DOI QR코드

DOI QR Code

The Study for Incidence Trends of Colorectal Cancer in Jeju-do

제주도 대장암 발생률 추세에 대한 연구

  • Chang, Weon-Young (Department of Surgery, School of Medicine, Jeju National University)
  • 장원영 (제주대학교 의과대학 외과학교실)
  • Received : 2016.02.18
  • Accepted : 2016.05.12
  • Published : 2016.05.31

Abstract

The age-adjusted incidence rate (AAR) of colorectal cancer in Korea peaked in 2011 and then began to decline. However, the AAR of colorectal cancer in Jeju increased continually from 1999 to 2013. Compared with the 16 major cities in Korea, the inhabitants of Jeju-do have a low cancer screening program participation rate, high alcohol consumption rate and high BMI. The present study aimed to provide a statistical basis for the lowering of the incidence of colorectal cancer in Jeju-do. The Jeju regional cancer institute data from 1999 to 2013 was used to analyze the between Jeju-do and Korea using the Joinpoint Regression program (Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute) Version 4.2.0 - April 2015. The AAR of colorectal cancer in Jeju-do has being increasing because of the increase in the rates of male colon cancer (average annual percent change 8.422%, p-value<0.000), female colon cancer (AAPC 6.136%, p-value<0.000), male rectal cancer (AAPC 4.221%, p-value 0.003) and colon cancer in people aged over 50 years (AAPC 7.986% p-value<0.000). The results of this study suggest that the treatment of precancerous lesions of the male rectum and lowering of the incidence of colon cancer in people aged over 50 years are necessary to reduce the colorectal cancer incidence rate in Jeju-do.

대한민국은 2011년을 정점으로 대장암의 연령표준화 발생률이 감소 추세이다. 그러나 제주도 대장암의 연령표준화 발생률은 1999년부터 2013년까지 계속 증가하고 있다. 제주도는 전국 16개 주요 시도와 비교할 때 암검진율이 낮고, 음주율과 비만율이 높은 지역이다. 본 연구는 제주도 대장암 발생률을 낮추는 데 필요한 통계적 기초 자료를 파악하기 위하여 제주 지역 암센터의 암등록 사업을 통해서 조사한 1999년부터 2013년까지의 자료를 Joinpoint Regression program(Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute) Version 4.2.0 - April 2015를 이용 국가 발생률과 이원비교 일치도 분석을 했다. 제주도는 남자 결장암 연평균 변화율이 8.422%(p-value<0.000), 여자 결장암의 연평균 변화율 6.136%(p-value<0.000), 남자 직장암의 연평균 변화율 4.221%(p-value 0.003)의 영향으로 대장암 발생률이 지속해서 증가하고 있다. 연령대는 50세 이상의 결장암이 연평균 변화율 7.986%(p-value<0.000)로 중요한 변수이다. 따라서 제주도 대장암 발생률을 낮추기 위해서는 남자 직장암에 대한 전암 단계의 치료와, 50세 이상 남녀 결장암 발생률을 낮추는 것이 중요하다.

