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. 2016 Nov 5;26(11):579-586.
doi: 10.2188/jea.JE20150257. Epub 2016 Apr 30.

Trends in Lung Cancer Incidence Rates by Histological Type in 1975-2008: A Population-Based Study in Osaka, Japan

Fukuaki Lee Kinoshita  1 , Yuri Ito, Tomio Nakayama
Affiliations

Trends in Lung Cancer Incidence Rates by Histological Type in 1975-2008: A Population-Based Study in Osaka, Japan

Fukuaki Lee Kinoshita et al. J Epidemiol. .

Abstract
in English, Japanese

Background: Monitoring trends in lung cancer incidence and mortality is important for the evaluation of cancer control activities. We investigated recent trends in age-standardized incidence rates by histological type of lung cancer in Osaka, Japan.

Methods: Cancer incidence data for 1975-2008 were obtained from the Osaka Cancer Registry. Lung cancer mortality data with population data in Osaka during 1975-2012 were obtained from vital statistics. We examined trends in age-standardized incidence and mortality rates for all histological types and age-standardized incidence rates by histological type and age group using a joinpoint regression model.

Results: The age-standardized incidence rate of lung cancer levelled off or slightly increased from 1975-2008, with an annual percentage change of 0.3% (95% confidence interval [CI], 0.1%-0.4%) for males and 1.1% (95% CI, 0.9%-1.3%) for females, and the mortality rate decreased by 0.9% (95% CI, 1.2%-0.7%) for males and 0.5% (95% CI, 0.8%-0.3%) for females. The incidence rates of squamous cell carcinoma (SQC) and small cell carcinoma (SMC) significantly decreased for both genders, whereas that of adenocarcinoma (ADC) significantly increased among almost all age groups in both genders.

Conclusions: The incidence rates of SQC and SMC decreased with the decline in smoking prevalence, which probably explains the change in trends in the incidence rates of lung cancer from the mid-1980s. However, the reason for the increase in ADC remains unclear. Therefore, trends in incidence rates of lung cancer should be carefully monitored, especially for ADC, and the associations between ADC and its possible risk factors should be studied.

背景：: 肺がんの罹患率や死亡率の傾向を調査することは現状のがん対策を評価していく上で重要である。本研究では、大阪府における肺がんの組織型別罹患率の推移を調査した。

方法：: 肺がんの罹患については大阪府がん登録より1975～2008年診断分のデータを入手した。肺がんの死亡については人口動態統計より1975～2012年死亡分のデータを入手した。joinpoint regression model を用いて、肺がん全体の年齢調整罹患率と年齢調整死亡率、また、組織型別、年齢区分別の年齢調整罹患率の推移を解析した。

結果：: 肺がんの年齢調整罹患率は男性においては年平均変化率0.3% (95%信頼区間: 0.1～0.4%)で横ばい、もしくは、わずかに増加していたが、女性においては1.1% (95%信頼区間: 0.9～1.3%)で増加していた。年齢調整死亡率は男性においては－0.9%で、女性においては－0.5%で減少していた。組織型別の解析では、扁平上皮癌と小細胞癌は男女ともに有意に減少していたが、腺癌は男女ともにほとんどすべての年齢区分で有意に増加していた。

結論：: 扁平上皮癌と小細胞癌の罹患率は喫煙率の減少とともに減少しており、それがおそらく、1980年代半ば以降における肺がん全体の罹患率の傾向の変化と関係していると考えられる。しかし、腺癌が増加している原因はよくわかっていない。したがって、これからも肺がんの罹患率の傾向、特に腺癌の傾向を調査し、腺癌とその危険因子との関係を明らかにしていく必要がある。

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Figures

Figure 1.
Figure 1.. Trends in age-standardized incidence and mortality rates for lung cancer in Osaka, Japan from 1975 to 2008.
Figure 2.
Figure 2.. Trends in age-standardized incidence rates of lung cancer by histological type in Osaka, Japan 1975 to 2008. ADC, adenocarcinoma; SMC, small cell carcinoma; SQC, squamous cell carcinoma.
See this image and copyright information in PMC

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