RARE CANCERS ARE ALSO NOT RARE IN ASIA
- Slides: 18
RARE CANCERS ARE ALSO NOT RARE IN ASIA : THE RARE CANCER BURDEN IN EAST ASIA Tomohiro Matsuda 1, Young-Joo Won 2 Ru. Ru Chun-Ju Chiang 3, Kumiko Saika 1, Jiwon Lim 2 and Annalisa Trama 4 1 National Cancer Center, Japan 2 National Cancer Center, Republic of Korea 3 Taiwan Cancer Registry, Taiwan 4 Istituto Nazionale dei Tumori, Italy IACR 2019 Vancouver, Canada 1
COI Disclosure Information Lead Presenter/Responsible Researcher: Tomohiro Matsuda n I have no financial relationships to disclose. IACR 2019 Vancouver, Canada 2
Rare cancer definition n Rare cancers: incidence <6/100, 000/year in Tier 2 in EU (Rare diseases: prevalence<50/100, 000/year) IACR 2019 Vancouver, Canada 3
Multi-layer structure of rare cancer classifiction Tier 3: WHO BB names of individual cancer entities and ICD-O-3 codes. n - - - Tier 2 (215): Grouped by using morph and topo. Consistent diagnostic and therapeutic approaches. Tier 1 (68): Includes NOS morph. major cancer entities in a clinical sense Family (19): Focusing on referral of patients Family Tier Tumor Category 1 EPITHELIAL TUMOURS OF NASAL CAVITY AND SINUSES 2 Squamous cell carcinoma with variants of nasal cavity and sinuses HEAD & 2 Lymphoepithelial carcinoma NECK of nasal cavity and sinuses 2 Undifferentiated carcinoma of nasal cavity and sinuses 2 Intestinal type adenocarcinoma of nasal cavity and sinuses 4 IACR 2019 Vancouver, Canada
Background n The project of surveillance of rare cancers in Asian countries (RARECAREnet Asia) provides the first standardized population -based incidence in Asia based on the latest list of rare cancers defined by the RARECARE group. IACR 2019 Vancouver, Canada 5
Background: Cancer Registry in East Asia Feature of available data Hosp. of Dx. Date Sex, Birth Hosp. of Tx. of Age at Staging Tx. date (type of Dx. hosp. ) Yes (Cancer Tx. From 2010, Yes 1993 -2015 Yes SEER around ICD-O- (4 digits) hospital or Yes (high quality 2016 (Y/M Yes summary Yes 900, 000/ye 3 Yes (Y/M/D) other 2010 -2015) /D) stage ar (6 digits) hospital/clini c) Yes SEER (4 digits) 1999 -2015, Yes summary around ICD-OYes (Y/M Yes 1999 -2015 2016 stage Yes. No 168, 000/ye 3 (5 digits), (Y/M/D) (from ar (Grade: 2005) from 2013) TNM 1995 -2015, stage Yes 1979 -2015 around Yes major ICD-O- (4 digits) Yes (high quality 2016 (Y/M Yes 37, 500 Yes 3 Yes (Y/M/D) cancers 1995 -2015) 105, 000 /D) (6 digits) (after /year IACR 2019 Vancouver, Canada 6 2004) Year of Digit Available classifi last Data size Topo. data cation F/U Morpho. JP KR TW Available data items
Methods n n n Common protocol for data analyses Analyses performed by each PBCR with the standardized analysis tool kit including the latest RARECARE list List of data quality indicators and checks 2 meetings and several call conference PBCR data on patients diagnosed from 2011 to 2015 in JP, KR and TW in comparison with the data in EU IACR 2019 Vancouver, Canada 7
