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Allemani C.,London School of Hygiene and Tropical Medicine | Weir H.K.,Centers for Disease Control and Prevention | Carreira H.,London School of Hygiene and Tropical Medicine | Harewood R.,London School of Hygiene and Tropical Medicine | And 19 more authors.
The Lancet | Year: 2015

Background Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. Methods Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75 000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. Findings 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. Interpretation International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems. Funding Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA). © 2015 Allemani et al. Open Access article distributed under the terms of CC BY.


Inoue M.,Research Center for Cancer Prevention and Screening | Sawada N.,Research Center for Cancer Prevention and Screening | Matsuda T.,Center for Cancer Control and Information Services | Iwasaki M.,Research Center for Cancer Prevention and Screening | And 4 more authors.
Annals of Oncology | Year: 2012

Background: To contribute to evidence-based policy decision making for national cancer control, we conducted a systematic assessment to estimate the current burden of cancer attributable to known preventable risk factors in Japan in 2005. Methods: We first estimated the population attributable fractions (PAFs) of each cancer attributable to known risk factors from relative risks derived primarily from Japanese pooled analyses and large-scale cohort studies and the prevalence of exposure in the period around 1990. Using nationwide vital statistics records and incidence estimates, we then estimated the attributable cancer incidence and mortality in 2005. Results: In 2005, ∼55% of cancer among men was attributable to preventable risk factors in Japan. The corresponding figure was lower among women, but preventable risk factors still accounted for nearly 30% of cancer. In men, tobacco smoking had the highest PAF (30% for incidence and 35% for mortality, respectively) followed by infectious agents (23% and 23%). In women, in contrast, infectious agents had the highest PAF (18% and 19% for incidence and mortality, respectively) followed by tobacco smoking (6% and 8%). Conclusions: In Japan, tobacco smoking and infections are major causes of cancer. Further control of these factors will contribute to substantial reductions in cancer incidence and mortality in Japan. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


Morita T.,Seirei Mikatahara General Hospital | Miyashita M.,Tohoku University | Yamagishi A.,Keio University | Akiyama M.,Keio University | And 8 more authors.
The Lancet Oncology | Year: 2013

Background: Improvement of palliative care is an important public health issue, but knowledge about how to deliver palliative care throughout a region remains inadequate. We used surveys and in-depth interviews to assess changes in the quality of palliative care after regional interventions and to gain insights for improvement of palliative care at a regional level. Methods: In this mixed-methods study, a comprehensive programme of interventions for regional palliative care for patients with cancer was implemented from April 1, 2008, to March 31, 2011 in Tsuruoka, Kashiwa, Hamamatsu, and Nagasaki in Japan. Interventions included education, specialist support, and networking. We surveyed patients, bereaved family members, physicians, and nurses before and after the interventions were introduced. We also did qualitative interviews with health-care professionals after the interventions were introduced. Primary endpoints were numbers of home deaths, coverage of specialist services, and patient-reported and family-reported qualities of care. This trial is registered with UMIN Clinical Trial Registry, Japan (UMIN000001274). Findings: 859 patients, 1110 bereaved family members, 911 physicians, and 2378 nurses provided analysable preintervention surveys; 857 patients, 1137 bereaved family members, 706 physicians, and 2236 nurses provided analysable postintervention surveys. Proportions of home deaths increased significantly, from 348 of 5147 (6·76%) before the intervention programme to 581 of 5546 (10·48%) after the intervention programme (p<0·0001). Furthermore, 194 of 221 (87·78%) family members of patients who died at home answered that these patients had wanted to die at home. The ratio of patients who received palliative care services to all patients who died of cancer increased significantly (from 0·31 to 0·50; p<0·0001). The patient-reported (effect size 0·14; adjusted p=0·0027) and family-reported (0·23; p<0·0001) qualities of care were significantly better after interventions than before interventions. Physician-reported and nurse-reported difficulties decreased significantly after the introduction of the interventions. Qualitative interviews showed improved communication and cooperation between health-care professionals because of greater opportunities for interactions at various levels. Interpretation: A regional programme of interventions could improve the quality of palliative care. Improvement of communication between health-care professionals is key to improvement of services. Funding: Third Term Comprehensive Control Research for Cancer Health and Labor Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan. © 2013 Elsevier Ltd.


