The Japan Cancer Surveillance Report: Incidence of Childhood, Bone, Penis and Testis Cancers

The Japan Cancer Surveillance Research Group and the Research Group for Population-based Cancer Registration in Japan have estimated cancer incidences in Japan from 1975 to 2000 based on selected population-based cancer registries (1). However, these estimations were restricted to major cancer sites. Neither more detailed sites nor histological type have yet been reported, although these analyses are of clinical interest. Our research group collected data on newly diagnosed cancers between 1993 and 2001 from 15 population-based cancer registries in Japan (Miyagi, Yamagata, Chiba (model area), Kanagawa, Niigata, Fukui, Aichi, Shiga, Osaka, Tottori, Okayama, Saga, Nagasaki, Kumamoto and Okinawa) (1). Detailed analysis of cancer, including rare sites, became possible based on approximately 1.37 million cases of cancer incidence over 9 years. This article briefly reports on childhood cancers and histological types of bone, penis and testis cancer. For each site, we calculated the proportion of cases with death certificate only (DCO), then excluded registries with high proportions of DCO (Tottori and Kumamoto were excluded from the analysis of childhood cancer and bone cancer). Data from Okayama prefecture with diagnosis years of 1993–1995 were excluded because registered cases in this period were restricted to stomach, lung, colon, rectum, breast and uterus cancer. Incidences of childhood cancer according to International Classification of Childhood Cancer (ICCC), 3rd edition (2) criteria were reported (Table 1). Between 1993 and 2001, a total of 5106 children (2890 boys, 2216 girls) aged 0–14 years and 7114 children (4006 boys, 3198 girls) aged 0–19 years were registered in 13 population-based cancer registries. The proportion of DCO was 7.1% for children aged 0–14 years and 7.6% for children aged 0–19 years. Among children aged 0–14 years, incidence of total cancer was 103.7 per million for boys and 80.1 per million for girls. The most frequent tumors were leukemias, myeloproliferative diseases and myelodysplastic diseases (leukemia) (boys, 34.2%; girls, 34.4%), central nervous system (CNS) and miscellaneous intracranial and intraspinal neoplasms (brain and CNS) (boys, 14.6%; girls, 16.9%) and neuroblastoma and other peripheral nervous cell tumors (neuroblastoma) (boys, 12.8%; girls, 11.4%). Among children aged 0–19 years, incidence of total cancer was 101.4 per million for boys and 79.4 per million for girls. The most frequent tumors were leukemia (31.9%), brain and CNS (14.0%) and lymphomas and reticuloendothelial neoplasms (12.1%) for boys, and leukemia (30.7%), brain and CNS (14.8%) and germ cell tumors, trophoblastic tumors and neoplasms of the gonads (9.4%) for girls. Number and incidence rates in children under 15-years-old and under 20-years-old by International Classification of Childhood Cancer (ICCC), 3rd edn, criteria in 13 Japanese population-based cancer registries, 1993–2001 ICCC, International Classification of Child hood Cancer; CNS, central nervous system. Number and incidence rates in children under 15-years-old and under 20-years-old by International Classification of Childhood Cancer (ICCC), 3rd edn, criteria in 13 Japanese population-based cancer registries, 1993–2001 ICCC, International Classification of Child hood Cancer; CNS, central nervous system. We further estimated the number of childhood cancers by ICCC group in Japan for ages of 0–14 and 0–19 years in 2000 (Table 2). The aggregate number of incidences for these ages were calculated from the sum of the number of incidences for four age groups (0–4, 5–9, 10–14 and 15–19 years), estimated on the basis of multiplying the incidence rate of each age group by each population in 2000 from the Japanese Population Census Report. The number of childhood cancer cases in Japan in 2000 was estimated as 977 boys and 718 girls for 0–14 year-olds and 1342 boys and 1000 girls for 0–19 year-olds. Estimated number of annual incidence of childhood cancers in Japan, 2000 Estimated number of annual incidence of childhood cancers in Japan, 2000 A total of 2022 primary cancer cases (1159 males, 863 female) with International Classification of Diseases for Oncology, 3rd edn (ICD-O-3) site codes of C40 (limbs) or C41 (other unspecified sites) were identified. Of these, 634 cases (31.4%) displayed ICD-O-3 histological code 8000 (neoplasm, malignant, NOS) and 30 cases (1.5%) displayed histological