Estimating the Economic Burden of Premature Mortality Caused by Cancer in Iran: 2006-2010

Background: Cancer is currently one of the main public health problems all over the world and its economic burden is substantial both for health systems and for society as a whole.To inform priorities for cancer control, we here estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran from 2006 to 2010. Materials and Methods: The number of cancer deaths by sex and age groups for top ten leading cancers in Iran were obtained from the Ministry of Health and Medical Education. To estimate theYPLL and the cost of productivity loss due to cancer-related premature mortality, the life expectancy method and the human capital approach were used, respectively. Results: There were 138,228 cancer-related deaths in Iran (without Tehran province) of which 76 % (106,954) were attributable to the top 10 ranked cancers. Some 63 % of total cancer-related deaths were of males. The top 10 ranked cancers resulted in 106,766,942 YPLL in total, 64,171,529 (60 %) in males and 42,595,412 (40%) in females. The estimated YPPLL due to top 10 ranked cancers was 58,581,737 during the period studied of which 32,214,524 (54%) was accounted for in males.The total cost of lost productivity caused by premature deaths because of top 10 cancers was 1.68 billion dollars (US$) from 2006 to 2010, ranging from 251 million dollars in 2006 to 283 million dollars in 2010. Conclusions: This study showed that the economic burden of premature mortality attributable to cancer is significant for Iranian society. The findings provide useful information about the economic impact of cancer for health system policy/ decision makers and should facilitate planning of preventive intervention and effective resource allocation.     

Burden of Cancers Related to Smoking among the Indonesian Population: Premature Mortality Costs and Years of Potential Life Lost

Background: As smoking is the leading preventable cause of multiple diseases and premature cancer deaths,estimating the burden of cancer attributable to smoking has become the standard in documenting the adverseimpact of smoking. In Indonesia, there is a dearth of studies assessing the economic costs of cancers related tosmoking. This study aimed to estimate indirect mortality costs of premature cancer deaths and years of potentiallife lost (YPLL) attributable to smoking among the Indonesian population. Materials and Methods: A prevalencebased method was employed. Using national data, we estimated smoking-attributable cancer mortality in 2013.Premature mortality costs and YPLL were estimated by calculating number of cancer deaths, life expectancy,annual income, and workforce participation rate. A human capital approach was used to calculate the presentvalue of lifetime earnings (PVLE). A discount rate of 3% was applied. Results: The study estimated that smokingattributable cancer mortality was 74,440 (30.6% of total cancer deaths), comprised of 95% deaths in men and 5%in women. Cancers attributed to smoking wereresponsible for 1,207,845 YPLL. Cancer mortality costs causedby smoking accounted for USD 1,309 million in 2013. Among all cancers, lung cancer is the leading cause ofdeath and economic burden. Conclusions: Cancers related to smoking pose an enormous economic burden inIndonesia. Therefore, tobacco control efforts need to be prioritized in order to prevent more losses to the nation.The data of this study are important for advocating national tobacco control policy.     

Measuring the societal burden of cancer: The cost of lost productivity due to premature cancer‐related mortality in Europe

Every cancer‐related death in someone of working age represents an economic loss to society. To inform priorities for cancer control, we estimated costs of lost productivity due to premature cancer‐related mortality across Europe, for all cancers and by site, gender, region and country. Cancer deaths in 2008 were obtained from GLOBOCAN for 30 European countries across four regions. Costs were valued using the human capital approach. Years of productive life lost (YPLL) were computed by multiplying deaths between 15 and 64 years by working‐life expectancy, then by country‐, age‐ and gender‐specific annual wages, corrected for workforce participation and unemployment. Lost productivity costs due to premature cancer‐related mortality in Europe in 2008 were €75 billion. Male costs (€49 billion) were almost twice female costs (€26 billion). The most costly sites were lung (€17 billion; 23% of total costs), breast (€7 billion; 9%) and colorectum (€6 billion; 8%). Stomach cancer (in Southern and Central‐Eastern Europe) and pancreatic cancer (in Northern and Western Europe) were also among the most costly sites. The average lost productivity cost per cancer death was €219,241. Melanoma had the highest cost per death (€312,798), followed by Hodgkin disease (€306,628) and brain and CNS cancer (€288,850). Premature mortality costs were 0.58% of 2008 European gross domestic product, highest in Central‐Eastern Europe (0.81%) and lowest in Northern Europe (0.51%). Premature cancer‐related mortality costs in Europe are significant. These results provide a novel perspective on the societal cancer burden and may be used to inform priority setting for cancer control.     

