PubMed Health⌕ Search

Biomedical subjects

A Hanai

Publications and source records attributed to A Hanai.

At least 37 records · Page 2Linked to original sources
PubMed1994

Interhospital differences in cancer survival: magnitude and trend in 1975-1987 in Osaka, Japan.

This study addresses the disparity in cancer survival rates among hospitals in Osaka, Japan. Using data from the Osaka Cancer Registry, four-year survival rates for stomach cancer patients (n = 8,845) diagnosed in 1976, 1981 and 1986, and lung cancer (n = 9,795) and breast cancer patients (n = 7,377) diagnosed in 1975-77, 1980-82 and 1985-87 were calculated according to four hospital categories (teaching hospitals, large hospitals: 400 + beds excluding teaching hospitals, medium-size hospitals: 150-399 beds, and small hospitals: 20-149 beds). Cox's proportional hazards model was employed with adjustment for sex, age, clinical stage at diagnosis, and treatment status. Stomach and lung cancer patients treated in large, medium-size and small hospitals showed significantly higher risks of death than those treated in teaching hospitals in 1975-87. Interhospital differences in breast cancer survival appeared to increase in 1975-87, whereas those in stomach and lung cancer survivals decreased during the same period.

Breast Neoplasms↗
PubMed1994

[Role of population-based cancer registry in cancer epidemiology--epidemiological studies in the Cancer Registration Scheme in Osaka, Japan].

A population-based cancer registration scheme started in three areas in Japan in the 1950s solely for studying cancer incidence in their respective areas. Soon thereafter, several prefectural governments started their own schemes as part of their cancer control programs, effectively expanding the aims of cancer registration: to clarify cancer facts, to elevate the medical care for cancer patients, and to plan and evaluate cancer control programs. The Osaka Cancer Registry (OCR) started in 1962, and has been using epidemiological methods as a tool in constructing its registration scheme, as well as analyzing and utilizing registry data. This report deals with the results obtained in the OCR, classifying these results into four activities of epidemiology. 1. Clarifying cancer facts (descriptive epidemiology): The OCR has been observing incidence, medical care for cancer patients, distribution of cases by clinical stage, and the 5-year relative survival rate, and has estimated the prevalence rate, cured-case rate, and future incidence into the 21st century. Population-based data on histology and multiple cancers collected at the OCR have also contributed to the new approaches in cancer epidemiology. 2. Research on risk factors (analytical epidemiology): The OCR developed a computerized record-linkage system in 1970. This not only made registry work more effective and reliable, but many cohort studies were able to be conducted with relatively little effort and highly reliable results. The cancer case file in the OCR has been linked with the newly prepared data file of the study group, and cancer incidence among the study group has been observed. Finally, cancer risks of possible causal factors in that group have been estimated quantitatively. 3. Evaluation of control programs: Secondary prevention programs (early detection) have been conducted in Japan as major cancer control programs, because effective risk factors were not previously defined. OCR data have been used for estimating sensitivity and specificity of screening tests for various cancers, as well as for evaluating the effect of clinical work on improving survival and on decreasing cancer deaths. 4. Planning future cancer control programs: The OCR has reported on the probable rapid increase of cancer incidence in the 21st century, especially of elderly cancer cases, and cancer cases with poor survival. To control these difficult problems, new cancer programs should be urgently designed and implemented. The authors have recommended that programs be prepared by cancer site, and have already presented a detailed program for lung cancer control.

Cohort Studies↗
PubMed1994

[Pharmacokinetic studies on continuous intraportal 5-fluorouracil infusion].

Pharmacokinetics of 5-FU administered by continuous intraportal infusion were studied by infusing 5 mg/kg, 10 mg/kg, 20 mg/kg, and 40 mg/kg of 5-FU, respectively, into the ileocecal vein for an hour. Blood samples were collected from portal vein, femoral vein and liver, and small intestine specimens were obtained at proper intervals. The rabbits were sacrificed at 120 minutes from the start of 5-FU infusion. The results were as follows: Extremely high concentrations of 5-FU in the portal vein, femoral vein and liver tissue were observed in the 5-FU group infused with 40 mg/kg. This phenomenon was suggested to rely on the effect by which the 5-FU catabolic enzyme, dihydrouracil dehydrogenase, was saturated with a large inflow of 5-FU. FdUMP concentration of the liver was lower than that of the small intestine in all groups. These results suggest that a large dose of 5-FU infusion is effective to increase the FdUMP concentration in the liver with continuous intraportal 5-FU infusion.

