A statistical analysis of lung cancer registered in the Annual of Pathological Autopsy Cases in Japan between 1958 and 1987, with special reference to the characteristics of lung cancer in Japan

Autopsy cases of lung cancer, 41,988 in males and 13,818 in females, consecutively registered between 1958 and 1987, were analysed statistically and compared with other case materials and mortality statistics. Cases of malignant tumor showed a gradual increase, and now comprise 60% of the total male and 55% of the total female autopsy cases. The percentage of lung cancer cases among the total autopsy cases was 9% for males and 5% for females. The percentage of lung cancer cases among total cases of malignant tumor was about 17% for males and 9% for females. Among fatal malignant tumors, gastric cancer and lung cancer showed the highest frequency. The relative incidence of gastric cancer was seen to decrease, whereas that of lung cancer increased. Of the histological types of lung cancer in both sexes, adenocarcinoma was the most frequent, followed by squamous cell carcinoma. During the period studied the peak age of patients with lung cancer shifted from the seventh to eighth decade, and a significant elevation of mean age was demonstrated for all of the major histological types in both sexes. The male:female ratio for all lung cancer cases was 3.0, which was much lower than those for the United States and Europe, but very similar to the ratios of mortality statistics in Japan and other Asian countries. As a result of a previous autopsy study at the University of Tokyo, it was also confirmed that the male:female ratio relative to age in each country reflects very well the histological distribution.     

An autopsy study of lung cancer in University of Tokyo for the last 27 years, from 1958 to 1984, with special reference to the characteristics of lung cancer in Japan

Four hundred and sixty-five male and 159 female consecutive autopsy cases of lung cancer, autopsied over the 27 years from 1958 to 1984, were analysed and were compared with other materials and mortality statistics, including statistics from other countries. Malignant tumor autopsy cases are gradually increasing and now comprise more than 60% of total autopsy cases. The percentage of lung cancer cases among all autopsy cases was 7% in males and 4% in females. The percentage of lung cancer in autopsies of patients with malignancies was about 13% for males and 9% for females. The most frequent fatal malignant tumors were gastric cancer, lung cancer, and leukemia. The relative incidence of gastric cancer was decreasing, while that of lung cancer was increasing. In the distribution of the histological types of lung cancer, adenocarcinomas were the most frequent types in both sexes. As has been noted in mortality statistics, we noticed a gradual shift in the peak age of lung cancer autopsy cases towards older patients. During the period under study, the peak shifted from patients in their sixties to patient in their seventies; this was true for most of the major histological types in both sexes. The male/female ratio of all lung cancer cases was 2.9, which was much lower than the ratio found in the United States and Europe, and very similar to the ratio of the mortality rates in Japan and other Asian countries. It was pointed out that the male/female ratios by age-group in each country is a very good reflection of the histological distribution.     

AN AUTOPSY STUDY OF LUNG CANCER IN UNIVERSITY OF TOKYO FOR THE LAST 27 YEARS, FROM 1958 TO 1984, WITH SPECIAL REFERENCE TO THE CHARACTERISTICS OF LUNG CANCER IN JAPAN

Four hundred and sixty-five male and 159 female consecutive autopsy cases of lung cancer, autopsied over the 27 years from 1958 to 1984, were analysed and were compared with other materials and mortality statistics, including statistics from other countries. Malignant tumor autopsy cases are gradually increasing and now comprise more than 60% of total autopsy cases. The percentage of lung cancer cases among all autopsy cases was 7% in males and 4% in females. The percentage of lung cancer in autopsies of patients with malignancies was about 13% for males and 9% for females. The most frequent fatal malignant tumors were gastric cancer, lung cancer, and leukemia. The relative incidence of gastric cancer was decreasing, while that of lung cancer was increasing. In the distribution of the histological types of lung cancer, adenocarcinomas were the most frequent types in both sexes. As has been noted in mortality statistics, we noticed a gradual shift in the peak age of lung cancer autopsy cases towards older patients. During the period under study, the peak shifted from patients in their sixties to patient in their seventies; this was true for most of the major histological types in both sexes. The male/ female ratio of all lung cancer cases was 2.9, which was much lower than the ratio found in the United States and Europe, and very similar to the ratio of the mortality rates in Japan and other Asian countries. It was pointed out that the male/female ratios by age-group in each country is a very good reflection of the histological distribution.     

