Abstract
The lung cancer death rate among Japanese males was projected for 50 years to the year 2041 by a computerized simulation model. Long‐term effects of anti‐smoking measures and mass screening on lung cancer deaths were also evaluated. The simulation showed that the age‐adjusted lung cancer death rate would increase and reach a peak of 166 per 100,000 in 1989 and then decrease to 148 per 100,000 in 2003. It then shows an increasing tendency again, up to 255 per 100,000 in 2028. The smoking initiation rates estimated from the observed lung cancer death rates showed that the changes in death rates may be attributed to a lower smoking initiation rate among those born in the 1930's. Promotion of mass screening programs is effective more quickly than anti‐smoking measures but the reduction in annual cancer deaths is expected to be only 11%, even if 100% participation is achieved by the year 2000. A reduction in smoking initiation rate, on the other hand, affects lung cancer deaths very slowly. It was predicted that a 1% annual reduction in smoking initiation rate would result in a 20% decrease in the number of lung cancer deaths in 2041. A smoking cessation program is intermediate with regard to promptness. The predicted reductions in lung cancer deaths in 2041 were 13%, 47%, and 66%, respectively, when the annual smoking cessation rate was increased from 0.46% (present status) to 1%, 3%, and 5%. In conclusion, the combined application of all three preventive measures seems essential to realize the most effective reduction in lung cancer deaths.
Keywords: Key words, Lung cancer, Epidemiology, Simulation, Smoking, Screening
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REFERENCES
- 1. ) Statistics and Information Department, Ministry of Health and Welfare . “ Vital Statistics 1988 Japan ,” pp. 94 – 102 ( 1990. ). Health and Welfare Statistics Association; , Tokyo . [Google Scholar]
- 2. ) The Bureau of Vital Statistics, Ministry of Health and Welfare . Long term trends in cancer mortality rates from 1955 to 1987 in Japan . Jpn. J. Clin. Oncol. , 20 , 305 – 317 ( 1990. ). [PubMed] [Google Scholar]
- 3. ) Tominaga , S.Smoking and cancer patterns and trends in Japan . In “ Tobacco: A Major International Health Hazard ,” ed. Zaridze D. G. and Peto R. , pp. 103 – 113 ( 1986. ). International Agency for Research on Cancer; , Lyon . [Google Scholar]
- 4. ) Sobue , T. , Suzuki , T. , Naruke , T.and The Japanese Lung Cancer Screening Research Group. A case‐control study for evaluating lung cancer screening in Japan . Int. J. Cancer , 50 , 1 – 8 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 5. ) Yamaguchi , N. , Tamura , Y. , Sobue , T. , Akiba , S. , Ohtaki , M. , Baba , Y. , Mizuno , S. and Watanabe , S.Evaluation of cancer prevention strategies by computerized simulation model: an approach to lung cancer . Cancer Causes Control , 2 , 147 – 155 ( 1991. ). [DOI] [PubMed] [Google Scholar]
- 6. ) Lung Cancer Task Force, The Japanese Joint Committee on TNM Classification and National Cancer Center . “ TNM Classification of Lung Cancer, 10,334 Cases in 1981 1982 1983 ,” pp. 62 – 77 ( 1988. ). Lung Cancer Task Force, The Japanese Joint Committee on TNM Classification and National Cancer Center (in Japanese) .
- 7. ) Suzuki , T. , Sobue , T. and Nakayama , N.Sensitivity and specificity of lung cancer screening in Osaka . Lung Cancer , 28 , 653 ( 1988. ) (in Japanese) . [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. ) Watanabe , S.Cancer morbidity and related problems . In “ Fifth National Cancer Morbidity Survey in Japan 1990 ,” ed. Suemasu K. , pp. 9 – 16 ( 1990. ). Sougou Igaku Sha; , Tokyo ( in Japanese ). [Google Scholar]
- 9. ) Ministry of Health and Welfare . “ National Health Survey 1980 Japan ,” pp. 24 – 25 ( 1980. ). Kosei Tokei Kyoukai; , Tokyo ( in Japanese ). [Google Scholar]
- 10. ) Ohtaki , M.A model for age‐dependence of lung cancer mortality . Bull Biom. Soc. Jpn. , 11 , 127 – 138 ( 1990. ). [Google Scholar]
- 11. ) Doll , R. and Peto , R.Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non‐smokers . J. Epidemiol. Comm. Health , 32 , 303 – 313 ( 1978. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12. ) Mizuno , S. , Akiba , S. and Hirayama , T.Lung cancer risk comparison among male smokers between the “six prefecture cohort” in Japan and the British physicians' cohort . Jpn. J. Cancer Res. , 80 , 1165 – 1170 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. ) Sobue , T. , Suzuki , T. , Fujimoto , I.Matsuda , M. , Doi , O. , Mori , T. , Furuse , K. , Fukuoka , M. , Yasumitsu , T. , Kuwahara , O. , Ichitani , M. , Taki , T. , Kuwabara , M. , Nakahara , K. , Endo , S. , Sawamura , K. , Kurata , M. and Hattori , S.Lung cancer risk among exsmokers . Jpn. J. Cancer Res. , 82 , 273 – 279 ( 1991. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. ) Abe , Y. , Onodera , M. , Kamiya , K. , Saito , H. and Matsunaga , T.On the revision of age‐adjusted death rate . Kosei no Shihyo , 38 , 12 – 16 ( 1991. ) (in Japanese) . [Google Scholar]
- 15. ) Statistics and Information Department , Ministry of Health and Welfare. Cause‐specific death rates in 1989 by sex and age . Man. Rep. Vital Statist. Jpn. , 44 , 38 – 39 ( 1990. ). [Google Scholar]
- 16. ) Statistics and Information Department , Ministry of Health and Welfare. Cause‐specific death rates in 1989 by sex and age . Mon. Rep. Vital Statist. Jpn. , 45 , 38 – 39 ( 1991. ). [Google Scholar]
- 17. ) Matsushita , K. , Nakamura , M. , Miyamoto , M. , Endo , S. and Oshima , A.'First Osaka Quit Contest'Results from one year follow‐up . Jpn. J. Public Health , 36 , 88 ( 1989. ) (in Japanese) . [Google Scholar]