Keywords

References

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer Journal international of cancer, Vol.136, No.5, pp. E359-86, March, 2015. https://doi.org/10.1002/ijc.29210
  2. Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre MF. The Global Burden of Cancer 2013. JAMA oncology, Vol. 1, No. 4, pp. 505-27, July, 2015. DOI: http://dx.doi.org/10.1001/jamaoncol.2015.0735
  3. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality, Gut, Accepted Article, 2016.
  4. Korea Central Cancer Registry, National Cancer Center. Annual report of cancer statistics in Korea in 2012, Ministry of Health and Welfare, 2014. (http://ncc.re.kr/english/infor/kccr.jsp)
  5. National Health Insurance Corporation, National Health Screening Statistics 2010-2014 [Internet] KOSIS, c2016[cited 2016 Jan. 28], Available from: http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=DT_35007_N009&conn_path=I2, (accessed Mar., 29. 2016)
  6. Ministry of Health, Welfare and Family Affairs, Community Health Survey 2008-2014 [Internet] KOSIS, c2015[cited 2015 May 6], Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_H_DR_HIGH&conn_path=I2, (accessed Mar., 29. 2016)
  7. Chang WY. The study for the Epidemiologic Characteristics of Cancer Patients in Jeju Special Self-governing Province. Journal of the Korea Academia-Industrial, cooperation Society Vol. 16, No. 2, pp. 1291-303, February, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.2.1292
  8. Ministry of Health, Welfare and Family Affairs. Cancer Registration Statistics 1999-2013 [Internet] KOSIS, c2016[cited 2016 Jan. 13], Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A0024&conn_path=I3, (accessed Mar., 29. 2016)
  9. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Statistics in medicine, Vol. 19, No. 3, pp. 335-51, February, 2000. DOI: http://dx.doi.org/10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.3.CO;2-Q
  10. Shin A, Jung K-W, Woo H, Jeong S-Y. Colorectal Cancer Incidence in Korea is not the Highest in the World. Cancer Research and Treatment, Accepted Article, 2016. https://doi.org/10.4143/crt.2015.484
  11. Axtell LM, Chiazze L, Jr. Changing relative frequency of cancers of the colon and rectum in the United States. Cancer, Vol. 19, No. 6, pp. 750-4, June, 1966. DOI: http://dx.doi.org/10.1002/1097-0142(196606)19:6<750::AID-CNCR2820190603>3.0.CO;2-B
  12. Cucino C, Buchner AM, Sonnenberg A. Continued rightward shift of colorectal cancer. Dis Colon Rectum, Vol. 45, No. 8, pp. 1035-40, August, 2002. DOI: http://dx.doi.org/10.1007/s10350-004-6356-0
  13. Takada H, Ohsawa T, Iwamoto S, Yoshida R, Nakano M, Imada S, et al. Changing site distribution of colorectal cancer in Japan. Dis Colon Rectum, Vol. 45, No. 9, pp. 1249-54, September, 2002. DOI: http://dx.doi.org/10.1007/s10350-004-6400-0
  14. Saltzstein SL, Behling CA. Age and time as factors in the left-to-right shift of the subsite of colorectal adenocarcinoma: a study of 213,383 cases from the California Cancer Registry. Journal of clinical gastroenterology, Vol. 41, No. 2, pp. 173-7, February, 2007. DOI: http://dx.doi.org/10.1097/01.mcg.0000225550.26751.6a
  15. Toyoda Y, Nakayama T, Ito Y, Ioka A, Tsukuma H. Trends in colorectal cancer incidence by subsite in Osaka, Japan. Jpn J Clin Oncol, Vol. 39, No. 3, pp. 189-91, March, 2009. DOI: http://dx.doi.org/10.1093/jjco/hyn144
  16. Shin A, Kim K-Z, Jung K-W, Park S, Won Y-J, Kim J, et al. Increasing Trend of Colorectal Cancer Incidence in Korea, 1999-2009. Cancer Research and Treatment : Official Journal of Korean Cancer Association, Vol. 44, No. 4, pp. 219-26, December, 2012. DOI: http://dx.doi.org/10.4143/crt.2012.44.4.219
  17. Nelson RL, Persky V, Turyk M. Determination of factors responsible for the declining incidence of colorectal cancer. Dis Colon Rectum, Vol. 42, No. 6, pp. 741-52, June, 1999. DOI: http://dx.doi.org/10.1007/BF02236929
  18. Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, et al. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet (London, England), Vol. 375, No. 9726, pp. 1624-33, May, 2010. DOI: http://dx.doi.org/10.1016/S0140-6736(10)60551-X
  19. Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA surgery, Vol. 150, No. 1, pp. 17-22, January, 2015. DOI: http://dx.doi.org/10.1001/jamasurg.2014.1756
  20. Siegel R, Desantis C, Jemal A. Colorectal cancer statistics, 2014. CA: A Cancer Journal for Clinicians, Vol. 64, No. 2, pp. 107-17, March/April, 2014. DOI: http://dx.doi.org/10.3322/caac.21220