Statistics of lung, stomach and esophageal cancer: status of oncological care, morbidity and mortality]

Lung cancer is the most common pattern of malignant neoplasms in males, gastric cancer ranks next. In the female pattern of cancer morbidity, gastric cancer is third in the incidence of tumors, pulmonary cancer occupies the 9th place. Esophageal cancer accounts for 3%. In the mortality pattern, lung cancer holds the lead in males and ranks 4th in females, gastric cancer is second in both sexes, esophageal cancer occupies the 7th place in males. In 1999 the standardized incidence rates of cancer of the lung were 64.8 and 6.8 in males and females, respectively. Those of the stomach and esophagus were 33.6 and 7.2 in males and 6.8 and 1.2 in females, respectively. There were tendencies for decreases in the morbidity and mortality of cancer at these sites in 1990 to 1999. The morphological verification of diagnosis of lung cancer does not reached 50%, this is higher for cancer of the stomach (71.6%) and esophagus (67.7%). There has been an increase in the proportion of patients with Stage IV disease in all tumor forms in question. The basic treatment for cancer of the stomach and lung was surgical (82.2 and 38.6%, respectively) and that for esophageal cancer is radiation (47.6%). As little as 10% of patients with gastric and lung cancer survive over 5 years. In esophageal cancer, this figure is much less (5%).     

Cancer of the Gastric Cardia and the Habit of Smoking

The habits of smoking and drinking were investigated in relation to pathologic findings in the stomachs of 1,347 patients who had undergone surgery for gastric cancer at Toranomon Hospital between 1977 and 1986. There were 1,210 patients (807 males and 403 females) with single gastric cancer and 137 (117 males and 20 females) with multiple gastric cancer. The most frequent location of the tumor in cases of single gastric cancer was the middle third (47.8%), followed by the distal third (33.4%), upper third (13.1%) and cardiac region (5.7%). Tobacco consumption was positively associated with gastric cancer in males (odds ratio as the approximate relative risk = 2.8), whereas alcohol consumption was not. Neither tobacco nor alcohol consumption was positively associated with gastric cancer in females. Among male patients with single cancer, the habit of smoking was more prevalent in those with cancer of the cardia than in those with cancer of other portions of the stomach (p<0.01). Acta Pathol Jpn 39:420-424, 1989.     

Cancer of the gastric cardia and the habit of smoking

The habits of smoking and drinking were investigated in relation to pathologic findings in the stomachs of 1,347 patients who had undergone surgery for gastric cancer at Toranomon Hospital between 1977 and 1986. There were 1,210 patients (807 males and 403 females) with single gastric cancer and 137 (117 males and 20 females) with multiple gastric cancer. The most frequent location of the tumor in cases of single gastric cancer was the middle third (47.8%), followed by the distal third (33.4%), upper third (13.1%) and cardiac region (5.7%). Tobacco consumption was positively associated with gastric cancer in males (odds ratio as the approximate relative risk = 2.8), whereas alcohol consumption was not. Neither tobacco nor alcohol consumption was positively associated with gastric cancer in females. Among male patients with single cancer, the habit of smoking was more prevalent in those with cancer of the cardia than in those with cancer of other portions of the stomach (p less than 0.01).     

The prevalence and character of the muscularis mucosae of the human urinary bladder

We report the results of a histological evaluation of 335 consecutive autopsy specimens of apparently normal urinary bladder for the presence of a complete, partial or minimal muscularis mucosae. There were 164 females (49%) and 171 males (51%), ranging in age from 20 weeks of gestation to 102 years. A muscularis mucosae was present in 117 bladders (35%). The female to male ratio was 2:1, with 45% of female and 25% of male bladders containing a muscularis mucosae. The muscularis mucosae was complete in one case (1%), partial in 23 cases (6%) and minimal in 93 cases (28%). The occurrence of a partial or complete muscularis mucosae was ten times more likely in women than men. The presence of a muscularis mucosae in both women and men was not associated with any known disease process, nor was it related to patient age.     

