• 한국인구학
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• 제35권1호
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• pp.151-179
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• 2012

본 연구는 Hernes 모형을 활용하여 출생코호트의 관점에서 최근까지 한국 사회가 경험한 혼인 및 출산 생애과정에서의 전반적인 변화 양상과 교육수준별 차이를 분석하고 있다. 분석 결과는, 첫째, 전반적으로 우리나라의 생애 혼인율이 매우 높은 수준이지만 상대적으로 가장 최근 출생코호트(1965~74) 남성의 경우 혼인율 감소폭이 다소 크게 나타나고 있음을 보여 주었다. 둘째, 출생코호트를 가로질러 관측된 생애 혼인율 감소는 추가적으로 교육수준별로 분화되는 모습을 보여 주었는데, 남성의 경우 저학력자 그리고 여성의 경우 고학력자의 생애 비혼 가능성이 높게 나타났다. 셋째, 출생코호트를 가로지른 출산 경험과 관련하여 첫째 및 둘째 출산에서는 출생코호트별 격차가 작은 반면 셋째 출산에서의 격차가 크게 나타남으로써 출생코호트를 가로질러 나타난 출산력에서의 양적 변화는 대체로 셋째 이상의 고순위 출산과 밀접히 연관됨을 시사하고 있다. 넷째, 출산에서의 교육수준별 격차와 관련하여 출산순위가 높아질수록 교육과 출산 사이에 보다 뚜렷한 역관계가 관측되었다. 마지막으로 본 연구의 분석 결과는 혼인 및 출산이 교육수준과 연계되는 방식이 다소 상이함을 보여 주었다. 남성과 여성 모두 최근의 출생코호트로 올수록 교육수준별 생애 혼인율에서의 격차가 커지는 경향을 보여 주지만 고순위 출산에서 관측되는 교육수준별 패턴은 최근 출생코호트로 올수록 교육수준별 격차가 오히려 감소하는 상반된 패턴을 보여 주었다.

• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.188-194
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• 2019

Objectives: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. Methods: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ${\leq}14years$ residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. Results: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. Conclusions: The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2407-2412
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• 2013

Background and Objectives: Data on associations between soy food intake after cancer diagnosis with breast cancer survival are conflicting, so we conducted this meta-analysis for more accurate evaluation. Methods: Comprehensive searches were conducted to find cohort studies of the relationship between soy food intake after cancer diagnosis and breast cancer survival. Data were analyzed with comprehensive meta-analysis software. Results: Five cohort studies (11,206 patients) were included. Pooling all comparisons, soy food intake after diagnosis was associated with reduced mortality (HR 0.85, 95%CI 0.77 0.93) and recurrence (HR 0.79, 95%CI 0.72 0.87). Pooling the comparisons of highest vs. lowest dose, soy food intake after diagnosis was again associated with reduced mortality (HR 0.84, 95%CI 0.71 0.99) and recurrence (HR 0.74, 95%CI 0.64 0.85). Subgroup analysis of ER status showed that soy food intake was associated with reduced mortality in both ER negative (highest vs. lowest: HR 0.75, 95%CI 0.64 0.88) and ER positive patients (highest vs. lowest: HR 0.72, 95%CI 0.61 0.84), and both premenopausal (highest vs. lowest: HR 0.78, 95%CI 0.69 0.88) and postmenopausal patients (highest vs. lowest: HR 0.81, 95%CI 0.73 0.91). In additioin, soy food intake was associated with reduced recurrence in ER negative (highest vs. lowest: HR 0.64, 95%CI 0.44 0.94) and ER+/PR+ (highest vs. lowest: HR 0.65, 95%CI 0.49 0.86), and postmenopausal patients (highest vs. lowest: HR 0.67, 95%CI 0.56 0.80). Conclusion: Our meta-analysis showed that soy food intake might be associated with better survival, especially for ER negative, ER+/PR+, and postmenopausal patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1313-1323
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• 2016

To study the full health effects of parental radiation exposure on the children of the atomic bomb survivors, the Radiation Effects Research Foundation developed a cohort of 76,814 children born to atomic bomb survivors (F1 generation) to assess cancer incidence and mortality from common adult diseases. In analyzing radiation-associated health information, it is important to be able to adjust for sociodemographic and lifestyle variations that may affect health. In order to gain this and other background information on the F1 cohort and to determine willingness to participate in a related clinical study, the F1 Mail Survey Questionnaire was designed with questions corresponding to relevant health, sociodemographic, and lifestyle indicators. Between the years 2000 and 2006, the survey was sent to a subset of the F1 Mortality Cohort. A total of 16,183 surveys were completed and returned: 10,980 surveys from Hiroshima residents and 5,203 from Nagasaki residents. The response rate was 65.6%, varying somewhat across parental exposure category, city, gender, and year of birth. Differences in health and lifestyle were noted in several variables on comparison across city and gender. No major differences in health, lifestyle, sociodemographics, or disease were seen across parental exposure categories, though statistically significant tests for heterogeneity and linear trend revealed some possible changes with dose. The data described herein provide a foundation for studies in the future.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4785-4790
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• 2013

