Increased alcohol-related oesophageal cancer mortality rates in Japanese men

Age-adjusted oesophageal cancer mortality rates for Japanese women declined by 58% between 1960 and 1989, whereas corresponding rates for Japanese men have shown no decline. We speculate that alcohol-related oesophageal 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 cirrhosis mortality rates, would also experience a rise in oesophageal cancer mortality rates. To test this hypothesis, we compared male to female ratios of oesophageal cancer mortality rates by birth cohort with those of liver cirrhosis mortality rates. We calculated the attributable risk of alcohol consumption and smoking to oesophageal cancer in Japanese men using oesophageal cancer mortality rates in Japanese women as a baseline, i.e. non-alcohol and non-smoking related oesophageal cancer deaths. We applied this method to head and neck cancer deaths to test its feasibility. Male birth cohorts born after 1926, which experienced male to female cirrhosis mortality ratios, also experienced increased oesophageal cancer mortality ratios. Overall, drinking and smoking accounted for 86% of all oesophageal cancer deaths and 85% of head and neck cancer deaths among Japanese men.