2014~2016年广西肿瘤医院肺癌患者流行病学及病理分布特征分析

目的 描述2014~2016年广西肿瘤医院收治肺癌患者的临床流行病学特征及病理类型特征,为广西肺癌的预防和控制提供参考依据。方法 对筛选出肺癌患者数据资料进行统计分析,描述肺癌患者的临床流行病学特征及病理类型特征。结果 共收集肺癌病例3510例,男性患者多于女性,男女性别比为1.99。肺癌患者主要集中在老年组（≥60岁）中,占肺癌患者总人数的50.11%,农村居民构成比超过50%。肺癌的主要病理类型为腺癌,鳞状细胞癌次之。腺癌的构成比呈上升趋势（P＜0.05）,男性、女性、中年组、老年组、城市居民以及农村居民的腺癌构成比上升（P＜0.05）。结论 60岁以上老年人,农村居民以及男性是肺癌防治的重点对象,尤其是符合多项条件的人群。     

Lung cancer--differences of incidence between the sexes

During the last decade increasing incidence of lung cancer among women have been observed in Poland. The aim of the study was to demonstrate differences among men and women with lung cancer. Lung cancer was diagnosed in 785 female and 4619 male in 1995 in Pulmonary Outpatients Departments. Women were younger than man when all histologic types of lung cancer were analysed (59.7 vs 61.9 years p. < 0.001). Particularly younger subjects were those with adenocarcinoma and small cell lung cancer (56.9 and 57.4 years for women and for men respectively 60.2 and 59.6 years, p < 0.001). Although squamous lung cancer was the most prevalent histological type among men (43.7%) and women (24.7%), about two times higher percentage of men had this neoplasm (p. < 0.001). Adenocarcinoma (18% vs 6.6%, p. < 0.001) and small cell lung cancer (18.5% vs 15.5% p. < 0.001) were prevalent in significantly higher percentage among female than male. Nonsmokers were more frequently noticed among women then men (20.4% vs. 1.9%, p. < 0.001), particularly those with adenocarcinoma. Also women smoked less intensively (33.6 pack/years vs. 42.3 pack/years, p < 0.001) except those with squamous cancer. The higher incidence of cancer was observed among mothers (7% vs 3.8% p. < 0.001) and fathers (7.1% vs 5.6%, p. < 0.001) of women than men with lung cancer.     

Pattern of cancer in Dayanand Medical College & Hospital,Ludhiana (a ten year retrospective study)

A ten year retrospective study was undertaken to ascertain the pattern and incidence of cancer in Ludhiana which is an industrial town with catchment area of Ludhiana consisting of Ludhiana distt., Sangrur, Jalandhar, Hoshiarpur, Faridkot, Ferozepur, Ropar, Kapurthala, some parts of Himachel Pradesh and Haryana. A total number of 56,565 biopsies were received for histopathological examinaiton in 10 years and 4,730 cases of cancer were diagnosed. The incidence of total malignant tumors was 8.36%. Females out numbered males in the incidence of cancer, with male to female ratio being 1:1.09. Most of the cancers were seen in the age group of 41-50 years. In females the two most common cancer sites were breast (21.07%) and cervix (19.4%) while in males hypopharynx--larynx (13.94%) and prostate (9.65%) were the most common sites of cancer.     

