The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.
Objectives : A method of estimation using 8 populationbased cancer registries databases in Korea(KRCR DB) has been introduced as another strategy for validly estimating the national cancer incidence(NCI) in Korea. The purpose of this study was to evaluate the validity of this method with using the 7 KRCR DBs, excluding Seoul covering 21% of the total population of Korea. Methods : We designed the study method(NCSE_7) as same as the estimating method with using 8 KRCR DBs (NCSE_8) in order to ensure maximal comparability. We defined the expected number of cancer cases in each registry as the number of observed cases and then we added the weighted observed cases according to gender, age and the proportion of the population covered by each registry for the population of the seven regions and the population of all areas, with excluding these seven regions. From the expected number of total cancer incidents, the estimated NCI was calculated by dividing the expected number of cancer cases by the number of the total population. The standard error(SE) of the estimated incidence was also taken from the expected number of total cancer incidents. Results : Compared with the results of the NCSE_8, the overall age-standardized rates(ASR) in men and women became over-estimated and under-estimated, respectively. Primary sites that showed statistically significant differences were the colo-rectum, prostate, breast and thyroid. The index of death certificate only(DCO)and microscopically verified(MV)% indicating levels of data quality were decreased, especially for the brain in DCO% and kidney in the MV%. Conclusions : The database of Seoul regional cancer registry has a key role for the method to estimate the valid nationwide cancer statistics in Korea with using the population-based cancer registries databases.
Kim, Deok-Hun;Yun, Jun-Yong;Lee, Ju-Hyun;Kim, Soung-Min;Myoung, Hoon
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.37
no.2
/
pp.97-108
/
2011
Cancer stem cells have stem cell-like features, such as the ability for self-renewal and differentiation but show unlimited growth because they have the lost normal regulation of cell growth. Cancer stem cells and normal stem cells have similar features. They show high motility, diversity of progeny, robust proliferative potential, association with blood vessels, immature expression profiles, nestin expression, epidermal growth factor (EGF)-receptor expression, phosphatase and tensin homolog (PTEN) expression, hedgehog pathway activity, telomerase activity, and Wnt pathway activity. On the other hand, with cancer cells, some of these signaling pathways are abnormally modified. In 1875, Cohnheim suggested the concept of cancer stem cells. Recently, evidence for the existence of cancer stem cells was identified. In 1994, the cancer stem cells' specific cell surface marker for leukemia was identified. Since then, other specific cell surface markers for cancer stem cells in solid tumors (e.g. breast and colon cancer) have been identified. In oral cancer, studies on cancer stem cells have been performed mainly with squamous cell carcinomas. Oral cancer specific cell surface markers, which are genes strongly expressed in oral cancer and cancer stem cell specific side populations, have been identified. Cancer stem cells are resistant to radiotherapy and chemotherapy. Therefore, to eliminate malignant tumors efficiently and reduce the recurrence rate, therapy targeting cancer stem cells needs to be performed. Currently, studies targeting the cancer stem cells' specific signaling pathways, telomerase and tumor vasculatures are being done.
Park, Sung-Jin;Myoung, Hoon;Kim, Young-Youn;Paeng, Jun-Young;Park, Jun-Woo;Kim, Myung-Jin;Hong, Soon-Min
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.1
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pp.1-10
/
2008
Oral squamous cell carcinoma (OSCC) is the most frequent form of oral cancer and holds the eighth position in the cancer incidence ranking. OSCC patients are treated by classical therapeutic modalities consisting of surgery, radiotherapy, and/or chemotherapy. But OSCC still shows significant mortality rates. Thus, new therapeutic approaches have been investigated and the most promising one is naturally acquired agents with known anti-cancer effects. Genistein is a compound extracted from soy bean. Its anti-cancer effect on breast cancer is well established now and it is investigated whether it has similar effect on OSCC. It inhibited the growth and invasive-ness of OSCC cells in vitro, but these effects did not work in living animals in vivo. Catechin is a compound from green tea and its anti-cancer effect on OSCC is known better than other agents. Catechin showed its anti-cancer effect in vitro via induction of apoptosis, cell cycle arrest, inhibition of growth, and down-regulation of invasion/metastasis. These effects were confirmed in vivo with mouse model. Cordycepin is one of major pharmacologically important components in Cordyceps Militaris and may exert its anti-cancer effect as an adenosine receptor agonist. In recent study, it inhibited the proliferation of OSCC cells via A3 adenosine receptor. But because there is very scarce evidence on this effect, more researches are needed on this theme.
Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.
Objectives: Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. Methods: We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. Results: A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. Conclusions: The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.
Jang, Si-Hyong;Kim, Kyung-Ju;Oh, Mee-Hye;Lee, Ji-Hye;Lee, Hyun Ju;Cho, Hyun Deuk;Han, Sun Wook;Son, Myoung Won;Lee, Moon Soo
Journal of Gastric Cancer
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v.16
no.2
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pp.85-92
/
2016
Purpose: PIK3CA is often mutated in a variety of malignancies, including colon, gastric, ovary, breast, and brain tumors. We investigated PIK3CA expression in gastric cancer and explored the relationships between the PIK3CA expression level and clinicopathological features as well as survival of the patients. Materials and Methods: We examined PIK3CA expression in a tissue microarray of 178 gastric adenocarcinomas by immunohistochemistry and reviewed patients' medical records. Results: In our study, 112 of the 178 gastric cancer patients displayed positive PIK3CA expression. Overexpression of PIK3CA was correlated with low grade differentiation (P=0.001), frequent lymphatic invasion (P=0.032), and high T stage (P=0.040). Patients with positive PIK3CA staining were more likely to display worse overall survival rate than those with negative PIK3CA staining, as determined by Kaplan-Meier survival analysis with log-rank test (P=0.047) and a univariate analysis using the Cox proportional hazard model (hazard ratio=1.832, P=0.051). Conclusions: Elevated PIK3CA expression was significantly correlated with tumor invasiveness, tumor phenotypes, and poor patient survival.
Objectives : This study introduced the healthy life-year(HeaLY), a composite indicator of disease burden, and used it to estimate the burden of major cancers in Korea. Methods : We collected data from the national death certificate database, the national health insurance claims database and the abridged life table. This data was used to create a spreadsheet and estimate the burden of major cancers by sex in terms of HeaLYs. Results : The burden of 10 major cancers for males was 2,248.97 person-year in terms of HeaLYs. Stomach cancer, liver cancer, and lung cancer were responsible for 75.2% of the burden of 10 major cancers. The disease burden of 10 major cancers for females was estimated to be 1,567.58 person-years. About two thirds of HeaLYs lost were from stomach cancer, liver cancer, lung cancer, colorectal cancer, and breast cancer. The rankings among 10 major cancers were somewhat different in terms of both HeaLYs and deaths as the HeaLY method considers both mortality and morbidity. Conclusions : Despite the limitations of the data sources, we conclude that HeaLY can aid in setting policy priorities concerning major cancers by estimating the disease burden of these cancers. Time-series analysis of the disease burden using HeaLY and DALY will elucidate the strengths and weaknesses of both methods.
Sohn, Seil;Chung, Chun Kee;Han, Kyung Do;Jung, Jin Hyung;Hyeun, Joung Ho;Kim, Jinhee;Chang, Ung-Kyu;Sohn, Moon Jun;Kim, Sung Hwan
Journal of Korean Neurosurgical Society
/
v.62
no.1
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pp.46-52
/
2019
Objective : The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods. Methods : Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated. Results : Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate. Conclusion : For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.
Objectives This study aimed to analyze the research trends in clinical studies on the traditional Korean medicine used for cancer treatment between 2011 and 2020. Methods We searched 7 Korean web databases (Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies Information Service System [KISS], Korean Medical database [KMBASE], DBpia, Korea Institute of Science and Technology Information [KISTI], and KoreaMed) and classified collected papers dated between 2011 and 2020 by the year of publication, publication journal, study design, type of cancer affecting the patients, interventions used, evaluation system used, and combination with conventional medicine. Results A total of 167 papers were collected. More than 10 papers were published annually. The papers were mainly published in the Journal of Korean Traditional Oncology (28.7%). The predominant type of the study was case study (67.7%). The main type of cancer was breast cancer, affecting 262 patients. Most of the studies reported using multiple traditional Korean medicine treatments (55.1%). Eighty-nine studies reported using clinical laboratory tests for evaluation. Most of the patients took conventional medicine simultaneously (608 patients). Conclusions Research related to Korean medicine for cancer patients is at a rudimentary level. Therefore, for further clarity, high evidence-based researches, including randomized controlled trials and cohort studies, should be conducted.
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