筛查计划实施后，结直肠癌、女性乳腺癌或宫颈癌的发病率或死亡率没有变化。
对日本癌症趋势的分析表明，死亡率最近有所下降，而发病率持续上升，这被认为反映了吸烟和感染等潜在危险因素的变化，部分原因是早期发现和治疗的改善。