Results Data quality in the 3 Asian countries were as high as EU. n - n n DCO%: 0. 8 -4. 8% Topography NOS: 0. 01 -4% Morphology NOS (mean): 7. 3 -13. 1% MV%: 83. 7 -91. 1% Incidence of all rare cancers was 93. 9 in JP, 106. 1 in KR and 103. 5 in TW and 67. 8 in EU corresponding to 16. 1% (JP), 23. 7% (KR), 24. 2% (TW) and 22. 2% (EU) of all new cancer diagnoses. Newly diagnosed rare cancers annually: 139, 497 (JP), 52, 071 (KR) and 24, 147 (TW). IACR 2019 Vancouver, Canada 8
Results Korea (2011 -2015) 120 Taiwan (2011 -2015) 100 Europe (2000 -2007) 80 60 40 RARE COMMON 20 Crude incidence rate /100, 000 IACR 2019 Vancouver, Canada 20> 10 -20 6 -10 5 -6 4 -5 3 -4 2 -3 0 1. 5 -2 - 140 1 -1. 5 - Japan (2011 -2015) 0. 5 -1 - 196 in JP, 203 in KR, 200 in TW, 198 in EU. Same rare cancer entities in 3 Asian countries: 194 entities 189 out of 193 were rare in all the 4 areas Same common cancer entities in 3 Asian countries : 2 entities 160 <0. 5 - 180 N of Tier 2 entities with crude incidence rate <6/100, 000 in Asia (out of 215): n 9
Results Among RARE cancer families, n - - - Epithelial tumours of nasopharynx, oropharynx and oral cavity and lips were not rare in TW. Epithelial tumours of oral cavity and lip was not rare in JP, neither. Epithelial tumours of gallbladder and extra hepatic biliary tract was not rare in JP and KR. Thyroid cancer was not rare in Asia. Among COMMON cancer families, n - - Epithelial tumours of esophagus was not common in KR. Epithelial tumours of corpus uteri was not common in KR and ovary was not common in KR and TW. Epithelial tumours of kidney was not common in TW. Skin melanoma was not common in Asia. IACR 2019 Vancouver, Canada 10
HEAD & NECK Tier 1 List EPITHELIAL TUMOURS OF NASOPHARYNX RARE CANCER FAMILIES Japan (201115) Korea (201115) Taiwan (201115) EU (2000 -07) Crud e rate 0. 54 Crud e rate 0. 77 Crud e rate 6. 66 Crud e rate 0. 47 C/R R C/R C C/R R EPITHELIAL TUMOURS OF HYPOPHARYNX AND LARYNX 7. 00 C 3. 03 R 7. 30 C 6. 33 C EPITHELIAL TUMOURS OF OROPHARYNX 2. 47 R 1. 31 R 6. 23 C 3. 34 R EPITHELIAL TUMOURS OF ORAL CAVITY AND LIP DIGESTIVE RARE 6. 49 C 1. 92 R 20. 19 C 4. 78 R EPITHELIAL TUMOURS OF GALLBLADDER AND EXTRAHEPATIC BILIARY TRACT ENDOCRINE ORGAN (EBT) 18. 15 C 11. 32 C 4. 09 R 4. 44 R CARCINOMAS OF THYROID GLAND 10. 79 C 72. 83 C 13. 29 C 5. 07 R 6. 55 C 1. 99 R 1. 68 R 2. 47 R HEMATOLOGIC RARE MYELODYSPLASTIC SYNDROME AND MYELODYSPLASTIC/MYELOPROLIF ERATIVE DISEASES IACR 2019 Vancouver, Canada 11
COMMON CANCER FAMILIES DIGESTIVE COMMON Tier 1 List EPITHELIAL TUMOURS OF OESOPHAGUS Japan (201115) Korea (201115) Taiwan (201115) EU (2000 -07) Crud e rate 17. 33 C/R C Crud e rate 4. 62 Crud e rate 10. 42 C/R C Crud e rate 7. 81 C/R C 10. 18 C 3. 95 R 8. 25 C 11. 39 C 8. 00 C 4. 38 R 5. 28 R 9. 38 C C/R R FEMALE GENITAL COMMON EPITHELIAL TUMOURS OF CORPUS UTERI EPITHELIAL TUMOURS OF OVARY AND FALLOPPIAN TUBE MALE GENITAL & UROGENITAL COMMON EPITHELIAL TUMOURS OF KIDNEY 12. 82 C 8. 40 C 5. 30 R 12. 71 C 1. 30 R 1. 07 R 1. 15 R 14. 06 C SKIN COMMON MALIGNANT SKIN MELANOMA IACR 2019 Vancouver, Canada 12