Animals↗
PubMed1994

[Trends of lung cancer incidence and its prognosis in Osaka, Japan].

Lung cancer incidence figures in Japan were estimated as 30,000 for males and 11,000 for females for 1989 and represented the second and the fifth leading site of cancer, respectively, according to the Research Group for Population-based Cancer Registration in Japan. It is also estimated that lung cancer will steadily increase in the future. In relative frequencies of the major histological types, squamous cell carcinoma showed a decreasing trend, while small as well as large cell carcinomas showed an increasing trend in Osaka. In the distribution of clinical staging, the proportion of localized cases accounted for only 20% of the lung cancers in 1990. Five-year relative survival rates for lung cancer were 11.3% for all patients and 43.0% for localized cases in Osaka in 1984-1986. The rates were reported as 13.5% and 36.6% for total patients and localized cases, respectively, among caucasians from the SEER Program, a NCI project including 10 population-based cancer registries in the US. No noticeable difference was observed between Japan and the US. To control lung cancer in Japan it is considered vitally important and urgent to develop (1) new examination methods for diagnosing lung cancer in the earlier stage, (2) an efficient and effective cessation campaign for cigarettes smoking and (3) non-smoking based education.

Carcinoma, Squamous Cell↗
PubMed1993

Interhospital differences in cancer survivals in Japan. The Research Group for Population-based Cancer Registration in Japan.

The present study was an investigation of variations in cancer survival rates among hospitals in Japan, focusing in particular on the number of hospital beds as an institutional characteristic. Using data from 11 population-based cancer registries, the three-year survival rates for stomach cancer (n 1665), colorectal cancer (n 1090) and lung cancer (n 895) patients diagnosed in 1985 were calculated according to three different hospital categories (100-299, 300-499, 500+ beds). Cox's proportional hazards model was conducted, with adjustments for sex, age, clinical stage at diagnosis and treatment status, excluding patients who had been detected by screening (asymptomatic cases). The stomach and lung cancer patients treated in small hospitals (100-299 beds) were at a significantly higher risk of death than those treated in large hospitals (500+ beds) (hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.11-1.65; HR = 1.41, 95% CI = 1.13-1.77, respectively). Similar findings were observed among colorectal cancer patients although they were not statistically significant. The findings can provide some information useful for the development of future public health policies aimed at controlling cancer mortality rates in our country.

Adult↗
PubMed1993

[Arterial infusion chemotherapy of 5-FU and leucovorin for patients with liver metastases from colorectal cancer].

Fifteen patients with liver metastases from colorectal cancer were treated by arterial infusion of 5-FU and leucovorin. Two regimens were performed. One was weekly bolus infusion of leucovorin following bolus infusion of 5-FU (bolus group), the other was 5 days continuous infusion of 5-FU and leucovorin in 3 weeks (continuous group). One PR was obtained both in the bolus group and in the continuous groups. The objective response rate was 11% in the bolus group and 20% in the continuous group. The one- and 2-year survival rates for these patients were 40% and 0% in the bolus group, and 80% and 60% in the continuous group, respectively. These results suggest that continuous arterial infusion of 5-FU and leucovorin was more effective than individual bolus arterial infusion of leucovorin and 5-FU for patients with liver metastases from colorectal cancer.

Adult↗
PubMed1992

Second primary cancer following laryngeal cancer with special reference to smoking habits.

The risk of developing a second primary cancer following laryngeal cancer was estimated by following-up 472 male laryngeal cancer patients for an average of 8.6 years by means of record linkage to the Osaka Cancer Registry. Of these patients, 115 developed a second cancer other than laryngeal cancer, whereas the expected number derived from the incidence rates among Osaka residents was 51.4 (relative risk (RR) = 2.2, 95% confidence interval = 1.85-2.69). Cumulative risk of developing a second primary cancer was estimated to be 31.1% at 15 years after laryngeal cancer. By site, the risks were significantly increased for tobacco-related cancers, RR = 24.5, 6.1 and 2.3 for cancers of the oral cavity & pharynx, esophagus and lung, respectively. Also, the risks were higher among heavy smokers for cancer of the oral cavity & pharynx and esophagus than among light smokers. No adverse effects of radiotherapy for laryngeal cancer on the development of thyroid cancer, lymphoma and leukemia were observed. The present study suggests the necessity of following-up laryngeal cancer patients over a long period in order to enable the early detection of tobacco-related cancer.