Stomach cancer-related mortality.

In Japan stomach cancer remains the leading cause of cancer-related mortality. We analysed the annual mortality rate of stomach cancer in relation to age, gender and life expectancy in Japan between 1970 and 1995. The adjusted stomach cancer-related mortality rates decreased from 88.9 in 1970 to 45.4 per 100,000 in 1995 in males and from 46.5 to 18.5 per 100,000 in females. The male-female ratio for stomach cancer-related mortality in all ages was 1.9-2.5 during this 25-year period, and the mortality rate was higher in females than in males at young age. The negative contribution to life expectancy for stomach cancer in males was 0.65 years and 0.42 years in females, which is consistent with a higher mortality rate in males. This negative contribution was 41.8% of total cancer in 1970 and 39.4% in 1995 in males and 34.4% and 16.0%, respectively, in females. Our results demonstrated the need to take into consideration the characteristics of stomach cancer in young women and the effects of ageing when designing programmes aimed at prevention and control of this malignancy.     

中国1990～1992年胃癌死亡调查分析

目的 为探讨胃癌对中国人群的危害,对中国胃癌死亡流行分布特点进行分析。方法 对1990－1992年中国的1／10人口死因抽样调查资料中胃癌死亡情况进行分析。结果 胃癌粗死亡率25．2／10万（男性为32．8／10万,女性为17．0／10万）,占全部恶性肿瘤死亡的23．2％,为恶性肿瘤死亡中的第一位。男性胃癌粗死亡率为女性的1．9倍。中国胃癌死亡率属世界高死亡率水平,其世界人口调整死亡率男性为40．8／10万,女性为18．6／10万,中国男性为欧美发达国家的4．2－7．9倍,女性为3．8－8．0倍。中国胃癌死亡率分布有明显的地区差异和城乡差别。全国抽样调查的263个点,胃癌调整死亡率水平在2．5－153．0／10万之间,城市胃癌调整死亡率为15．3／10万,而农村为24．4／10万,农村胃癌调整死亡率为城市的1．6倍。结论 在较长时间内,中国的胃癌防治、尤其是农村以及西北经济欠发达地区应予以高度重视,胃癌是消化系统恶性肿瘤防治的重点,应采取切实可行的预防与早诊措施。     

Cancer occurrence in Ardabil: results of a population-based cancer registry from Iran

The provincial health authority reported a high mortality rate from upper GI cancer in the newly established Ardabil Province of northwest Iran. A comprehensive search was undertaken to survey and register all cases of cancer during a 4-year (1996-1999) period among the indigenous population of Ardabil Province, including subjects seeking care in the cities of Tabriz and Tehran. Diagnosis of cancer was based on histopathology in 71.4%, clinical or radiologic findings in 25% and death certificate in 3.6% of cases. A total of 3,455 cancers (mean age 57.1 +/- 17.3 years) was found during the study. Of these, 60% (2,072) were in males. ASRs for all cancers in males and females were 132.0 and 96.3, respectively. The top 5 cancers in males (excluding skin cancer) according to the calculated ASR were stomach (49.1) [corrected], esophagus (15.4), lung and bronchus (7.9), colon and rectum (7.9) and bladder (7.6); in females, these were stomach (25.42), esophagus (14.4), breast (7.6), colon and rectum (5. 9) and lung and bronchus (3.6). Compared to rates obtained 30 years ago, the incidence of upper GI cancer in this region has increased about 100%, and there is a striking increase in the incidence of gastric cancer with a decline in the esophageal cancer rate. ASRs for gastric cancer in Ardabil were 49.1 for males and 25.4 for females, while for esophageal cancer these were 15.4 and 14.4, respectively. The ASR for cervical cancer was the lowest (0.4) recorded in the world before. Gastric cancer alone constitutes one-third of all cancers in Ardabil, the ASR of which is the highest reported from Iran up to now and one of the highest in the world.     

