Cancer rates vary dramatically between countries, none more so than between Japan and the USA. Overall age adjusted cancer rates in the USA are more than 50% higher than in Japan.
Americans have a 30% chance of developing cancer and a 11.2% chance of dying from it by the age of 75 compared to a 20.4% chance of developing cancer and a 9.7% chance of dying from it in Japan. The only common forms of cancer that are more prevalent in Japan are pancreatic, liver, colorectal, and stomach cancer. Interestingly enough, Japan has one of the lowest cancer rates in the developed world despite a relatively high percentage of Japanese being regular smokers.
The disparities in cancer rates are one of the major reasons life expectancy is almost five years higher in Japan than the United States (82.9 vs 78.1).
The following table shows age adjusted cancer rates per 100,000 people for both the United States and Japan courtesy of data from GLOBOCAN, 2008. Rates are for men and women combined with the exception of breast and prostate cancer which are female and male only rates respectively.
|Cancer Type||USA Rate||Japan Rate|
Data courtesy of GLOBOCAN, 2008 (http://globocan.iarc.fr)
Interestingly, despite a much higher incidence, mortality from cancer is only marginally higher in the USA compared to Japan. The age standardized mortality rate from cancer in the USA is 104.1 per 100,000 compared to 94.8 per 100,000 in Japan, a difference of just 10%. This is partly due to the Japanese having higher rates of cancers that carry a poor prognosis such as pancreatic, liver, and stomach cancer, and partly due to superior survival rates across most cancer sites in the USA (despite many complaints about an inefficient health system, the USA has some of the highest cancer survival rates in the world).
Reasons for the differences in cancer rates between the two countries include: height and weight differences, differences in meat consumption, differences in fruit and vegetable consumption, skin color, salt intake, Helicobacter Pylori infection rates, hepatitis B & C rates, and differences in the carcinogenicity of cigarettes.
These factors are discussed in more detail below.
Height and weight differences: Japanese men and women are around 3 inches shorter than their American counterparts. Studies have found that tall people are more likely to develop several forms of cancer including colorectal, melanoma, and breast cancer. Americans are also much more likely to be overweight than Japanese people, 26% of adult Americans have a BMI over 30 compared to just 4% of Japanese. Obesity increases the risk of developing several forms of cancer including pancreatic, bladder, and prostate cancer.
Differences in meat consumption: Japanese eat less red and processed meats and more fish than Americans. Red and processed meats have been linked to an increased risk of colorectal and pancreatic cancer, particularly when they are cooked at high temperatures. Fish on the other hand has been linked to a decreased risk of some forms of cancer including the esophagus and colon.
Differences in fruit and vegetable consumption: The Japanese consume a similar amount of fruit to Americans but have a much higher vegetable intake (excluding potatoes). Popular vegetables in Japan include mushrooms, peppers, cabbage, spinach, daikon (radish), and green beans. High consumption of fruit and vegetables, particularly of the green leafy variety, can decrease overall cancer risk by as much as 15%.
Skin color: Japanese melanoma rates are much lower than Caucasian American rates because darker skin colors naturally protect against UV radiation.
Salt intake: A high intake of salt has been linked to an increased risk of stomach cancer. Japanese diets tend to be very high in salt. Soy sauce, a popular condiment in Japanese cuisine, contains more than 1,000mg of sodium per serving – almost half the recommended daily intake.
Helicobacter Pylori infection: Helicobacter Pylori is a bacterium that inhabits the upper gastro-intestinal tract of infected individuals. Helicobacter Pylori is thought to be responsible for as many as 80% of stomach cancer cases worldwide. Infection rates are higher in Japan than in the United States.
Hepatitis B & C rates: Hepatitis B and C combined are responsible for 78% of primary liver cancers. Both hepatitis B & C are more common in Japan where liver cancer rates are more than twice the rate of the USA.
Carcinogenicity of cigarettes: Cigarettes in Japan tend to have lower levels of carcinogens than cigarettes in the USA. Cigarette smoking raises the risk of cancers of the lung, oesophagus, stomach, colon, mouth, and pancreas among others.
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