Background and Objectives: Evidence for associations between alcohol consumption with breast cancer survival are conflicting, so we conducted the present meta-analysis. Methods: Comprehensive searches were conducted to find cohort studies that evaluated the relationship between alcohol consumption with breast cancer survival. Data were analyzed with meta-analysis software. Results: We included 25 cohort studies. The meta-analysis results showed that alcohol consumption was not associated with increased breast cancer mortality and recurrence after pooling all data from highest versus lowest comparisons. Subgroup analyses showed that pre-diagnostic or post-diagnostic consumpotion, and ER status did not affect the relationship with breast cancer mortality and recurrence. Although the relationships of different alcohol consumption with breast cancer mortality and recurrence were not significant, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence. Only alcohol consumption of >20 g/d was associated with increased breast cancer mortality, but not with increased breast cancer recurrence. Conclusion: Although our meta-analysis showed alcohol drinking was not associated with increased breast cancer mortality and recurrence, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence and alcohol consumption of >20 g/d was associated with increased breast cancer mortality.

• Journal of Preventive Medicine and Public Health
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• 제54권1호
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• pp.37-45
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• 2021

Objectives: Bisphenol A (BPA) is used in the electrical, mechanical, medical, and food industries. Previous studies have suggested that BPA is an endocrine disruptor. Regulation of BPA has led to increased use of bisphenol F (BPF) and bisphenol S (BPS). However, few studies have investigated the associations of BPF and BPS with thyroid dysfunction in children. Our study investigated the associations of prenatal BPA and early childhood BPA, BPF, and BPS exposure with thyroid function in 6-year-old children. Methods: Prenatal BPA concentrations were measured during the second trimester of pregnancy in an established prospective birth cohort. We measured urinary BPA, BPF, and BPS concentrations and thyroid hormone levels (thyroid-stimulating hormone, total T3, and free T4) in 6-year-old children (n=574). We examined the associations between urinary bisphenol concentrations and percentage change of thyroid hormone concentrations using multivariate linear regression. We also compared thyroid hormone levels by dividing the cohort according to BPA, BPF, and BPS concentrations. Results: The associations between prenatal BPA and total T3 levels were statistically significant in all models, except for girls when using a crude model. The associations between urinary BPA and BPS concentrations and levels of all thyroid hormones were not statistically significant. However, we observed that lower free T4 levels (-1.94%; 95% confidence interval, -3.82 to -0.03) were associated with higher urinary BPF concentrations in girls only. Conclusions: Our findings identified significant associations between prenatal BPA exposure and total T3 levels in all children and between BPF exposure and free T4 levels in girls only.

• 한국대기환경학회지
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• 제32권1호
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• pp.114-126
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• 2016

Many cohort studies have reported associations of individual-level long-term exposures to $PM_{10}$ and health outcomes. Individual exposures were often estimated by using exposure prediction models relying on $PM_{10}$ data measured at national regulatory monitoring sites. This study explored spatial and temporal characteristics of regulatory $PM_{10}$ measurement data in South Korea and suggested $PM_{10}$ concentration metrics as long-term exposures for assessing health effects in cohort studies. We obtained hourly $PM_{10}$ data from the National Institute of Environmental Research for 2001~2012 in South Korea. We investigated spatial distribution of monitoring sites using the density and proximity in each of the 16 metropolitan cities and provinces. The temporal characteristics of $PM_{10}$ measurement data were examined by annual/seasonal/diurnal patterns across urban background monitoring sites after excluding Asian dust days. For spatial characteristics of $PM_{10}$ measurement data, we computed coefficient of variation (CV) and coefficient of divergence (COD). Based on temporal and spatial investigation, we suggested preferred long-term metrics for cohort studies. In 2010, 294 urban background monitoring sites were located in South Korea with a site over an area of $415.0km^2$ and distant from another site by 31.0 km on average. Annual average $PM_{10}$ concentrations decreased by 19.8% from 2001 to 2012, and seasonal $PM_{10}$ patterns were consistent over study years with higher concentrations in spring and winter. Spatial variability was relatively small with 6~19% of CV and 21~46% of COD across 16 metropolitan cities and provinces in 2010. To maximize spatial coverage and reflect temporal and spatial distributions, our suggestion for $PM_{10}$ metrics representing long-term exposures was the average for one or multiple years after 2009. This study provides the knowledge of all available $PM_{10}$ data measured at national regulatory monitoring sites in South Korea and the insight of the plausible longterm exposure metric for cohort studies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2583-2589
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• 2013