Evaluation of the Trends of Stomach Cancer Incidence in Districts of Iran from 2000-2010: Application of a Random Effects Markov Model

Background: Stomach cancer is the fifth most common cancer and the third leading cause of death among cancers throughout the world. Therefore, stomach cancer outcomes can affect health systems at the national and international levels. Although stomach cancer mortality and incidence rates have decreased in developed countries, these indicators have a raising trend in East Asian developing countries, particularity in Iran. In this study, we aimed to determine the time trend of age-standardized rates of stomach cancer in different districts of Iran from 2000 to 2010. Materials and Methods: Cases of cancer were registered using a pathology-based system during 2000-2007 and with a population-based system since 2008 in Iran. In this study, we collected information about the incidence of stomach cancer during a 10 year period for 31 provinces and 376 districts, with a total of 49,917 cases. We employed two statistical approaches (a random effects and a random effects Markov model) for modeling the incidence of stomach cancer in different districts of Iran during the studied period. Results: The random effects model showed that the incidence rate of stomach cancer among males and females had an increasing trend and it increased by 2.38 and 0.87 persons every year, respectively. However, after adjusting for previous responses, the random effects Markov model showed an increasing rate of 1.53 and 0.75 for males and females, respectively. Conclusions: This study revealed that there are significant differences between different areas of Iran in terms of age-standardized incidence rates of stomach cancer. Our study suggests that a random effects Markov model can adjust for effects of previous responses.     

Time-trends in cancer incidence and mortality in Japan

The cancer incidence and mortality in Japan are described herein. The total number of deaths from all malignant neoplasms in 1998 was 284,000, corresponding to 30.3% of the total number of deaths among Japanese. Lung was the leading site of cancer deaths (17.9%), followed by the stomach (17.9%), large bowel (12.1%), liver (11.8%), pancreas (6.2%), gallbladder and extrahepatic biliary tract (5.2%), lymphatic tissue (3.7%), esophagus (3.4%), breast (3.1%), prostate (2.4%), leukemia (2.3%) and uterus (1.8%). The stomach was the leading site of cancer deaths until 1997, but was replaced by the lungs in 1998. The age-standardized mortality rates (1975-1998) have increased gradually for males, but decreased slightly for females. The rates have decreased remarkably for the stomach and uterus, while increasing for the lungs, large bowel, female breast, gallbladder and extrahepatic biliary tract, pancreas, and others. The total incidence for all cancers in Japan was estimated to be 454,000 in 1995. The stomach was the leading cancer site (22.2%), followed by the large bowel (17.7%), lung (11.6%), liver (7.8%), breast (6.6%), pancreas (3.7%), gallbladder and extrahepatic biliary tract (3.4%), lymphatic tissue (3.1%) and uterus (2.9%). The age-standardized incidence rates for all sites (1975-1995) have increased gradually for males, while remaining constant for females after a slight increase in the late 1970s. The incidence rates have decreased for the stomach and uterus, but increased for the large bowel, female breast, lung, liver, gallbladder and extrahepatic biliary tract, pancreas, prostate and others. The increase in the incidence rate was prominent for the large bowel, female breast and prostate.     