Katanoda K.,Center for Cancer Control and Information Services | Jiang Y.,U.S. Center for Disease Control and Prevention | Park S.,Yonsei University | Lim M.K.,National Cancer Control Institute | And 2 more authors.
Tobacco Control | Year: 2014

East Asia is one of the world's largest tobacco epidemic regions. Although several international studies have evaluated the status of tobacco control in this region, the findings have not been integrated with knowledge on domestic activities at the national and municipal levels. We analysed the current tobacco control situation in three East Asian countries, Japan, China and the Republic of Korea, using both international and domestic data sources. We collected data between 2008 and 2011 in each country according to the framework of WHO's MPOWER (Monitoring, Protect, Offer, Warn, Enforcement and Raise) approach for guiding implementation of the WHO Framework Convention on Tobacco Control. Analysis revealed that 37-53% of adult men were current smokers and that smoking prevalence among middle-aged men reached 63%. Less than 20% of male smokers plan to quit and the use of nicotine replacement drugs was 14% at maximum. Forty-six percent or more of men and 20% or more of women were exposed to passive smoking at workplaces and at home, respectively. Many tobacco industry activities remain unrestricted and prevalent. Our findings indicate an urgent need for the following set of policies: raise cigarette prices to increase the quit attempt rate, particularly among adult men; develop a multicomponent quitting assistance system to provide adequate assistance for smoking cessation; implement effective smoke-free policies in workplaces and public places to reduce exposure to passive smoking; and rebuild the administrative structure to denormalise tobacco industry activities. The importance of these standard approaches should be reaffirmed by all tobacco control policymakers in East Asia.


Matsuda A.,Center for Cancer Control and Information Services | Matsuda T.,Center for Cancer Control and Information Services | Shibata A.,Center for Cancer Control and Information Services | Katanoda K.,Center for Cancer Control and Information Services | And 2 more authors.
Japanese Journal of Clinical Oncology | Year: 2014

The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2008 based on data collected from 25 of 34 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan project. The incidence in Japan for 2008 was estimated to be 749 767 (C00-C96). Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively. © The Author 2014. Published by Oxford University Press. All rights reserved.


Sobue T.,Center for Cancer Control and Information Services
Fukushima journal of medical science | Year: 2011

When evaluating cancer risk of low-dose radiation, it is difficult to distinguish the actual effect from that of chance, bias, and confounding as they become relatively large. This is why the relation between radiation doses of less than 100 mSv and cancer risk is considered unknown. Based on data of atomic bomb survivors in Hiroshima and Nagasaki, the cancer risk at 100 mSv is calculated at 1.05 times. On the other hand, the risk ratio for the relation between passive smoking and lung cancer is estimated at approximately 1.3 and judging the actual effects faced difficulties. It is almost impossible for epidemiology research alone to show that the risk ratio of 1.05 is the actual effects of radiation. The ICRP estimation, " exposure to 100 mSv increases cancer risk by 0.5%" , has been frequently cited, however, it is not a simple excess lifetime risk of death. It will be more appropriate to indicate a value with clear definition to people in general, such as excess lifetime risk of death or excess lifetime risk of morbidity rather than the value obtained from such complicated process. Radiation epidemiology equally uses ratio and difference to indicate degrees of risk increase. Difference largely changes depending on effects of background factors whereas ratio is often relatively stable. Therefore the use of ratio would be more appropriate when comparing other cancer risk factors.


Matsuda A.,Center for Cancer Control and Information Services | Matsuda T.,Center for Cancer Control and Information Services | Shibata A.,Center for Cancer Control and Information Services | Katanoda K.,Center for Cancer Control and Information Services | And 2 more authors.
Japanese Journal of Clinical Oncology | Year: 2013

The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2007 based on data collected from 21 out of 33 population-based cancer registries as part of the Monitoring of Cancer Incidence in Japan (MCIJ) project. The total number of incidences in Japan for 2007 was estimated to be 704 090 (C00-C96). Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively. © 2013 The Author. Published by Oxford University Press. All rights reserved.