code 8800 (sarcoma NOS). From the total of 2022 cases, we extracted 1268 cases (730 males, 538 females) with histological codes listed in the section of ‘bone’ in the AJCC Cancer Staging Manual (3). The DCO proportion of extracted cases was 25.8%. We report the distributions of age at diagnosis and histological type for these 1268 cases. Table 3 shows the distribution of histological type for primary bone cancer in 13 Japanese population-based cancer registries for 1993–2001. Distributions of histological type were similar for both sexes. Osteosarcoma was the most frequent histological type, accounting for approximately 40%. Chondrosarcoma was the second-most frequent, accounting for approximately 25%. Ewing sarcoma was the third-most frequent, accounting for approximately 10%. These three major histological types covered approximately three-quarters of all bone cancer cases. Malignant fibrous histocytoma and giant cell tumor accounted for approximately 6 and 2%, respectively. Distribution of histological type of primary bone cancer in 13 Japanese population-based cancer registries, 1993–2001 Distribution of histological type of primary bone cancer in 13 Japanese population-based cancer registries, 1993–2001 Table 4 shows the distribution of age at diagnosis for bone cancer and three selected histological types of bone cancer: osteosarcoma, chondrosarcoma and Ewing sarcoma. The most common age group was 10–24 years for overall bone cancer, osteosarcoma and Ewing sarcoma. Ewing sarcoma was more clearly skewed to these age groups than osteosarcoma. In contrast, the most frequent age group for chondrosarcoma was 40–79 years and a more even distribution across young and old age groups was seen compared to osteosarcoma and Ewing sarcoma. No clear sex differences were seen in the distribution of age at diagnosis for bone cancer. Distribution of age at diagnosis for primary bone cancer and selected histological types in 13 Japanese population-based cancer registries, 1993–2001 Distribution of age at diagnosis for primary bone cancer and selected histological types in 13 Japanese population-based cancer registries, 1993–2001 We used data from all 15 registries for penis (C60) and testis (C62) cancer according to ICD-O-3 codes. Cancer cases were classified according to International Union Against Cancer (UICC) criteria. Totals of 675 cases and 2694 cases were registered for penis and testis cancer during the study period, respectively. The proportion of DCO was 13.3% for penis cancer. The=age-standardized incidence rate (standard population: the world population) (ASR) was 0.2 per 100,000 males. The most frequent morphology was squamous cell carcinoma (79.1%), followed by precursor legions (15.3%) such as Paget disease and Bowen disease, with unclassified cases removed (Table 5). Number of cases of penis tumor according to histological type in 15 Japanese population-based cancer registries, 1993–2001 Number of cases of penis tumor according to histological type in 15 Japanese population-based cancer registries, 1993–2001 The ASR of testis cancer was 1.3 per 100,000 males. The proportion of DCO was 4.9%. The 409 testis cancer cases were histologically unclassified. The ratio of germ-cell tumors to non-germ-cell tumors was 95:5 among the remaining 2285 cases (Table 6). About 70% of germ-cell tumors were seminomas, with the other 30% described as non-seminomatous germ-cell tumors. In men > 30-years-old, the major histological type of testis cancer was seminoma. Non-seminomatous germ-cell tumors predominates in young cases < 30-years-old and frequent histologies comprised embryonal carcinoma (35.6%), mixed germ cell tumor (28.0%) and yolk sac tumor (22.0%). Number of cases of testis tumor according to histological type in 15 Japanese population-based cancer registries, 1993–2001 Number of cases of testis tumor according to histological type in 15 Japanese population-based cancer registries, 1993–2001 The survey on cancer incidence in Japan was conducted with contributions from 15 registries: Miyagi (Dr D. Shibuya); Yamagata (Dr A. Shibata); Chiba (Dr H. Mikami); Kanagawa (Dr N. Okamoto); Niigata (Dr K. Ogoshi); Fukui (Dr M Fujita); Aichi (Dr H. Ito); Shiga (Dr K. Mizuta); Osaka (Dr A. Oshima); Tottori (Dr T. Kishimoto); Okayama (Dr H. Kasai); Saga (Dr K. Kosa); Nagasaki (Dr M. Soda); Kumamoto (Dr A. Higashi); and Okinawa (Ms K. Nakahodo). This study was supported by the 3rd-term Comprehensive Ten-year Strategy for Cancer Control. None declared.