Cancer mortality in Rio de Janeiro

Cancer mortality data for 1979-81 are presented for the state of Rio de Janeiro, Brazil. The population in 1980 was over II million, and more than 30,000 deaths (11% of the total) were certified as being due to cancer during the 3-year period. Death certification was fairly complete, and for two-thirds there was complementary medical evidence of the certified cause of death. Cancers of the stomach, lung and female breast accounted for one-third of all cancers, and cancers of the oesophagus and liver ranked 4th and 5th, respectively, among both sexes combined. Lung cancer mortallty was higher in both sexes (ASR 27.9 in males, 6.1 in females) than elsewhere in Brazil. Mortality from liver cancer (ASR 5.9 in males, 4.5 in females) was more than 8 times higher than in the city of So Paulo. Cervix cancer mortality was only one-third of that of Fortaleza, a rural state. The results confirm large regional differences in the pattern of cancer mortality within Brazil.     

江苏省昆山市2012年肿瘤死亡率与疾病负担分析

[目的]探究江苏省昆山市2012年恶性肿瘤死亡率与疾病负担.[方法]昆山市2012年肿瘤死亡数据来源于肿瘤登记.按照中国第五次(2000年)人口普查年龄结构及Segi's世界人口年龄结构为标准计算中标死亡率和世标死亡率.以伤残调整寿命年(disability adjusted life years,DALY)作为疾病负担评价指标.[结果]江苏省昆山市2012年肿瘤粗死亡率为186.42/10万(男性为238.26/10万,女性为134.86/10万);中标死亡率为99.55/10万(男性为125.68/10万,女性为72.10/10万).恶性肿瘤死亡前10位肿瘤分别为肺癌、胃癌、肝癌、胰腺癌、结直肠癌、食管癌、女性乳腺癌、脑癌、白血病及胆囊癌,占全部肿瘤的87.39％.恶性肿瘤所致DALY为23 514.0个健康生命年,其中男性为12 801.1个健康生命年,女性为10 712.9个健康生命年.恶性肿瘤所致的每千人DALY为32.8/千人,其中男性与女性分别为35.7/千人和29.8/千人.因恶性肿瘤而早亡导致的寿命损失年(years of life lost,YLL)占DALY的比例为71.6％,其中男性为79.3％,女性为62.3％.[结论]肺癌和消化道恶性肿瘤是影响2012年昆山居民生命健康的主要癌种,依据现有条件开展恶性肿瘤预防控制十分必要.     

Trends in Gastrointestinal Cancer Mortality Rate in Hungary

The aim of this study was to investigate the annual death trends for gastrointestinal cancer in Hungary between 1963 and 2012. Data on the numbers of cancer deaths were obtained from the published nationwide population register. Numbers of deaths from esophageal, gastric and colorectal cancer were available during the study period. However, the mortality data for hepatic, pancreatic and gallbladder cancer have been published only since 1979. Joinpoint regression was applied to investigate the annual trends in the rates of cancer mortality. The annual mortality rates of gastric and gallbladder cancer decreased throughout the study period. Furthermore, declines in mortality from esophageal and hepatic cancers have been observed since 1998 and 1995, respectively. However, the rates of colorectal and pancreatic cancer mortality have been increasing in the past few years. Nevertheless, the mortality rates of colorectal and pancreatic cancers have increased in males aged 40–59 years during the study period. Moreover, significantly higher risks of gastrointestinal cancer-related deaths have been observed in males as compared with females except for death related to cancer of the gallbladder. The presented data suggest that the Hungarian mortality rates are particularly high. The detection of gastrointestinal cancers at an early stage would significantly improves the outcome of these malignancies.     