Clinicopathological analysis on cancers of autopsy cases in a geriatric hospital

It is generally accepted that cancers in the eiderly are of low grade mallgnancy. In order to clarify this point, autopsy cases from a medical center for the elderly between 1982 and 1994 were pathologlcally analyzed. Three hundred and fifty (160 males, 190 females) out of a total of 871 (361 males, 510 females) autopsy cases were examined. The Incidence of cancer In varlous age groups were found to be as follows: <69 years, 24/67 (36%); 70–74 years, 401102 (39%); 75–79 years, 54/136 (39%); 80–84 years, 79/180 (44%); 85–89 years, 66/172 (38%); 90–94 years, 59/137 (43%); 95–99 years, 17/56 (30%); and >100 years, 12/21 (57%). The incidences did not significantly differ among the groups, that is, there was no age-dependency in the Incidence of cancer. Furthermore, the incidences of multiple cancers (two or more different malignancies In one patient) also did not differ. However, deaths due to the cancers showed a tendency to decrease with age. The survival periods of clinical cancer cases without a surgical operation history (time period between the date of diagnosis and death), were age-related for female cases. However, the rate of distant metastasis was not age-related. The incidence of latent cancers in individuals over 85 years of age was 79/174 (45.4%) and significantly higher than the value of 69/234 (29.5%) for those under 85. The number of malignant tumors in various organs for the different age groups was also counted and the total numbers of clinical cancers and latent cancers in each organ were, 50 and 23 in the lung, 46 and 20 in the stomach, 41 and 31 in the colon, 0 and 39 in the prostate, and 14 and 0 in the mammary glands, respectively. All prostate cancers were latent cancers, and all mammary cancers were clinical cancers. These findings provide strong evidence that cancers In individuals of advanced age have less mailgnency potential.     

Pulmonary Tuberculosis and Lung Cancer Risk in Current Smokers: The Seoul Male Cancer Cohort Study

Authors evaluated pulmonary tuberculosis (PTB) history as a risk factor for lung cancer in current male smokers in a prospective, population-based cohort study. The subjects were the 7,009 males among the participants in the Seoul Male Cancer Cohort Study for whom there was full information on PTB history and smoking habits. With a 16-yr follow-up, 93 cases of lung cancer occurred over the 99,965 person-years of the study. The estimated relative risk (RR) of PTB history of current smokers in lung cancer after adjusting for three confounders - intake of coffee and tomatoes, and age at entry - was 1.85 (95% CI: 1.08-3.19). The observed joint RRs and attributable risks (ARs) across strata of three confounders were greater than the expected, indicating a positive interaction. Thus a history of PTB in current smokers may be another risk factor for lung cancer. Based on a synergic interaction, a heavy male smoker with a PTB history would be expected to belong to the group at high risk of lung cancer.     

Changes in some hepatic enzyme activities related to phase II drug metabolism in male and female rats as a function of age

Changes in activity of some hepatic enzymes related to UDP-glucuronic acid conjugation (UDP-glucose dehydrogenase and UDP-glucuronyl transferase) and glutathione-related enzymes (glutathione reductase and glutathione peroxidase) were investigated in male and female Wistar rats as a function of age. UDP-glucose dehydrogenase activity showed a decrease in the ageing period in both sexes (26.4% and 37.7% in males and females respectively), and no sex differences were found in all the ages studied. The UDP-glucuronyl transferase (using p-nitrophenol as substrate) showed an age-dependent decrease in its activity for males, but an increase for female rats. A sex difference (male values were higher than female values) was observed only in young rats (1 and 3 months old). Glutathione peroxidase activity increased with age in both sexes (the activity found in male and female old rats was about 162% and 149% respectively to those found in adulthood), and a marked difference was observed between sexes in young and old rats (57.8% and 45.4% higher in females in young and old rats respectively). In contrast, the glutathione reductase activity showed a decrease in the ageing (39% in male and 35.5% in female) and the highest levels during lifetime was found in males.     