Adult↗
PubMed1992

[DNA ploidy pattern of flow cytometry as indicator of degrees of malignancy and prognosis in colorectal cancers].

Cellular DNA content of primary colorectal cancers was measured by flow cytometry and investigated on clinico-pathological features to elucidate the relationship between DNA ploidy patterns and outcomes. IN 144 colorectal carcinomas, DNA diploid carcinomas accounted for 23% and DNA aneuploid carcinomas for 77%. NO significant difference was observed between DNA ploidy pattern and tumor differentiation, lymph node metastasis or lympangial invasion. DNA aneuploid tumor had a tendency to invade vein and to lead to hematogenic metastasis. Patients with DNA aneuploid tumor showed a significantly poor disease-free and overall survival rate. Significantly increased incidence of hematogenic recurrence was demonstrated in the DNA aneuploid cases. These results suggest that the DNA ploidy pattern of colorectal cancers may prove to be of prognostic value.

Adult↗
PubMed1992

[Pharmacokinetic studies of continuous and bolus intraportal 5-fluorouracil infusion].

We studied the pharmacokinetics of continuous and bolus intraportal 5-FU infusion. In continuous intraportal infusion group, 20 mg/kg of 5-FU was infused into ileocecal vein for an hour and the same dose was infused bolusly in bolus intraportal infusion group. Blood samples were collected from portal vein continuously and liver specimens were obtained continuously. The rabbits were sacrificed at 180 minutes from the start of infusion of 5-FU and small intestine was obtained. The results were as follows: A significantly higher concentration of 5-FU in the portal vein was observed in the continuous intraportal infusion group compared with the one-shot infusion group. But the elimination rate of 5-FU was more rapid after cessation of infusion in the continuous infusion group. The rate of FdUMP elimination in the liver tended to be lower in bolus intraportal infusion. The FdUMP concentration in the small intestine was higher in the continuous intraportal infusion group than in the bolus infusion group. In the continuous intraportal infusion group, the FdUMP concentration in the liver was lower than in the small intestine. This depended on the effect of the 5-FU catabolic enzyme, dihydrouracil dehydrogenase, which is contained in the liver in large quantities. The results suggest that in order to increase the FdUMP concentration in the liver with continuous intraportal 5-FU infusion, suppression of the effect of this enzyme is necessary.

Animals↗
PubMed1992

[Trends of cancer occurrence and survival in Japan, and in Osaka].

Recent improvements in cancer medical care in Osaka have resulted in the elevation of survival rates of cancer patients, except for the so-called "refractory" cancers. Five-year relative survival rates for reported patients diagnosed in 1981-1983 were higher than 60% for cancers of the breast, uterus and bladder, and around 40% for rectum, colon and stomach cancers. However, cancers of the liver, gallbladder, pancreas, and lung continued to show very low survival rates of less than 10%. In higher age-groups, advanced cases occupied a larger proportion while cases which received curative resection occupied a smaller proportion. Reflecting this, survival rates were lower in age-groups higher than 75, and the reduction of age-differences between younger and older groups was not observed during the decade. Cancer incidence for all sites in Japan was estimated by the Research Group for Population-based Cancer Registries to be 320,000 in 1985. The stomach, colorectal, lung, liver, and breast were the five leading cancer sites. According to the authors' studies, cancer incidence is projected to be 740,000 in Japan in 2015, of which 40% would be patients of "refractory" cancers and 62% would be aged patients in their upper than 70, though these were 19% and 32% in 1985. In order to combat this difficult situation in the near future, the following activities are urgently required: (1) Promotion of primary preventive measures for incurable cancers. (2) Development of specific therapy programs taking into account of QOL for aged patients as well as advanced patients. (3) Promotion of secondary preventive measures for aged people as well as younger people.

Age Factors↗
PubMed1991

Second primary cancers following colon and rectal cancer in Osaka, Japan.

