Malignant Neoplasms Found by Autopsy in Hisayama, Japan, During the First Ten Years of A Community Study2

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Abstract
In Hisayama (a farming community in Kyushu island, Japan), autopsies were performed on 360 unselected residents dying at or after the age of 20 years, from November 1, 1961 to October 31, 1971. The autopsy rate among residents dying at or after the age of 40 years was about 84%. On the basis of autopsy data, frequency and site of malignant neoplasms were studied. The accuracy of clinical diagnosis was assessed by comparison of the diagnosis completed before autopsy with the autopsy findings. Malignant neoplasms were found at autopsy in 89 of 339 people 40 years old or over; double carcinoma was found in 2 of the 89. Among the 91 malignant neoplasms verified, the three most frequent sites were stomach (38.5%), pancreas (12.1%), and lung (11.0%). The accuracy of clinical diagnosis was poor for carcinomas of the pancreas and lung, whereas it was good for carcinomas of the stomach and cervix uteri. Death rates for carcinoma of pancreas and lung have risen sharply in Japan in recent years, whereas those for carcinoma of stomach and cervix uteri have been stable or declining. Such findings suggested that the rise in the death rates for carcinomas of the pancreas and lung was, in part, due to change in diagnostic techniques. Stomach carcinoma was not overdiagnosed in our series.

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