Comparison of 3 Asian countries (ASR(W)) RARE 01. HEAD & NECK 02. DIGESTIVE RARE EPITHELIAL TUMOURS OF MIDDLE EAR EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF EYE AND ADNEXA EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF ORAL CAVITY AND LIP EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF OROPHARYNX EPITHELIAL TUMOURS OF AN. . . EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF HYPOPHARYNX AND LARYNX 0. 0 1. 0 2. 0 3. 0 4. 0 5. 0 6. 0 7. 0 EPITHELIAL TUMOURS OF MAJOR SALIVARY GLANDS AN. . . Japan (2011 -2015) Taiwan (2011 -2015) EPITHELIAL TUMOURS OF NASOPHARYNX 10. ENDOCRINE ORGAN EPITHELIAL TUMOURS OF NASAL CAVITY AND SINUSES 0. 0 Japan (2011 -2015) Taiwan (2011 -2015) Korea (2011 -2015) CARCINOMAS OF THYROID. . . 5. 0 10. 0 Korea (2011 -2015) 15. 0 0. 0 10. 0 20. 0 30. 0 40. 0 50. 0 60. 0 Japan (2011 -2015) Korea (2011 -2015) Taiwan (2011 -2015) IACR 2019 Vancouver, Canada 13
Comparison of 3 Asian countries (ASR(W)) COMMON 13. DIGESTIVE COMMON 16. MALE GENITAL & UROGENITAL COMMON EPITHELIAL TUMOURS OF LU. . . EPITHELIAL TUMOURS OF BLADDER LYMPHOID DISEASES EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF KIDNEY EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF PROSTATE EPITHELIAL TUMOURS OF. . . 0. 0 EPITHELIAL TUMOURS OF. . . Japan (2011 -2015) EPITHELIAL TUMOURS OF. . . 5. 0 10. 0 15. 0 20. 0 Korea (2011 -2015) Taiwan (2011 -2015) EPITHELIAL TUMOURS OF. . . 17. SKIN COMMON EPITHELIAL TUMOURS OF. . . EPITHELIAL TUMOURS OF SKIN EPITHELIAL TUMOURS OF. . . MALIGNANT SKIN MELANOMA 0. 0 Japan (2011 -2015) Taiwan (2011 -2015) 10. 0 20. 0 30. 0 Korea (2011 -2015) 40. 0 Japan (2011 -2015) 5. 0 Korea (2011 -2015) 10. 0 Taiwan (2011 -2015) IACR 2019 Vancouver, Canada 14
Discussion n n EU based RARECARE rarity threshold fits well to cancer incidence in East Asia. Most of rare cancers between three countries are similiar, and most of the continental gaps found in the current study were due to well known risk factors. IACR 2019 Vancouver, Canada 15
Discussion Nasopharynx and oral cavity cancers in Taiwan n - - Betel quid chewing is popular in Asian countries, including Taiwan. Smoking and alcohol drinking. Prevalence of HPV and EBV is a possible risk factor. Different incidence for esophageal cancers n - Risk factors for squamous cell carcinoma: smoking, alcohol, diet (Food rich in nitrogenous, tea, coffee, mate consumed at high temperature), genetic predisposition. Liver cancer n - High prevalence of HBV and HCV career in the area has been known as the main risk factor. IACR 2019 Vancouver, Canada 16
Discussion Gallbladder n - Because of an anomalous pancreatobiliary duct junction (APBDJ), a congenital malformation of the biliary tract that is more frequent in Japan, Korea, and possibly China, than in Western countries. Thyroid cancer n - Ultrasound screening of thyroid in Korea is also well known “artificial” risk factor for high incidence rate in thyroid cancer. Gastroenteropancreatic neuroendocrine tumour (GEP-NET) n - Rare in all the 4 areas. The notion was proposed in 2010 by the WHO classification which may result in confusion in the clinical setting in Asian countries. IACR 2019 Vancouver, Canada 17
Future collaborations n n n Survival analysis Prevalence estimation Additional countries interested to join? This research was supported by the Health Labour Sciences Research Grant in Japan (Cancer Control-General- 016, 2018 FY) IACR 2019 Vancouver, Canada 18
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