Mizota Y.,Center for Cancer Control and Information Services | Yamamoto S.,Center for Cancer Control and Information Services
Japanese Journal of Clinical Oncology | Year: 2012

Objective: Breast cancer is the most common type of cancer in women worldwide. Although the incidence of breast cancer is still on an increasing trend, there are few studies concerning breast cancer risk factors in Japan. Therefore, we conducted an Internet survey investigating the prevalence of risk factors for breast cancer. Methods: We conducted an Internet survey using opt-in panels in women aged from 20 to 70 years. The survey items consisted of potential and proven risk factors for breast cancer such as age at menarche, menopausal status, premenopausal use of oral contraceptives, postmenopausal use of hormones, parity, height, alcohol consumption and family history of breast cancer. Results: Subjects comprised 2002 persons who were matched for sex, age and residential area with the National Census in 2005. Statistically significant trends were observed for most factors: age at menarche is becoming lower, age at first birth is higher, height is higher, the proportion of women who have given birth is smaller and the proportion of women who drink alcohol is larger. Conclusions: We showed a clear increase in the prevalence of risk factors for breast cancer. Based on the results, the incidence of breast cancer in Japan may be increasing for at least a few decades. © The Author 2012. Published by Oxford University Press. All rights reserved.


Nakahara S.,Mariana University | Katanoda K.,Center for Cancer Control and Information Services | Ichikawa M.,University of Tsukuba
Journal of Epidemiology | Year: 2013

Background: In Japan, introduction of severe drunk-driving penalties and a lower blood alcohol concentration (BAC) limit in June 2002 was followed by a substantial reductionin fatal alcohol-related crashes. However, previous research suggests that this reductionstarted before the legal amendments. The causes of the decrease have not been studied in detail. Methods: Monthly police data on fatal road traffic crashes from January 1995 to August 2006 were analyzed using a joinpoint regression model to identify change-points in the trends of the proportion of drunk-driving among drivers primarily responsible for fatal crashes. We analyzed the data by BAC level (=0.5 or <0.5 mg/ml), then conducted analyses stratified by vehicle type (car or motorcycle) and age group (<45 or =45 years) only for the proportion of those with a BAC of 0.5 mg/ml or higher. Results: Among all drivers,the proportion of those with a BAC of 0.5 mg/ml or higher and those with a BAC greater than 0 but less than 0.5 mg/ml showed a change-point from increase to decrease in February 2000 and in May 2002, respectively. The proportion of those with a BAC of 0.5 mg/ml or higher showed a change-point from increase to decrease in October 1999 among car drivers and in April 2000 among drivers younger than 45 years. There was no change-point among motorcyclists. A change-point from no trend to a decrease in January 2002 was observed among those 45 years or older. Conclusions: The change-point identified around the end of 1999 to the start of 2000 suggests that a high-profile fatal crash in November 1999, which drew media attention and provoked public debate, triggered subsequent changes in drunk-driving behavior. © 2013 Japan Epidemiological Association.


Matsuda T.,Center for Cancer Control and Information Services | Marugame T.,Center for Cancer Control and Information Services | Kamo K.-I.,Sapporo Medical University | Katanoda K.,Center for Cancer Control and Information Services | And 2 more authors.
Japanese Journal of Clinical Oncology | Year: 2011

The Japan Cancer Surveillance Research Group estimated the cancer incidence in 2005 as part of the Monitoring of Cancer Incidence in Japan (MCIJ) project, on the basis of data collected from 12 of 30 population-based cancer registries. The total number of incidences in Japan for 2005 was estimated as 646 802 (C00-C96). The leading cancer site was the stomach for men and the breast for women. Age-standardized incidence rates remained almost the same level as the previous 2 years. © The Author (2010). Published by Oxford University Press. All rights reserved.

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