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