Epidemiology of the major cancers in the Asian Pacific

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The descriptive epidemiology of cancer in the Asian Pacific region of the world is now well-established due to the activities of cancer registries. Major differences in the most prevalent cancers continue to be observed, both within and between individual countries, gastric cancer being a prime example with high incidences in Japan, China and Korea but very low burdens in Thailand and Indonesia. Hepatocellular carcinomas are particularly prevalent in Mongolia while cancers of the oral cavity predominate in South Asia and are also relatively common in Taiwan, with a common link to betel chewing. Both ethnicity and specific dietary habits retain importance, for example with nasopharyngeal cancer in southern Chinese and cholangiocarcinoma in the north-east of Thailand. However, there are consistent trends affecting all countries, and cancer of the lung in males and lung and breast in females appear to be on the increase across the region. Of particular concern is the increase in adenocarcinoma of the female lung in non-smokers. Regarding mortality, there is major variation depending on the facilities available, level of awareness and socioeconomic background. For risk and beneficial factor analysis, great advances have recently been made due to the establishment of the Hospital-Based Epidemiologic Research Program at Aichi Cancer Center (HERPACC) and the Korean Multi-center Cancer Cohort Study including a Biological Materials Bank (KMCC-I). These are providing valuable clues as to potential preventive measures, generally in line with the literature for other regions of the globe. Included in HERPACC is a comprehensive approach to analysis of gene-environment interactions and influence of polymorphisms. The future should see greater emphasis on education and practical efforts by epidemiologists across the Asian Pacific to counter the growing threat of cancers due to tobacco smoking and the change to a high fat western diet. In addition to the focus on diet and physical exercise as preventive agents, for example now being tested for efficacy in the colon, further development of primary prevention approaches focusing on vaccines and chemopreventive agents await clinical trials.(Communicated by Takashi SUGIMURA, M. J. A., Feb. 12, 2003)
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Epidemiology of the major cancers in the Asian Pacific

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