Cancer is one of the major targets of disease control programs in Japan. A Joinpoint regression model was used to analyze the longterm trends of mortality related to overall cancer and the 15 most common cancers based on published data from the National Vital Statistics of Japan between 1958 and 2004. Since 1996, a decline has been seen in overall cancer for both sexes in Japan. Most of the common sites, including cancers of the stomach, colon, liver, gallbladder and lung and leukemia in both sexes, cancer of esophagus in men and rectal and ovarian cancers in women showed a decreasing trend, and cancers of the rectum, pancreas, prostate and urinary bladder and malignant lymphoma in men and cancers of the esophagus and uterus in women leveled off during the most recent period. However, an increasing trend was confirmed for cancers of the pancreas, breast and urinary bladder and malignant lymphoma in women. An effective cancer control program including prevention, early detection and treatment should be implemented to further reduce the cancer mortality, particularly for cancer sites that show higher mortality rates or increasing trends.

The relation between smoking and pancreatic cancer is most consistently described. A further analysis of the relationships between family history, hormonal factors in females, dietary and nutritional factors, obesity, physical activity and pancreatic cancer is necessary.

The cumulative incidence of secondary cancers in children in Japan was not high; however, the SIR was relatively high. Retinoblastoma or sarcoma in addition to allogeneic stem cell transplantation were significant risk factors for secondary cancers.

The present study provides updated figures and trends in childhood cancer mortality in Japan and other developed countries. This will help to estimate care needs and to plan intervention and the quantity of appropriate childhood cancer treatment.