Analysis of Mortality of Stomach Cancer in China from 1990-1992

OBJECTIVE To assess the impact of stom‘ach cancer on the Chinese population by epidemiological analysis of its distributional mortality.METHODS Data from 1990-1992 on stomach cancer mortality collected by a sampling survey involved one tenth of the total Chinese population.RESULTS The crude mortality rate of stomach cancer in China was 25.2per 10^5 (32.8 per 10^5for males and 17.0 per 10^5 for females), which comprised23.2% of the total cancer deaths from 1990 to 1992, making stomach cancerthe leading cause of cancer death. The stomach cancer mortality rate ofmales was 1.9 times of that of females. The Chinese mortality rates ofstomach cancer adjusted by the world standard population were 40.8 per105 and 18.6 per 105 for males and females, which were 4.2-7.9 (for males)and 3.8-8.0 (for females) times of those in developed countries. Age-adjusted mortality rates of stomach cancer in China have distinctgeographical differences: form the lowest of 2.5 per 10^5 to the highest of153.0 per 10^5 in the 263 selected sites, and 15.3 per 10^5 in urban areas and24.4 per 10^5 in rural areas, a difference of 1.6 times.CONCW$10N The prevention and treatment of stomach cancer in L;n~na,especially in the countryside and the under-developed areas in thenorthwest, should be a long-term focus in preventing of cancers of thedigestive system. Urgent measures for prevention and early detection of stomach cancer should be taken.     

Proportion attributable to medical care of the reduction in stomach cancer deaths in Miyagi, Japan

To estimate the contribution of medical care to the reduction in stomach cancer deaths, the trends of incidence and death rates were compared from 1960 to 1970 and from 1970 to 1980 in Miyagi, Japan. The mortality data were derived from the reports by Miyagi Prefectural Government. The incidence data from the Miyagi Prefectural Cancer Registry were used after being adjusted by the proportion of DCO (death certificate only), which is one of the indices of the reliability of the cancer registry. The time lag of 1.2 years was considered when these trends were compared. The proportion attributable to medical care of the reduction from 1960 to 1970 was estimated to be 13.6% for males and 8.2% for females in those 40 years of age or older. The proportion from 1970 to 1980 was estimated to be 17.9% for males and 11.0% for females. Medical care reduced stomach cancer deaths, to be 17.9% for males and 11.0% for females. Medical care reduced stomach cancer deaths, which exceeded the decrease in the total incidence, although it was not possible to estimate the proportions attributed to early detection and to improvement of the treatment methods.     

Migration from Mexico to the United States: A high‐speed cancer transition

Differences and similarities in cancer patterns between the country of Mexico and the United States' Mexican population, 11% of the entire US population, have not been studied. Mortality data from 2008 to 2012 in Mexico and California were analyzed and compared for causes of cancer death among adult and pediatric populations, using standard techniques and negative binomial regression. A total of 380,227 cancer deaths from Mexico and California were included. Mexican Americans had 49% and 13% higher mortality than their counterparts in Mexico among males and females, respectively. For Mexican Immigrants in the US, overall cancer mortality was similar to Mexico, their country of birth, but all‐cancers‐combined rates mask wide variation by specific cancer site. The most extreme results were recorded when comparing Mexican Americans to Mexicans in Mexico: with mortality rate ratios ranging from 2.72 (95% CI: 2.44–3.03) for colorectal cancer in males to 0.28 (95% CI: 0.24–0.33) for cervical cancer in females. These findings further reinforce the preeminent role that the environment, in its multiple aspects, has on cancer. Overall, mortality from obesity and tobacco‐related cancers was higher among Mexican origin populations in the US compared to Mexico, suggesting a higher risk for these cancers, while mortality from prostate, stomach, and especially cervical and pediatric cancers was markedly higher in Mexico. Among children, brain cancer and neuroblastoma patterns suggest an environmental role in the etiology of these malignancies as well. Partnered research between the US and Mexico for cancer studies is warranted.     