Purpose: Studies have indicated that diabetes mellitus (DM) is a risk factor for bladder cancer; however, not all evidence supports this conclusion. The aim of this meta-analysis was to collate and evaluate all primary observational studies investigating the risk of bladder cancer associated with DM. Methods: The PubMed and Google Scholar databases were searched to identify studies that estimated the association of DM and bladder cancer. Summary effect estimates were derived using a random-effects meta-analysis model. Results: A total of 23 studies (8 case-control studies, 15 cohort studies) including 643,683 DM and 4,819,656 non-DM cases were identified. Analysis of all studies showed that DM was associated with an increased risk of bladder cancer compared with non-DM overall (OR=1.68, 95% CI 1.32-2.13). Analysis of subgroups demonstrated this to be the case in both case-control studies (OR=1.59, 95% CI 1.28-1.97, $I^2$=58%) and cohort studies (RR=1.70, 95% CI 1.23-2.33, $I^2$=96%). There was no gender difference in DM-associated bladder cancer risk. Bladder cancer risk was increased in Asia and the North America region, but not in Europe. Furthermore, DM-associated bladder cancer risk was obviously higher in Asia than North America and Europe or in those with Caucasian ethnicity. With extension of follow-up time, the bladder cancer risk was not increased for the patients with DM. Conclusions: This meta-analysis provided further evidence supporting theDM association with a significantly higher risk of bladder cancer obtained from observational studies.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.159-164
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• 2008

Objectives : The purpose of this systematic review was to investigate the association between dietary intake of citrus fruits and prostate cancer risk. Methods : Authors searched electronic databases and the reference lists of publications of diet and prostate cancer studies until August 2007. All of the epidemiological studies that obtained individual data on dietary intake of citrus fruits and presented risk estimates of the association between intake of citrus fruits and risk of prostate cancer were identified and included. Using general variance-based methods, study-specific odds ratios (OR)/ relative risk (RR) and associated confidence interval (CI)/ standard error (SE) for highest versus lowest intake of citrus fruits level were extracted from each paper. Results : Eleven articles including six case-control studies, one nested case-control study and four cohort studies, proved eligible. Overall summary OR using random effect model did not show an association in risk of prostate caner with intake of citrus fruits (summary OR=1.03, 95% CI=0.89-1.19) with large heterogeneity across studies that we were unable to explain ($I^2$=67.88%). The summary ORs in case-control studies and cohort studies were 1.10 (95% CI=0.97-1.22) and 1.05 (95% CI=0.96-1.14), respectively. Conclusions : Pooled results from observational studies did not show an association between intake of citrus fruits and the risk of prostate cancer, although results vary substantially across studies.

• 응용통계연구
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• 제31권4호
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• pp.427-446
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• 2018

UN의 고령화사회(ageing society) 정의와 통계청의 장래인구추계 (2016)에 따르면 우리나라는 만 30여년 만에 초고령사회(super-aged society)를 맞이하게 되며, 세계 어느 나라와도 비교할 수 없는 빠른 고령화 속도를 보인다. 이러한 유례없는 고령화 속도에 비해서 장기 시계열의 사망관련 데이터 확보와 연금과 복지정책을 고민하는 인식은 뒤처져 있다. 본 연구는 과거 및 미래 예측을 통해 우리나라 1955-2200년까지 245여 연간의 사망률 자료를 추정 예측하여 가상코호트와 실제코호트의 기대수명을 비교함으로써 그 차이가 어느 정도인지를 가늠해 보았다. 더불어 우리나라 고령화수준을 파악하기 위해 국제비교도 하였다. 역 추계(back-projection) 기간의 추정치는 선행연구와 Lee-Carte (LC) 모형으로 비교 분석해 정확성과 객관성을 높였으며, 2016년 이후의 예측치는 LC method extended with rotation (LC-ER) 모형을 활용해 우리나라의 사망률 개선의 교대현상을 반영하였다. 분석결과 60년 동안(1955-2015년) 약 30년에 가까운 기대수명의 증가가 이루어졌고, 2세기(1955-2155)동안 실제코호트의 기대수명이 가상코호트보다 높게 도출되었다. 실제코호트의 기대수명 비교우위는 비교 국가들 모두 공통적인 경향임을 확인하였다. 그리고 일본과 우리나라가 기대수명의 상위를 점하고 있고, 모든 국가들이 85-90세를 기점으로 가상과 실제코호트의 기대수명에 대한 증가속도가 이전보다 높지 않음을 보였다.