EPIDEMIOLOGY OF BLADDER CANCER DEATHS IN JAPAN

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  • Epidemiology of Bladder Cancer Deaths i

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To explore epidemiological and etiological implications of bladder cancer mortality in Japan, national mortality statistics for 1947∼74 were analysed. Age-adjusted death rate for bladder cancer was on the upward trend in both sexes prior to early 1960's, after which the rate, however, leveled off in males and even on the downward trend in females. The mortality trend of leveling off or down has been already demonstrated in Western countries in much earlier years than in Japan. Almost identical risks for bladder cancer deaths were noted in males born after 1910 and in females born after 1900. The following facts were also revealed: Apparent decrease in bladder cancer deaths among younger population and increase in much older age groups, delay in mean age at death from bladder cancer for 5.7 years in males and 12.7 years in females for the intervening 28 years, virtually unchanged age-specific death rate in males aged below 65 years and its distinct decline in females similarly aged, no definite geographic gradients of standardized mortality ratio over years, and no apparent clustering of high ratios in the prefectures with many highly industrialized areas and large cities, along the Pacific coast. These relevant findings with recent bladder cancer mortality are rather incompatible with the recent remarkable increases in potentially hazardous agents in the environment in Japan. Since bladder cancer is one of the few malignant neoplasms in which the rôle of environmental and occupational agents has been clearly shown to be important, the present fingings might possibly indicate the relative importance of inherent host factors and unidentified environmental factors in bladder cancer. Such a hypothetical concept was further endorsed by the very consistent proportion, over years and over districts, of bladder cancer death in the deaths from cancer of all urinary organs. Further studies on inherent host factors in bladder cancer were emphasized, possibly in the light of the relationship between carcinogenesis and enzyme system in the human body.

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