Epidemiology of Cancer of the Digestive Tract

266 Pages·1982·8.652 MB·English

by  Elaine M. Smith (auth.), Pelayo Correa, William Haenszel (eds.)

EPIDEMIOLOGY OF CANCER OF THE DIGESTIVE TRACT
DEVELOPMENTS IN ONCOLOGY 6
Previously published in this series:
I. FJ. Cleton and J.W.l.M. Simons, eds., Genetic Origins of Tumor Cells
ISBN 90-247-2272-1
2. J. Aisner and P. Chang, eds., Cancer Treatment Research
ISBN 90-247-2358-2
3. B.W. Ongerboer de Visser, D.A. Bosch and W.M.H. van Woerkom-Eykenboom, eds.,
Neuro-Oncology: Clinical and Experimental Aspects
ISBN 90-247-2421-X
4. K. Hellmann, P. Hilgard and S. Eccles, eds., Metastasis: Clinical and Experimental Aspects
ISBN 90-247-2424-4
5. H.F. Seigler, ed., Clinical Management of Melanoma
ISBN 90-247-2584-4
Series ISBN: 90-247-2338-8
EPIDEMIOLOGY OF
CANCER OF THE
DIGESTIVE TRACT
edited by
PELAYO CORREA
Professor of Pathology,
Louisiana State University Medical Center,
Nell' Orleans, Louisiana, USA
and
WILLIAM HAENSZEL
Projessor of Epidemiology,
University of 1llinois and Senior Epidemiologist,
Illinois Cancer Council,
Chicago, Illinois, USA
1982
MARTINUS NIJHOFF PUBLISHERS
THE HAGUE/BOSTON/LONDON
Distributors:
for the United States and Canada
Kluwer Boston, Inc.
190 Old Derby Street
Hingham, MA 02043
USA
for all other countries
Kluwer Academic Publishers Group
Distribution Center
P.O. Box 322
3300 AH Dordrecht
The Netherlands
Library of Congress Cataloging in Publication Data
Main entry under title:
Epidemiology of cancer of the digestive tract.
(Developments in oncology; v. 6)
Includes index.
I. Gastrointestinal system-Cancer.
2. Epidemiology. 3. Digestive organs-Cancer.
L Correa, Pelayo. II. Haenszel, William.
III. Series. [DNLM: I. Digestive system neoplasms-Occurence.
WI DE998N v. 6/ WI 149 E64]
RC280.D5E64 616.99'43071 81-1 ~986
AACR2
ISBN -13: 978-94-009-7504-0 e-ISBN -13 :978-94-009-7502-6
DOl: 10.1007/978-94-009-7502-6
Copyright © 1982 by Martinus Nijhoff Publishers, The Hague.
Softcol'er reprint of the hardcover 1st edition 1982
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without
the prior written permission of the publishers,
Martinus NijhofJ Publishers, P.O. Box 566,2501 CN The Hague, The Netherlands.
Table of Contents
Preface VII
List of Contributors IX
1. Epidemiology of Cancers of the Oral Cavity and Pharynx.
Elaine B. SMITH
2. Epidemiology of Esophageal Cancer: A Review . . . . 21
Nicholas E. DAY, Nubia MUNOZ and Parviz GHADIRIAN
3. Epidemiology of Gastric Cancer . . . . 59
Pelayo CORREA and William HAENSZEL
4. Epidemiology of Large Bowel Cancer 85
William HAENSZEL and Pelayo CORREA
5. Epidemic Colon Cancer in Children and Adolescents? . . . . 127
Charles B. PRATT and Stephen L. GEORGE
6. Epidemiology of Gastrointestinal Lymphomas 147
Clark W. HEATH, Jr.
7. Epidemiology of Primary Liver Cancer. . . 161
Nubia MUNOZ and Allen UNSELL
8. Ethnogeographic Patterns in Gallbladder Cancer. 197
Eric J. DEVOR
9. Epidemiology of Cancer of the Gallbladder and Extra-Hepatic
Biliary Passages. . . . . . . . . . . 227
Thomas M. MACK and Herman R. MENCK
10. Epidemiology of Cancer of the Pancreas. 243
Elizabeth T.H. FONTHAM
Subject Index 261
Preface
The digestive organs are the most frequent site of cancer in the world, accounting
for approximately 30% of all malignant tumors. This prominent position has
been present for many decades in spite of marked shifts in the freq uency ofc ancer
of specific organs. The most remarkable shift has been the decrease in gastric
cancer rates occurring concomitantly with an increase in colon cancer rates in
most 'western' industrialized societies. Important exceptions to this rule, as well
as other epidemiologic evidence, indicate that the opposite trends for gastric and
colon cancers are not inevitable consequences of each other. Although genetic
ally determined precancerous syndromes are well recognized, it is generally
agreed that environmental factors play an overriding role in digestive cancer
causation. The most obvious environmental factors seem to be the result of what
we eat, drink, or smoke. Although the nutritional component of the diet is of
unquestionable importance, the nonnutrient elements in our diet have also
proven to be influential causative factors. Several studies have focused on the
microenvironment at the level of the mucosa or the digestive organs as a micro
cosmos where forces promoting and inhibiting carcinogenesis are operating for a
prolonged period of time. Their interaction eventually determines the presence
or absence of a malignant tumor. Our understanding of such modulating forces,
hopefully, will someday allow us to modify the microenvironment in a favorable
way and attain the goal ofc ancer prevention. Epidemiologic studies have already
indicated that the cancer-related microenvironment is different in each digestive
organ. Ongoing epidemiologic studies throughout the world most probably will
contribute new information in the near future and better clarify the role of the