Cancer Incidence and Mortality in Central Myanmar: Report of Nay Pyi Taw Population-Based Cancer Registry

Background: Cancer is a major public health problem in Myanmar, and cancer registration activities are currently underway through both hospital-based and population-based approaches. So far, there are no population-based cancer incidence and mortality estimates in the country. Methods: According to the 2014 census, the total population of Nay Pyi Taw Union Territory was 1,160,242 within the area of 70,571 km2. Nay Pyi Taw Cancer Registry team collected data of new cancer cases both actively and passively from all data sources in the region. The data were registered, updated, cross-checked, quality-assured, and analyzed in CanReg5. The results were presented as the number of cases by site, sex, and age, cumulative risk (CR), crude rate, age-specific, and age-standardized incidence rates (ASRs) per 100,000. Results: Total 5,952 new cancer cases and 1874 cancer deaths were recorded among the population of the Nay Pyi Taw Union Territory between 2013 and 2017. The age-standardized incidence rate for all cancer sites excluding non-melanoma skin cancers in males was 125.9 and 107.3 for females. For both sexes combined, the most common cancers were lung (14%), breast (11.4%), liver (10.2%), mouth and pharynx (8.5%), and stomach cancers (7.8%). In males, the most common were lung (18.1%), liver (14.8%), mouth and pharynx (13%), stomach (8.9%) and colon, rectum, and anus (7.4%) cancers. In females, these were breast (21.2%), cervix (13.0%), lung (10.3%), stomach (6.9%) and colon, rectum, and anus (6.3%) cancers. The most common cancer deaths were caused by liver (20.8%), lung (15.7%), mouth and pharynx (9.3%), stomach (7.5%), and Colon, rectum, and anus (6.8%) cancers. Conclusion: The findings in this study are salient and have potential to serve as important information for the National Cancer Control Program to formulate prevention and control strategies.     

Cancer Occurrence in Semnan Province,Iran: Results of a Population-Based Cancer Registry

Introduction: suitable information of different cancers in special geographic areas can help define medical ‍programs for treatment and screening of high-risk groups. ‍Aims and Methods: The provincial health authority reported a high mortality rate from upper GI cancer in the ‍center of Iran. A comprehensive search was undertaken to survey and register all cases of cancer during a 5-year ‍(1998-2002) period among the indigenous population of Semnan Province. Diagnosis of cancer was based on ‍histopathology, clinical or radiological findings, and death certificates. ‍Results: A total of 1732 patients with cancers (mean age 59.41%+19.08% years) were found during the study. Of ‍these, 936(54.86%) were in males. Crude rates were 124.8/100’000 and 112.1/100,000 for males and females, ‍respectively. Age-standardized ratios (ASRs) for all cancers in males and females were 156/100’000 and 136/100,000 ‍person-year, respectively. Gastric cancer was the most common tumor with an incidence rate of 19.7 per 100,000 ‍people (ASR=27.5). In upper gastrointestinal cancers, gastric cancer was the most common (47.17%), followed by ‍colon malignancies (8.1%, 9.5 per 100,000 populations), esophagus (6.8%, 7.9 per 100,000 populations), liver (2.4%, ‍and 2.8 per 100,000 populations). In women, breast, uterine and ovary, stomach and skin were the most common ‍cancers. In the child population the most common tumors were of the brain, acute lymphocytic leukemia, and bone. ‍Conclusion: Gastric cancer alone constitutes one-sixth of all cancers in Semnan, with the highest ASR incidence ‍rate reported from Iran up to now.     

北京市丰台区2005～2014年户籍居民恶性肿瘤死亡特征及减寿情况分析

[目的]了解2005～2014年北京市丰台区户籍居民恶性肿瘤的死亡特征及对全人群寿命的影响.[方法]应用死亡率、标化死亡率、构成比,潜在减寿年数(PYLL)、潜在减寿率(PYLLR)、标化潜在减寿率(SPYLLR)、平均减寿年数(AYLL)等指标对丰台区恶性肿瘤死亡特征及减寿情况进行分析.[结果] 10年间恶性肿瘤年均死亡率为183.12/10万,标化死亡率为84.59/10万,占全死因构成的27.68％.男性死亡率是女性的1.46.2005～2014年恶性肿瘤粗死亡率从162.78/10万上升到208.98/10万.肺癌死亡率居恶性肿瘤首位,为58.01/10万.10年来排名前10的恶性肿瘤共损失潜在寿命188290.87年,人均损失12.01年.[结论]北京市丰台区2005～2014年恶性肿瘤死亡呈现上升趋势,男性恶性肿瘤死亡率明显高于女性,以食管癌差异最为明显,恶性肿瘤对寿命的影响中肺癌贡献最大,是影响丰台区居民健康的重点恶性肿瘤,另外白血病、乳腺癌对居民寿命影响较大,应重点关注.     

