Cancer Information and Epidemiology Division

9. Cancer Information and Epidemiology Division

This division covers a whole variety of research activities related to cancer information and epidemiology. Information relevant to cancer occurrence and its clinical outcomes is collected, stored into cancer databases, and analyzed using various techniques including epidemiology and statistics. Clinical images are also under investigation. Our final goal is to provide not only health professionals but also the public and cancer patients with information that will be useful in the fight against cancer. Therefore, the technical aspects for data collection and distribution are also within the scope of our research activities.
Collection and Analysis of Cancer Databases

The cancer databases currently under investigation include the cancer patients database of the National Cancer Center Hospital and other cancer centers, a database of familial cancer patients, and a cancer mortality database. Biological databases such as a transcription factors database are also under development.⁽¹⁴³⁾ Analysis of the cancer patients database, identified an increased risk of second prima ry cancers among patients who were treated by cyclophosphamide and cisplatin for their first malignancies. Databases of gastric and lung cancer patients with familial aggregation of cancer among first degree relatives are currently under development in collaboration with the Biology Division. Epidemiological analysis of cancer mortality data is also under way. The cancer maps of Japan and the world have been updated for major sites using 1995 mortality data.
Epidemiological Studies

Epidemiological studies are being conducted to identify risk and protective factors of various cancers.^{(144, 145)} Special efforts are made for lifestyle-related factors such as diet. The Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases is currently under way as a collaborative study with the Epidemiology and Biostatistics Division and the National Cardiovascular Center. Other studies include an epidemiological study of indoor radon exposure and a case-control study of lung cancer by histologic subtypes. The secular trend of lung cancer incidence rate was found to show differences by histologic subtypes. The incidence rate of squamous cell carcinoma was found to have reached a plateau in recent years, whereas that of adenocarcinoma and small cell carcinoma remain on the increase. Statistical analyses were also conducted as collaborations with researchers outside the division.^{(146, 147)}
JCOG Data Center

The division is running the Data Center (formerly, Statistical Center) of the Japan Clinical Oncology Group (JCOG), which is a multi-institutional collaborative study group. It is currently running 52 clinical trials, 29 of which are in the patients enrollment phase and the remaining 23 trials are in the follow-up phase. A new database management system is currently under development, in which the assurance of safety and ethical issues are placed as the main goals to be achieved in addition to the assurance of data quality. A guideline for statistical analysis of clinical data was outlined for clinical research.⁽¹⁴⁷⁾ Methodologies of data management in collaborative clinical trials are also investigated.
Research and Development of Clinical Support Systems

The division plays a part in the development and maintenance of hospital information systems and the Cancer Center network system.⁽¹⁴⁸⁾ New clinical support systems are also under development, including a virtual reality surgical simulation system and a virtual reality application for terminal care. Other topics under investigation include the use of mobile computers in hospital care and computer-assisted diagnosis of chest thin section CT images.⁽¹⁴⁹⁾ In the latter study, a new computer algorithm to adjust the background bias in the chest field was developed and applied to the automatic extraction of vessels in the lung and high er diagnostic accuracy was achieved.⁽¹⁴⁹⁾
WHO Collaborating Centre for Reference on Smoking and Health

The National Cancer Center is designated by the World Health Organization as a WHO Collaborat ing Centre for Reference on Smoking and Health and the division takes the responsibility of running this Centre. The lung cancer mortality rate in Japan was investigated in relation to tobacco smoking and the age-specific lung cancer mortality rate was shown to increase linearly with the cumulative cigarettes consumption by that age. This linear increase was shown for 5-year age groups from 40-44 to 75-79. Using these linear equa tions, the risk of an individual with any level of cigarette consumption in the past can be estimated on an individual basis.
The prevalence of nicotine addiction in Japan was also studied and about half of Japanese smokers were found to be nicotine addicted. This clearly showed that nicotine addiction should be taken into account in smoking cessation programs.




	9. Cancer Information and Epidemiology Division



		This division covers a whole variety of research activities related to cancer information and epidemiology. Information relevant to cancer occurrence and its clinical outcomes is collected, stored into cancer databases, and analyzed using various techniques including epidemiology and statistics. Clinical images are also under investigation. Our final goal is to provide not only health professionals but also the public and cancer patients with information that will be useful in the fight against cancer. Therefore, the technical aspects for data collection and distribution are also within the scope of our research activities. Collection and Analysis of Cancer Databases The cancer databases currently under investigation include the cancer patients database of the National Cancer Center Hospital and other cancer centers, a database of familial cancer patients, and a cancer mortality database. Biological databases such as a transcription factors database are also under development.⁽¹⁴³⁾ Analysis of the cancer patients database, identified an increased risk of second prima ry cancers among patients who were treated by cyclophosphamide and cisplatin for their first malignancies. Databases of gastric and lung cancer patients with familial aggregation of cancer among first degree relatives are currently under development in collaboration with the Biology Division. Epidemiological analysis of cancer mortality data is also under way. The cancer maps of Japan and the world have been updated for major sites using 1995 mortality data. Epidemiological Studies Epidemiological studies are being conducted to identify risk and protective factors of various cancers.^{(144, 145)} Special efforts are made for lifestyle-related factors such as diet. The Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases is currently under way as a collaborative study with the Epidemiology and Biostatistics Division and the National Cardiovascular Center. Other studies include an epidemiological study of indoor radon exposure and a case-control study of lung cancer by histologic subtypes. The secular trend of lung cancer incidence rate was found to show differences by histologic subtypes. The incidence rate of squamous cell carcinoma was found to have reached a plateau in recent years, whereas that of adenocarcinoma and small cell carcinoma remain on the increase. Statistical analyses were also conducted as collaborations with researchers outside the division.^{(146, 147)} JCOG Data Center The division is running the Data Center (formerly, Statistical Center) of the Japan Clinical Oncology Group (JCOG), which is a multi-institutional collaborative study group. It is currently running 52 clinical trials, 29 of which are in the patients enrollment phase and the remaining 23 trials are in the follow-up phase. A new database management system is currently under development, in which the assurance of safety and ethical issues are placed as the main goals to be achieved in addition to the assurance of data quality. A guideline for statistical analysis of clinical data was outlined for clinical research.⁽¹⁴⁷⁾ Methodologies of data management in collaborative clinical trials are also investigated. Research and Development of Clinical Support Systems The division plays a part in the development and maintenance of hospital information systems and the Cancer Center network system.⁽¹⁴⁸⁾ New clinical support systems are also under development, including a virtual reality surgical simulation system and a virtual reality application for terminal care. Other topics under investigation include the use of mobile computers in hospital care and computer-assisted diagnosis of chest thin section CT images.⁽¹⁴⁹⁾ In the latter study, a new computer algorithm to adjust the background bias in the chest field was developed and applied to the automatic extraction of vessels in the lung and high er diagnostic accuracy was achieved.⁽¹⁴⁹⁾ WHO Collaborating Centre for Reference on Smoking and Health The National Cancer Center is designated by the World Health Organization as a WHO Collaborat ing Centre for Reference on Smoking and Health and the division takes the responsibility of running this Centre. The lung cancer mortality rate in Japan was investigated in relation to tobacco smoking and the age-specific lung cancer mortality rate was shown to increase linearly with the cumulative cigarettes consumption by that age. This linear increase was shown for 5-year age groups from 40-44 to 75-79. Using these linear equa tions, the risk of an individual with any level of cigarette consumption in the past can be estimated on an individual basis. The prevalence of nicotine addiction in Japan was also studied and about half of Japanese smokers were found to be nicotine addicted. This clearly showed that nicotine addiction should be taken into account in smoking cessation programs.