Elsevier

Oral Oncology

Volume 35, Issue 1, January 1999, Pages 9-16
Oral Oncology

Trends in site-specific mortality from oral and pharyngeal cancer among Japanese males, 1950–94

https://doi.org/10.1016/S1368-8375(98)00038-4Get rights and content

Abstract

In order to obtain some etiological clues for oral and pharyngeal cancer in Japanese males, we examined mortality trends from cancer of the lip, buccal cavity and pharynx by site with other descriptive epidemiological features (1950–94). The data were obtained from Vital Statistics (Ministry of Health and Welfare, Japan). The 45-year trend in mortality was evaluated by computing crude and age-adjusted mortality rates, age-specific mortality rates, with birth cohort analysis. The crude mortality rate from cancer of the lip, buccal cavity and pharynx has increased by 3.7-fold, and age adjusted mortality rate by 1.7-fold in the 45-year period, with different mortality trends by site. In general, age-specific mortality has also been increasing with advancing age. The birth cohort analysis showed that the higher the mortality rate, the younger the birth cohort, but with different effects of birth cohort by site. Mortality from cancer of the lip, buccal cavity and pharynx has consistently been increasing in Japanese males from 1950 to 1994, with similar upward mortality trends for some specific sites.

Introduction

Mortality from cancer of the lip, buccal cavity and pharynx, hereafter denoted as oral and pharyngeal cancer, is relatively low in Japanese males as compared to those among the developed countries[1], since the age-adjusted mortality rates were 15.0, 15.6, 11.1 and 14.5 per 100 000 of the population in 1983–87 in males in France, Hong Kong, Hungary and Singapore, respectively, whereas it was only 3.5 in Japan.

In Japan, oral and pharyngeal cancer deaths numbered 2408 in males and 859 in females in 1994, a 5.6-fold and 3.2-fold increase when compared with 1950s figures[2]. The age-adjusted mortality rates have gradually increased in males (1.3–2.1 in 1953–57 to 1983–87), while there was an almost unaltered mortality trend in females in the same period[1]. The trends in mortality from oral and pharyngeal cancer are different for many countries: France, Hungary and Singapore have an increasing mortality in males (6.7, 4.1 and 12.7 per 100 000 in 1953–57), but for Hong Kong, in spite of a high mortality rate, it was almost unaltered in males (15.2 and 15.6 per 100 000 in 1953–57 and 1983–87). In US males, the mortality declined in whites and increased in non-whites (4.8–3.6 and 4.5–7.1 per 100 000 from 1953–57 to 1983–87)[1].

According to the International Classification of Diseases and Injuries (ICD: 9th revision) the lip, buccal cavity and pharynx included such sites as the lip, tongue, salivary gland, gum, floor of mouth, unspecified parts of mouth, oropharynx, nasopharynx, hypopharynx, and ill-defined parts within the lip, buccal cavity and pharynx. This indicates that oral and pharyngeal cancer mortality itself would probably be affected by changing mortality rates from these various sites. The authors, then, attempt in this paper to examine the time trend in mortality from oral and pharyngeal cancer by separate site and combination in Japanese males.

Section snippets

Materials and methods

Annual number of population by 5-year age group and of certified death from oral and pharyngeal cancer by site for 5-year age group was obtained from national population census data and mortality statistics which have been routinely published by the Ministry of Health and Welfare of Japan[2]

Based on these data for males, crude and age-adjusted mortality rates, and age-specific mortality rates were calculated, and birth cohort analysis for oral and pharyngeal cancer mortality were undertaken by

Annual numbers of deaths and proportion in total male cancer deaths (Table 2)

Annual numbers of oral and pharyngeal cancer death have changed from only 432 in 1950 to 2408 in 1994. The proportion of oral and pharyngeal cancer deaths among total male cancer deaths decreased from 1.24% in 1950 to 0.91% in 1966, but increased consistently thereafter to 1.60% in 1994. The mean age at death increased by 5.9 years from 59.0 years in 1950 to 64.9 years in 1994.

Crude and age-adjusted mortality (Fig. 1)

The crude mortality rate from oral and pharyngeal cancer was unaltered from 1950–54 (1.02 per 100 000) to 1955–59, but

Discussion

Several investigations on mortality from oral and pharyngeal cancer have been reported in countries other than Japan4, 5, 6, 7, 8, 9. The findings were somewhat different from country to country and area to area. Our study revealed a distinctly increasing trend in mortality from oral and pharyngeal cancer (the malignant neoplasms of the lip, buccal cavity and pharynx) and some different trends by separate site among Japanese males in 1950–94, i.e. an increase in mortality from such separate

References (25)

  • N.E Breslow et al.

    Indirect standardization and multiplicative methods for rates, with reference to the age adjustment of cancer incidence and relative frequency data

    Journal of Chronic Diseases

    (1975)
  • Aoki K., Kurihara M., Hayakawa N., Suzuki S. Death rates for malignant neoplasms for selected sites by sex and...
  • Ministry of Health and Welfare, Vital Statistics of Japan, 1950 to 1991. Tokyo, Health and Welfare Statistical...
  • H.I Goldberg et al.

    Trends and differentials in mortality from cancers of the oral cavity and pharynx in the United States, 1973–1987

    Cancer

    (1994)
  • G.L Abente et al.

    Female mortality trends in Spain due to tumors associated with tobacco smoking

    Cancer Causes and Control

    (1993)
  • G.J Macfarlane et al.

    Rising trends of oral cancer mortality among males worldwide: the return of an old public health problem

    Cancer Causes and Control

    (1994)
  • G.J Macfarlane et al.

    Oral cancer in Scotland: changing incidence and mortality

    British Medical Journal

    (1992)
  • J.K Chen et al.

    Epidemiology of oral cancer in Connecticut, 1935 to 1985

    Cancer

    (1990)
  • T Bundgaard et al.

    Case-control study of squamous cell cancer of the oral cavity in Denmark

    Cancer Causes and Control

    (1995)
  • Ohno, Y., Wakai, K. Descriptive epidemiology of prostate cancer in Japan. Fundamental approaches to the diagnosis and...
  • Tominaga, S., Aoki, K. Cancer Mortality and Morbidity Statistics, Japan and the World—1994. Tokyo: Japan Scientific...
  • R Talamini et al.

    The Role of alcohol in oral and pharyngeal cancer in non-smokers, and of tobacco in non-drinkers

    International Journal of Cancer

    (1990)
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