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RARE CANCERS ARE ALSO NOT RARE IN ASIA :THE RARE CANCER BURDEN IN EAST ASIA

This study examines the incidence and classification of rare cancers in East Asia based on standardized population-based data. Results show similarities and differences in rare cancer patterns among Asian countries compared to Europe.

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RARE CANCERS ARE ALSO NOT RARE IN ASIA :THE RARE CANCER BURDEN IN EAST ASIA

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  1. RARE CANCERS ARE ALSO NOT RARE IN ASIA:THE RARE CANCER BURDEN IN EAST ASIA Tomohiro Matsuda1, Young-Joo Won 2 RuRu Chun-Ju Chiang 3, Kumiko Saika 1, Jiwon Lim 2 and Annalisa Trama 4 1National Cancer Center, Japan 2 National Cancer Center, Republic of Korea 3 Taiwan Cancer Registry, Taiwan 4 IstitutoNazionaledeiTumori, Italy IACR2019 Vancouver, Canada

  2. COI Disclosure Information • I have no financial relationships to disclose. Lead Presenter/Responsible Researcher: Tomohiro Matsuda IACR2019 Vancouver, Canada

  3. Rare cancerdefinition • Rare cancers: incidence<6/100,000/year in Tier 2 in EU (Rare diseases: prevalence<50/100,000/year) IACR2019 Vancouver, Canada

  4. Multi-layerstructure of rare cancerclassifiction • Tier 3: WHO BB names of individual cancer entities and ICD-O-3 codes. • Tier 2 (215): Grouped by using morph and topo. Consistent diagnostic and therapeutic approaches. • Tier 1 (68): Includes NOS morph. major cancer entities in a clinical sense • Family (19): Focusing on referral of patients IACR2019 Vancouver, Canada

  5. The project of surveillance of rare cancers in Asian countries (RARECAREnet Asia) provides the first standardized population-based incidence in Asia based on the latest list of rare cancers defined by the RARECARE group. Background IACR2019 Vancouver, Canada

  6. Background: Cancer Registry in East Asia IACR2019 Vancouver, Canada

  7. Methods • Common protocol for data analyses • Analyses performed by each PBCR with the standardized analysis tool kit including the latest RARECARE list • List of data quality indicators and checks • 2 meetings and several call conference • PBCR data on patients diagnosed from 2011 to 2015 in JP, KR and TW in comparison with the data in EU IACR2019 Vancouver, Canada

  8. Data quality in the 3 Asian countries were as high as EU. DCO%: 0.8-4.8% Topography NOS: 0.01-4% Morphology NOS (mean): 7.3-13.1% MV%: 83.7-91.1% Incidence of all rare cancers was 93.9 in JP, 106.1 in KR and 103.5 in TW and 67.8 in EU corresponding to 16.1% (JP), 23.7% (KR), 24.2% (TW) and 22.2% (EU) of all new cancer diagnoses. Newly diagnosed rare cancers annually: 139,497 (JP), 52,071 (KR) and 24,147 (TW). Results IACR2019 Vancouver, Canada

  9. Results • N of Tier 2 entities with crude incidence rate <6/100,000 in Asia (out of 215): • 196 in JP, 203 in KR, 200 in TW, 198 in EU. • Same rare cancer entities in 3 Asian countries: 194 entities • 189 out of 193 were rare in all the 4 areas • Same common cancer entities in 3 Asian countries : 2 entities RARE COMMON IACR2019 Vancouver, Canada

  10. Among RARE cancer families, Epithelial tumours of nasopharynx, oropharynx and oral cavity and lips were not rare in TW. Epithelial tumours of oral cavity and lip was not rare in JP, neither. Epithelial tumours of gallbladder and extra hepatic biliary tract was not rare in JP and KR. Thyroid cancer was not rare in Asia. Among COMMON cancer families, Epithelial tumours of esophagus was not common in KR. Epithelial tumours of corpus uteri was not common in KR and ovary was not common in KR and TW. Epithelial tumours of kidney was not common in TW. Skin melanoma was not common in Asia. Results IACR2019 Vancouver, Canada

  11. RARE CANCER FAMILIES HEAD &NECK DIGESTIVE RARE ENDOCRINE ORGAN HEMATOLOGIC RARE IACR2019 Vancouver, Canada

  12. COMMON CANCER FAMILIES DIGESTIVE COMMON FEMALE GENITAL COMMON MALE GENITAL & UROGENITAL COMMON SKIN COMMON IACR2019 Vancouver, Canada

  13. Comparison of 3 Asian countries (ASR(W)) RARE IACR2019 Vancouver, Canada

  14. Comparison of 3 Asian countries (ASR(W)) COMMON IACR2019 Vancouver, Canada

  15. Discussion • EU based RARECARE rarity threshold fits well to cancer incidence in East Asia. • Most of rare cancers between three countries are similiar, and most of the continental gaps found in the current study were due to well known risk factors. IACR2019 Vancouver, Canada

  16. Discussion • Nasopharynx and oral cavity cancers in Taiwan • Betel quid chewing is popular in Asian countries, including Taiwan. • Smoking and alcohol drinking. • Prevalence of HPV and EBV is a possible risk factor. • Different incidence for esophageal cancers • Risk factors for squamous cell carcinoma: smoking, alcohol, diet (Food rich in nitrogenous, tea, coffee, mate consumed at high temperature), genetic predisposition. • Liver cancer • High prevalence of HBV and HCV career in the area has been known as the main risk factor. IACR2019 Vancouver, Canada

  17. Discussion • Gallbladder • Because of an anomalous pancreatobiliary duct junction (APBDJ), a congenital malformation of the biliary tract that is more frequent in Japan, Korea, and possibly China, than in Western countries. • Thyroid cancer • Ultrasound screening of thyroid in Korea is also well known “artificial” risk factor for high incidence rate in thyroid cancer. • Gastroenteropancreatic neuroendocrine tumour (GEP-NET) • Rare in all the 4 areas. The notion was proposed in 2010 by the WHO classification which may result in confusion in the clinical setting in Asian countries. IACR2019 Vancouver, Canada

  18. Future collaborations • Survivalanalysis • Prevalenceestimation • Additionalcountriesinterested to join? This research was supported by the Health Labour Sciences Research Grant in Japan (Cancer Control-General- 016, 2018 FY) IACR2019 Vancouver, Canada

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