The frequencies of second primary cancers following colon and rectal cancers were estimated using the Osaka Cancer Registry's population-based data for Osaka, Japan. A series of 7,312 colon and 6,923 rectal cancer cases newly diagnosed in the period of 1966-1986 were followed up until the end of 1986. The average follow-up period was 3.6 years for colon cancer and 3.7 years for rectal cancer. Significantly elevated risks of second primary cancers following colon cancer were observed for cancers of the rectum (O/E = 2.0; 95% confidence interval (CI) = 1.1-3.4 among males, O/E = 4.3; 95% CI = 2.4-7.2 among females), corpus uteri (O/E = 8.2; 95% CI = 3.3-16.9), ovary (O/E = 4.3; 95% CI = 1.0-5.0), and female thyroid gland (O/E = 4.7; 95% CI = 1.7-8.8). These findings were more notable among right-sided colon cancer patients than left-sided colon cancer patients. The elevated risks of second primary cancers were particularly evident among patients younger than 50 years of age at the time of diagnosis of the initial cancer (colon cancer: O/E = 3.1 among males, 3.4 among females, rectal cancer: O/E = 1.7 among males, 1.3 among females). These findings suggest that younger colorectal cancer patients should undergo more careful checkups throughout their lives.

Age Factors↗
PubMed1991

Second primary cancer after diagnosis of stomach cancer in Osaka, Japan.

The risk of developing a second primary cancer following stomach cancer was estimated from data accumulated in the Osaka Cancer Registry. Of the 38,777 male patients and 22,391 female patients newly diagnosed in the period 1966-1986 who were followed up until the end of 1986, 778 and 267 developed a second cancer other than stomach cancer, respectively, whereas the expected numbers had been 928.8 (RR = 0.84, 95% CI = 0.78-0.90) and 297.7 (RR = 0.90, 95% CI = 0.79-1.01). The risks were higher among younger patients (aged 30-54 at the diagnosis of stomach cancer) than among older patients (aged 55-69 at the diagnosis of stomach cancer). Significantly elevated risks were observed for cancers of the oral cavity & pharynx (RR = 1.56), colon (RR = 1.61) and rectum (RR = 1.56) for males, and oral cavity & pharynx (RR = 2.59) for females as second cancers. Results were substantially similar among the localized stomach cancer patients. Among younger male patients with gastrectomy, the risk of developing pancreatic cancer was elevated 10 or more years after stomach cancer diagnosis. The present study suggests the necessity of following up stomach cancer patients in order to enable the early diagnosis of digestive tract cancer.

Adult↗
PubMed1991

[Experimental studies on prevention of liver metastases by continuous intraportal chemotherapy].

Our experiment was designed to elucidate the efficacy of continuous intraportal chemotherapy (CIPC) for the prevention of liver metastases. Catheter was introduced into ileocecal vein of white rabbit for administration of adriamycin (ADM). VX2 cells were inoculated into portal vein to form liver metastases. Three experiments were designed as follows: 1) Immediately after inoculation of tumor cells, ADM was administered continuously for 7 days. 2) Continuous administration of ADM started on the 3rd day after inoculation of tumor cells. 3) Immediately after inoculation of tumor cells, ADM was administered by CIPC or systemically for 7 days. The same number of tumor cells were inoculated into portal vein and no treatment was given in control group. The rabbits were sacrificed on the 14th day. Number and size of liver metastases were calculated. Results were as follows: In 1) and 2), the metastases in CIPC group were significantly decreased in number and size compared with those in control group. In 3), no metastasis was observed in CIPC group, but a third of the rabbits developed metastases in systemic group. These results suggest that CIPC is effective for prevention of liver metastases and its efficacy is greater than for systemic chemotherapy.

Animals↗
PubMed1991

[A retrospective cohort study of workers in small asbestos industries in south Osaka].

