中・下咽頭癌の疫学・臨床統計

Epidemiology and Clinical Statistics of Oropharyngeal and Hypopharyngeal Carcinoma

要旨　中・下咽頭癌は食道癌に比べて頻度は少ないが，最近は徐々に増加しつつある．大阪府がん登録のデータによる最近3年間（1999～2001年）の男性の年齢調整罹患率（人口10万対，1985年日本モデル人口）は，下咽頭癌1.9，中咽頭癌1.1であり，35年前より約6倍増加している．大部分は扁平上皮癌であり，明らかに過度の喫煙，飲酒が発癌危険因子となっている．これらの癌では約25％に多重癌がみられ，その部位は頭頸部，食道，胃，肺の4つで82％を占めており，なかでも食道癌が37％と最も多い．このことは上部気道消化管を重点的に検索する必要性を示唆している．今後，関連診療科の協力の必要性がますます高くなるであろう．

　The incidence of carcinoma of the oropharynx (OPC) and the hypopharynx (HPC) has been gradually increasing, although much less than that of the esophagus. According to data from Osaka Cancer Registry, the male age-standardized incidence rates per 100,000 (The Japanese 1985 model population) of OPC and HPC are 1.9 and 1.1 respectively over the last three years (1999～2001). These figures are about six times higher than 35 years ago. Most histological types of OPC and HPC are squamous cell carcinoma and the major carcinogenic risk factors are evidently excessive drinking and smoking. Multiple primary malignancies arise in about 25％ of the patients with OPC and HPC, 82％ of which are in the esophagus (37％), the head ＆ neck, the stomach and the lung. This suggests that careful examination for multiple primary malignancies in the upper aerodigestive tract is essential, especially in high-risk patients. Cooperation between concerned medical staffs will become increasingly important.