Trends of cancer occurrence and survival in Japan, and in Osaka]

Recent improvements in cancer medical care in Osaka have resulted in the elevation of survival rates of cancer patients, except for the so-called "refractory" cancers. Five-year relative survival rates for reported patients diagnosed in 1981-1983 were higher than 60% for cancers of the breast, uterus and bladder, and around 40% for rectum, colon and stomach cancers. However, cancers of the liver, gallbladder, pancreas, and lung continued to show very low survival rates of less than 10%. In higher age-groups, advanced cases occupied a larger proportion while cases which received curative resection occupied a smaller proportion. Reflecting this, survival rates were lower in age-groups higher than 75, and the reduction of age-differences between younger and older groups was not observed during the decade. Cancer incidence for all sites in Japan was estimated by the Research Group for Population-based Cancer Registries to be 320,000 in 1985. The stomach, colorectal, lung, liver, and breast were the five leading cancer sites. According to the authors' studies, cancer incidence is projected to be 740,000 in Japan in 2015, of which 40% would be patients of "refractory" cancers and 62% would be aged patients in their upper than 70, though these were 19% and 32% in 1985. In order to combat this difficult situation in the near future, the following activities are urgently required: (1) Promotion of primary preventive measures for incurable cancers. (2) Development of specific therapy programs taking into account of QOL for aged patients as well as advanced patients. (3) Promotion of secondary preventive measures for aged people as well as younger people.