Determinant Factors on Differences in Survival for Gastric Cancer Between the United States and Japan Using Nationwide Databases
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- Ito Yuri
- Department of Medical Statistics, Research & Development Center, Osaka Medical College Cancer Control Center, Osaka International Cancer Institute
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- Miyashiro Isao
- Cancer Control Center, Osaka International Cancer Institute
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- Ishikawa Takashi
- Department of Medical Informatics, Niigata University Medical and Dental Hospital
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- Akazawa Kohei
- Department of Medical Informatics, Niigata University Medical and Dental Hospital
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- Fukui Keisuke
- Department of Medical Statistics, Research & Development Center, Osaka Medical College Cancer Control Center, Osaka International Cancer Institute
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- Katai Hitoshi
- Department of Gastric Surgery, National Cancer Center Hospital
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- Nunobe Souya
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital
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- Oda Ichiro
- Endoscopy Division, National Cancer Center Hospital
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- Isobe Yoh
- Department of Surgery, National Hospital Organization Tokyo Medical Center
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- Tsujitani Shunichi
- Department of Gastroenterological Surgery, Tottori University
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- Ono Hiroyuki
- Endoscopy Division, Shizuoka Cancer Center
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- Tanabe Satoshi
- Department of Advanced Medicine Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine
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- Fukagawa Takeo
- Department of Surgery, Teikyo University School of Medicine
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- Suzuki Satoshi
- Department of Surgery, Kobe University Graduate School of Medicine
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- Kakeji Yoshihiro
- Department of Surgery, Kobe University Graduate School of Medicine
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- Sasako Mitsuru
- Department of Surgery, Hyogo College of Medicine
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- Bilchik Anton
- Department of Surgical Oncology, The John Wayne Cancer Institute
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- Fujita Manabu
- Department of Surgical Oncology, The John Wayne Cancer Institute
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抄録
<p>Background: Although the incidence and mortality have decreased, gastric cancer (GC) is still a public health issue globally. An international study reported higher survival in Korea and Japan than other countries, including the United States. We examined the determinant factors of the high survival in Japan compared with the United States.</p><p>Methods: We analysed data on 78,648 cases from the nationwide GC registration project, the Japanese Gastric Cancer Association (JGCA), from 2004–2007 and compared them with 16,722 cases from the Surveillance, Epidemiology, and End Results Program (SEER), a United States population-based cancer registry data from 2004–2010. We estimated 5-year relative survival and applied a multivariate excess hazard model to compare the two countries, considering the effect of number of lymph nodes (LNs) examined.</p><p>Results: Five-year relative survival in Japan was 81.0%, compared with 45.0% in the United States. After controlling for confounding factors, we still observed significantly higher survival in Japan. Among N2 patients, a higher number of LNs examined showed better survival in both countries. Among N3 patients, the relationship between number of LNs examined and differences in survival between the two countries disappeared.</p><p>Conclusion: Although the wide differences in GC survival between Japan and United States can be largely explained by differences in the stage at diagnosis, the number of LNs examined may also help to explain the gaps between two countries, which is related to stage migration.</p>
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ
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Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ 31 (4), 241-248, 2021-04-05
日本疫学会