Epidemiology of Esophageal Cancer in Japan and China

Yingsong Lin,Shogo Kikuchi,Youlin Qiao,Yutong He,Yukari Totsuka,Junko Ueda,Wenqiang Wei,Hideo Tanaka,Manami Inoue

doi:10.2188/jea.je20120162

Abstract

In preparation for a collaborative multidisciplinary study of the pathogenesis of esophageal cancer, the authors reviewed the published literature to identify similarities and differences between Japan and China in esophageal cancer epidemiology. Esophageal squamous cell carcinoma (ESCC) is the predominant histologic type, while the incidence of esophageal adenocarcinoma remains extremely low in both countries. Numerous epidemiologic studies in both countries show that alcohol consumption and cigarette smoking are contributing risk factors for ESCC. There are differences, however, in many aspects of esophageal cancer between Japan and China, including cancer burden, patterns of incidence and mortality, sex ratio of mortality, risk factor profiles, and genetic variants. Overall incidence and mortality rates are higher in China than in Japan, and variation in mortality and incidence patterns is greater in China than in Japan. During the study period (1987–2000), the decline in age-adjusted mortality rates was more apparent in China than in Japan. Risk factor profiles differed between high- and low-incidence areas within China, but not in Japan. The association of smoking and drinking with ESCC risk appears to be weaker in China than in Japan. Genome-wide association studies in China showed that variants in several chromosome regions conferred increased risk, but only genetic variants in alcohol-metabolizing genes were significantly associated with ESCC risk in Japan. A well-designed multidisciplinary epidemiologic study is needed to examine the role of diet and eating habits in ESCC risk.

Highlights

Since the signing in November 2008 of a memorandum between the Ministry of Health (China) and the Ministry of Health, Labour and Welfare (Japan), the National Cancer Center (Tokyo) and Chinese Academy of Medical Sciences (Beijing) have each assembled a research group to facilitate collaboration on cancer epidemiology, prevention, and control
After literature review and mutual field visits, the 2 research groups have reached an agreement on conducting a multidisciplinary study of the pathogenesis of esophageal and gastric cardia cancer in Hebei Province, China, a region that contains areas with some of the highest incidences of esophageal cancer in the world
Summary relative risk (RR) for ever smokers was 3.01, based on 4 cohort and 11 case-control studies [Ref 19] Summary RR for ever drinkers was 3.30, based on 9 cohort and 9 case-control studies [Ref 18] Positive associations observed in 3 clinical studies [Refs 42–44], but no prospective cohort studies confirmed these associations

Summary

Introduction

Since the signing in November 2008 of a memorandum between the Ministry of Health (China) and the Ministry of Health, Labour and Welfare (Japan), the National Cancer Center (Tokyo) and Chinese Academy of Medical Sciences (Beijing) have each assembled a research group to facilitate collaboration on cancer epidemiology, prevention, and control. After literature review and mutual field visits, the 2 research groups have reached an agreement on conducting a multidisciplinary study of the pathogenesis of esophageal and gastric cardia cancer in Hebei Province, China, a region that contains areas with some of the highest incidences of esophageal cancer in the world. To prepare for this collaborative work, the authors reviewed the published literature to identify similarities and differences in esophageal cancer epidemiology between Japan and China and generate hypotheses for further study. While EAC has emerged as the major type in some Western countries, in Asia ESCC is the predominant type and EAC remains rare.[2,3,4,5] ESCC and EAC share biologic features and some common risk factors

Findings

Discussion

Conclusion