different components of the microenvironment.
This volume brings together updated epidemiologic information pointing out
similarities and differences between the etiologic pathways observed in the
several digestive organs. We hope that it will be helpful to all professionals
concerned with digestive cancer causation by bringing them up to date, prepar
ing them for better use of forthcoming information, and helping them design a
rationale for preventive measures.
Pelayo Correa
William Haenszel
List of Contributors
CORREA, Pelayo, M.D., Department of Pathology, Louisiana State University Medical Center,
1901 Perdido St., New Orleans, LA 70112, USA
DAY, Nicholas E., Ph.D., Biostatistics Programme, Division of Epidemiology and Biostatistics,
International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 2,
France
DEVOR, Eric J., Ph.D., Dept. of Psychiatry, Washington University School of Medicine, 216 S.
Kingshighway Blvd., St. Louis, MO 61378, USA
FONTHAM, Elizabeth T.H., M.P.H., Department of Pathology, Louisiana State University Medi
cal Center, 1901 Perdido St., New Orleans, LA 70112, USA
GEORGE, Stephen L., Ph.D., Biostatistics Section St. Jude Children's Research Hospital, 332
North Lauderdale, P.O. Box 318, Memphis, TN 38101, USA
GHADIRIAN, Parviz, M.Sc., Institute of Public Health Research, University of Teheran, Teheran,
Iran
HAENSZEL, William, D.P.H., Illinois Cancer Council, 36 South Wabash, Chicago, IL 60603, USA
HEATH, Clark W., Jr., M.D., Director, Chronic Diseases division, Center for Environmental
Health, Centers for Disease Control, 1600 Clifton Road, N.L, Atlanta, GA 30333, USA
UNSELL, Allen, M.B.B.S., F.R.C.PATH., Director, Division of Epidemiology and Biostatistics,
International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 2,
France
MACK, Thomas M., M.D., M.P.H., Department of Family and Preventive Medicine, University of
Southern California School of Medicine, and Cancer Surveillance Program, Los Angeles Coun
ty/University of Southern California Cancer Center, Los Angeles, CA 90033, USA
MENCK, Herman R., C.Phi\', Department of Family and Preventive Medicine, University of
Southern California, Los Angeles, CA 90033, USA
MUNOZ, Nubia, M.D., Analytical Epidemiology Programme, Division of Epidemiology and
Biostatistics, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372
Lyon Cedex 2, France
PRATT, Charles B., M.D., St. Jude Children's Research Hospital, 332 North Lauderdale, P.O. Box
318, Memphis, TN 38101, USA
SMITH, Elaine M., M.P.H., Ph.D., University of Iowa, School of Medicine, Department of Pre
ventive Medicine, and Downstate SEER Program, Iowa City, IA 52242, USA
1. Epidemiology of Cancers of the Oral Cavity and Pharynx
ELAINE M. SMITH
Introduction
Despite the relative visibility of oral and pharyngeal cancers (lCD-A 140-149,
9th revision) which should make them easier to diagnose than other digestive
cancers, most of these tumors are found in later stages and have poor survival.
For some buccal cavity and pharyngeal sites lethality is even higher than that of
the stomach, colon, or rectum.
Epidemiologic data of oral and pharyngeal cancers are limited. The most
reliable information comes from areas with population-based cancer registries,
but more information is needed to determine the accuracy of the international
differences in incidence, mortality, and survival.
Detailed investigations on various sites are uneven. Those of the lip, mouth,
and nasopharynx have drawn more attention than have other oral and pharyn
geal tumors because of their relatively high frequency in certain parts of the
world or because of their correlation with specific etiologic conditions. The sites
referred to in this chapter include ICD 140-149, 7-9th revision. Despite some
inadequacies, there are some extreme differences in international incidence pat
terns that are difficult to account for completely as artifacts due to differences in
methodology.
Morbidity and mortality
Relative frequency often has been used to assess the morbidity risk for oral ca vity
and pharynx cancer when incidence data are unavailable. In North America and
Western Europe (1-8) the frequency is between 2-5%, while in Asia, Southeast
Asia, Middle East, and USSR (2) it accounts for as much as 50% of all cancers.
The ranking of sites in order of frequency varies, but in general the order among
North American and Western European countries is lip with highest, pharynx
with lowest, and mouth, gum, floor of mouth, salivary glands, and tongue of
similar frequency (1,8,9).
The major sources of international figures on age-specific and adjusted inci
dence are the three volumes of 'Cancer incidence in five continents' (2, 12-13). A
Correa, P. and Haenszel, W. (eds.), Epidemiology of Cancer of the Digestive Tract.
© 1982 Martinus Nijhoff Publishers. The Hague/Boston/London. ISBN-13:978-94-009-7504-0
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