Pheochromocytoma in Sweden 1958-1981. An analysis of the National Cancer Registry Data

An epidemiological study of 439 cases (184 males, 255 females) of pheochromocytoma (paraganglioma) diagnosed in Sweden from 1958-81 is presented. From the mid 1960's an average of 22 cases have been diagnosed each year. In 255 cases, the pheochromocytoma was diagnosed by clinical examination and/or surgery. In 184 cases (40%), the diagnosis was achieved by autopsy and out of which 60 (14% of all cases) were reported as incidental findings. Ninety-five pheochromocytomas (22%) were located outside the adrenals. The average (+/- SD) age at diagnosis for the total study population was 55.8 +/- 17.7 years. Clinically diagnosed tumour cases were significantly younger (48.5 +/- 16.3 years) compared to cases diagnosed at autopsy (65.8 +/- 14.0). Pheochromocytomas were more common among women than among men. The age specific incidence rate increased continuously for both sexes from the youngest to the oldest age groups. The average incidence of pheochromocytoma in the 24 counties of Sweden was 2.1 cases per million inhabitants per year, range 0.9-5.3. A North to South gradient was noted with a higher incidence in the Southern parts of the country. Whether this is due to a real geographical variation of incidence, to a larger number of unreported cases in the Northern parts, or to presence of families with Sipple's syndrome in the South is unclear.     

Sexual segregation in the left and right horns of the gerbil uterus: "the male embryo is usually on the right, the female on the left" (Hippocrates)

We examined reproductive tracts of 253 female Mongolian gerbils (Meriones unguiculatus) and recorded the uterine locations (relative to siblings of opposite sex) in which 812 male and 823 female fetuses were found. Within-litter comparisons revealed that sexes were not distributed randomly across uterine horns. The percentage of males in right horns (55.0%) was greater than the percentage of males in left horns (41.8%) and the percentage of females in right horns (45.0%) was significantly less than the percentage of females (58.2%) in left horns. We did not find differences in the total number of fetuses in left and right uterine horns or a sex bias in the total sample of 1635 fetuses. Results were discussed in terms of: (a) effects of sexual segregation of fetuses on expected probabilities of fetuses developing adjacent to 0, 1, or 2 fetuses of opposite sex and (b) consequent alterations in expected frequencies of behavioral phenotypes in populations of gerbils.     

Oesophageal and other cancer patterns in four selected districts of the Transkei, Southern Africa:1985-1990

New data regarding the incidence of oesophageal and other cancers during the period 1985-1990 are reported for all clinics and hospitals in four selected districts of Transkei, Southern Africa i.e. Kentani, Butterworth, Lusikisiki and Bisana. Active and passive methods were used to obtain the hospital-based cancer registry data. The mean annual number of cancer cases recorded for the period 1985-1990 was 292. Age-standardised incidence rates (ASIR, African standard) for all recorded cancer were 81.4 and 52.6/100,000 for males and females respectively. Histopathological examination of 52.6% of recorded tumors revealed that 67.3% were squamous carcinomas, 21.7% adenocarcinomas and the remainder non-epithelial neoplasm. Cancer of the oesophagus (OC) was the most frequently recorded cancer and accounted for the 46.5% of the cases with mean ASIR of 46.7 and 19.2/100,000 for males and females respectively. The male/female ratio was 2.4:1. The highest mean ASIR per annum for OC in males (55.6/100,000) occurred in Kentani and in females (22.3/100,000) in Lusikisiki, whereas the lowest rates in both sexes (37.0 and 11.7/100,000 respectively) occurred in Bizana. Comparison of the OC rates in the four districts of Transkei during 19985-1990 with previous reported trends, confirms a consistently high rate in the south-western districts of Kentani during the past 35 years and progressively increasing rates in the north-eastern districts of Bizana and Lusikisiki. These results have profound implications for further epidemiological and aetiological studies on OC in Transkei, but we need to be corroborated by data form other sources such as statistics on histologically diagnosed cancer in Transkei by districts in the South African National Cancer Registry. The second most frequent recorded cancer among males was liver cancer with a mean annual ASIR of 6.0/ 100,000 and male:female ratio of 3:1. The most frequent recorded cancer among females was cervical cancer with a mean annual ASIR of 20.9/100,000 followed by OC (19.2/100,000) and breast cancer (5.8/100,000).     

