INCREASED ALCOHOL-RELATED ESOPHAGEAL CANCER MORTALITY-RATES IN JAPANESE MEN

Age-adjusted oesophageal cancer mortality rates for Japanese women dec lined by 58% between 1960 and 1989, whereas corresponding rates for Ja panese men have shown no decline. We speculate that alcohol-related oe sophageal cancer mortality rates have been increasing in Japanese men replacing non-alcohol related oesophageal cancer deaths. Specifically, male birth cohorts, which experienced increased alcohol-related cirrh osis mortality rates, would also experience a rise in oesophageal canc er mortality rates. To test this hypothesis, we compared male to femal e ratios of oesophageal cancer mortality rates by birth cohort with th ose of liver cirrhosis mortality rates. We calculated the attributable risk of alcohol consumption and smoking to oesophageal cancer in Japa nese men using oesophageal cancer mortality rates in Japanese women as a baseline, i.e. non-alcohol and non-smoking related oesophageal canc er deaths. We applied this method to head and neck cancer deaths to te st its feasibility. Male birth cohorts born after 1926, which experien ced male to female cirrhosis mortality ratios, also experienced increa sed oesophageal cancer mortality ratios. Overall, drinking and smoking accounted for 86% of all oesophageal cancer deaths and 85% of head an d neck cancer deaths among Japanese men.