A retrospective cohort study was carried out on asbestos workers who had received health examinations in 1972 to 1974 conducted by the Osaka Health Center. The subjects, total of 789 (329 males, 460 females) were followed-up for 10 years (Jan. 1, 1975-Dec. 31, 1984). There were sixty-one deaths in the cohort--4 tuberculosis, 12 malignant neoplasms (4 stomach cancers, 8 respiratory cancers including one case of pleural mesothelioma), 18 circulatory diseases, 24 respiratory diseases, and 3 other causes of death. Standardized mortality ratio (SMR) was calculated age and sex-specific death rates for the general population in Osaka between 1975-79 and 1980-84. SMR for all causes of death, stomach cancer, respiratory cancer, circulatory diseases, and respiratory diseases were 1.15, 3.29, 0.75, 3.88, 0.93 and 8.63 respectively. Respiratory cancer and respiratory diseases showed statistically significant (p less than 0.01) excess death with a mean death age of 59 and 56 years old respectively.

Adolescent↗
PubMed1990

Trends and differentials in ovarian cancer: incidence, mortality and survival experience.

Ovarian cancer was reported to be increasing in the 1970s. A continuously increasing trend has been anticipated for quite some time and an observation of international trends and differentials in the mortality, morbidity and survival from ovarian cancer is provided. Recent data on mortality and morbidity were obtained from the WHO and IARC data banks. Globally, ovarian cancer had moderate or relatively low rates for both mortality (1.5-10 per 100,000) and incidence (4-15 per 100,000), using standardized (world) rates. The ranges were the narrowest among all major cancers. The observed pattern of long-term trends was classified into three types: 1) increase followed by a plateau, then a decrease, 2) steady increase, and 3) uncertain. The rate was seen to be fairly high in the first group and still low in the second while it fluctuated in the third. A decrease of the rates in younger age-groups has extended to upper age-groups in countries with the first type of trend. Germ-cell tumours appeared more frequently in younger ages and low-incidence areas, while the common "epithelial" cancers were more apparent in older age-groups and high-incidence areas. The geographical differences seem to be smaller for germ cell carcinomas than the common "epithelial" carcinomas which may be associated more with environmental risk factors. Five-year survival rates improved to a range of 25-41% in the latter half of the 1970s.

Adolescent↗
PubMed1988

A comparative epidemiologic study on geographic distributions of cancers of the lung and the large intestine in Japan.

To examine what kinds of factors could have caused the geographic variation observed in lung cancer morbidity in Japan, a correlation study was performed comparing various regional traits. The same study was also conducted on large intestinal cancer, aiming to distinguish the possible urban factors associated with both cancers. Lung cancer was highly correlated with industrialization-related factors such as localization of manufacturing industries, automobile traffic and air pollution, whereas colon cancer was correlated with the population density of workers in the tertiary industries such as services, trade and government. A multiple regression analysis could not detect any single factor with an exceptionally strong influence on either cancer. The present findings suggest that the hazardous environmental condition of urban areas has, to some extent, contributed to the recent increase of lung cancer cases in this country.

Age Factors↗
PubMed1988

Comparison of lung cancer incidence rates by histological type in high and low incidence countries, with reference to the limited role of smoking.

To find a clue to lung cancer etiology in Japan, differences in the pattern of lung cancer histology and related time trends between Osaka, Japan, and the North West Region of England were investigated. Material comprised all incident lung cancer cases registered in both regional registries (14,521 in the Osaka Cancer Registry and 29,859 in the North West Regional Cancer Registry). (1) The age-standardized incidence rate of lung cancer was higher in the North West Region than in Osaka (80.4 among males and 20.9 among females per 100,000 population in 1979-82 versus 32.1 and 9.2 respectively). (2) A higher proportion of adenocarcinoma was observed in Osaka (36.3% in males and 62.0% in females) than in the North West Region (12.3% and 18.9% respectively). (3) Using the relative frequencies of each histological type according to sex and age-group, age-standardized incidence rates were calculated for the main lung cancer histological types. It was shown that the incidence rates of adenocarcinoma were similar in the two areas (10.6 in males and 5.3 in females in Osaka versus 10.0 and 3.5 in the North West Region, respectively) while those of squamous cell and small cell carcinomas were much higher in the North West Region than in Osaka. (4) Time trends of incidence rates showed an increase only for adeno- and small cell carcinomas in Osaka. Slight increases were observed for adenocarcinoma in both sexes and for squamous cell carcinoma in females in the North West Region. (5) Considering cigarette consumption and the relative risks of smoking in the two areas, the possible existence of other risk factors for adenocarcinoma in both sexes in Japan, besides active smoking, was suggested.

Adenocarcinoma↗