Cancer mortality in Shanghai during the period 1963-77.

In Shanghai a population-based Cancer Registry has been in operation since 1963 covering the urban area, with total population of about 5.6 million. In this report methods of collecting cancer deaths and population data are described in detail, and cancer mortality data for the period 1963-77 presented. The main fatal cancers were those of stomach, lung, liver, oesophagus and colon-rectum; among females, in addition there were cancers of uterus and breast. During the 15-year period a rapid increase in cancer-mortality rate was seen for lung, colon-rectum, pancreas in both sexes, and for bladder in males. A notable decrease in mortality rate for cancer of the uterus (mainly for cancer of cervix uteri) occurred.     

Cancer Mortality and Serum Levels of Carotenoids,Retinol, and Tocopherol: a Population-based Follow-up Study of Inhabitants of a Rural Area of Japan

A total of 3,182 subjects (1,239 males and 1,943 females) aged from 39y to 79y, were recruited from the inhabitants ‍of a rural area in Japan who participated in health check-up programs from 1988 to 1995. During the 10.5 year ‍follow-up, 287 deaths (175 males and 112 females) from all causes, 134 (81 males and 53 females) from cancer of all ‍sites, 31 from lung cancer, 21 from colorectal cancer, 20 from stomach cancer, and 62 from other cancers, were ‍identified among the cohort subjects. Fasting serum samples were taken at the time of the health check-ups, and ‍serum levels of carotenoids, retinol and tocopherols were separately determined by HPLC. Statistical analyses were ‍performed using Cox’s proportional hazard model after adjusting for sex, age, and other confounding factors. High ‍serum levels of á- and â- carotenes and lycopene were found to marginally significantly or significantly reduce the ‍risk for mortality rates of cancer of all sites and of colorectal cancers. High serum levels of â-cryptoxanthin also ‍showed an inversely relation with the risk of mortality from lung and stomach cancers, but this was not statistically ‍significant. High intake of green-yellow vegetables contributing to serum levels of á- and â- carotenes, as well as ‍lycopene, may reduce the risk of cancer mortality, especially from colorectal cancer, in rural Japanese.     

Cancer mortality in the USSR, 1986-88

Mortality rates in the USSR for the major cancer sites have been computed for the period 1986-88 from official numbers of certified deaths and population estimates provided by the World Health Organization databank, and compared with rates for 26 other European countries. Among males, elevated mortality rates (age-adjusted, world standard) were observed for cancer of the oral cavity and pharynx (6.6/100,000), oesophagus (8.4/100,000) and larynx (6.8/100,000). Mortality from cancer of the stomach (38.4/100,000 males and 16.5/100,000 females, for a total of 87,000 deaths per year) was the highest in Europe. Likewise, overall lung cancer rates among males (61.0/100,000, for over 77,000 deaths per year) were among the highest in Europe, and showed substantial rises over the last 2 decades. Lung cancer mortality in females was comparatively low (6.9/100,000), and increased only moderately. Rates for cancers of the intestine (14.6/100,000 males and 10.6/100,000 females) and of the female breast (12.9/100,000) were comparatively low as compared to most other European countries, and those for prostatic cancer (5.9/100,000) were the lowest registered in Europe. In contrast, mortality for cancer of the uterus (9.7/100,000) was among the highest in Europe, probably due to high mortality from cervical cancer. Priorities for cancer control in the Soviet Union are thus reduction of consumption of tobacco and alcohol, which largely explain the high rates for lung and upper digestive and respiratory sites, improvements in diet composition and food storage to reduce the substantial excess of stomach cancer, and rational screening for cervical cancer.