Breast lesions in young females--a 20-year study for significance of early recognition

The aim of this case series is to evaluate the pattern of breast lumps in males and females with special reference to spectrum of lesions in females below 40 years of age. A 20 years retrospective study was undertaken from the records of the department of Pathology, Bhopal. The lesions were classified into benign and malignant. In young females histological pattern was analyzed in various age groups. A total of 1824 cases were studied. 1724 (94.5%) cases were seen in females and 100 (5.5%) in males. There were 1276 (74%) females below 40 years of age and 448 (26%) were above 40 years of age. In young females 1136 (89%) lesions were benign and 140 (11%) were malignant lumps. Fibrocystic disease in 60 (49%) cases constituted the largest group of benign lumps followed by 30 (24.5%) cases of inflammatory lesion in older females. The mean age of malignant tumors was 34.1 in young females and 51.4 in females above 40. Infiltrating duct carcinoma constituted 83.5% of malignant tumors in young females and 86.1% in older females.     

Sex differences in lung cancer incidence: A genetic model

Family histories pertaining to cancer of all anatomic sites were ascertained on 88 Caucasian patients (61 males, 27 females) with histologically verified lung cancer. Lifetable analysis revealed that relatives of female probands had a significantly higher risk for cancer (all sites) at younger ages (p<.04) compared to relatives of male probands. This trend was peculiar to nonsmoking-associated cancer sites, and was not apparent for smoking-associated cancer sites. We hypothesize that certain components of genetic liability to lung cancer are common to nonsmoking-associated malignant neoplasms, and that females who develop lung cancer are more extreme with respect to genotype than are males who develop lung cancer. Our hypothesis accounts for the lower incidence of lung cancer among females, as well as the apparent increased susceptibility to cancer among their relatives.     

Risks of Lung Cancer due to Radon Exposure among the Regions of Korea

Radon is likely the second most common cause of lung cancer after smoking. We estimated the lung cancer risk due to radon using common risk models. Based on national radon survey data, we estimated the population-attributable fraction (PAF) and the number of lung cancer deaths attributable to radon. The exposure-age duration (EAD) and exposure-age concentration (EAC) models were used. The regional average indoor radon concentration was 37.5 95 Bq/m³. The PAF for lung cancer was 8.3% (European Pooling Study model), 13.5% in males and 20.4% in females by EAD model, and 19.5% in males and 28.2% in females by EAC model. Due to differences in smoking by gender, the PAF of radon-induced lung cancer deaths was higher in females. In the Republic of Korea, the risk of radon is not widely recognized. Thus, information about radon health risks is important and efforts are needed to decrease the associated health problems.

Graphical Abstract

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The role of sex as a prognostic factor in lung cancer

The aim of this study was to demonstrate the prognostic role of the gender. Lung cancer was diagnosed in 785 female and 4619 male registered in Pulmonary Outpatients Departments in 1995. Women were younger than man when all histologic types of lung cancer were analysed (59.7 vs 61.9 years of age p. < 0.001), particularly those with adenocarcinoma(56.9 vs 60.2 years of age, p. < 0.012) and small cell lung cancer (57.4 vs 59.6 years of age, p. < 0.001). Although squamous lung cancer was the most prevalent among men (43.7%) and women (24.7%), about two times higher percentage of men had this neoplasm. Adenocarcinoma (18% vs 6.6%, p. < 0.001) and small cell lung cancer (28.5% vs 15.5% p. < 0.001) were prevalent in significantly higher percentage among female than male. Women were treated more aggressively by surgery (17.1% vs 14.1%, p. = 0.04) but similar percentage of men and women received radiotherapy, chemotherapy and multimodality treatment. Women more frequently survived one year (43% vs 35.7%, p. < 0.04). Significant and independent negative prognostic factors were: gender (RR-1.17 for men), age older than 50 age (RR-1.2), bed performance status (RR-3.28), disseminated disease (RR-2.78) small cell histological type of cancer (RR-1.21) and nonsurgical therapy (RR-3.29).