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The effects of a wide variety of ecological factors on sex and age-specific mortality rates from five major and from all malignant neoplasms in 46 Japanese prefectures were analyzed by stepwise regression analysis twice with a 5-year interval. The major risk factors identified in the two years were as follows: (1) urban residence for malignant neoplasms of the stomach, lung, breast and uterus in elderly women, and for all malignant neoplasms in elderly men and women (and middle-aged women); (2) rural residence for leukemia and all malignant neoplasms in middle-aged men and for leukemia in girls of school age; (3) low income for malignant neoplasm of the uterus in middle-aged and elderly women, for malignant neoplasm of the lung in middle-aged women and elderly men, and for all malignant neoplasms in elderly men; and (4) the old age factor for malignant neoplasm of the stomach in middle-aged men, for leukemia in young girls, and for all malignant neoplasms in young and elderly men. Mortality rates from all malignant neoplasms in elderly men, together with those from malignant neoplasm of the lung and leukemia, significantly increased between 1970 and 1975. Age-adjusted mortality rates from malignant neoplasms of the lung, breast and uterus, and all malignant neoplasms in urban areas within the 46 prefectures surveyed, were significantly higher than those in rural areas in the two years.

Ecological risk factors for mortality from major malignant neoplasms by age and sex.