• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3951-3955
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• 2015

Background: Colorectal cancer mortality has started to decrease in several developed countries in Asia. The current study aimed to present the long-term trends in colorectal cancer mortality in Korea using joinpoint analysis and age-period-cohort modeling. Materials and Methods: The number of colorectal cancer deaths and the population for each 5-year age group were obtained from Statistics Korea for the period 1984-2013 for adults 30 years and older. Joinpoint regression analysis was conducted to determine changes in trends in age-standardized mortality rates, and age-period-cohort analysis was performed to describe trends in colorectal cancer mortality using the intrinsic estimator method. Results: In men, the age-standardized mortality rate for colorectal cancer increased from 1984 to 2003, and the mortality rates stabilized thereafter, whereas the mortality rate of colorectal cancer in women has decreased since 2004. The age-specific mortality rate of colorectal cancer increased in both men and women over time, whereas decreases in the age-specific mortality rate in younger cohorts were observed. In the age-period-cohort analysis, old age and recent period were associated with higher mortality for both men and women. The birth cohort born after 1919 showed reduced colorectal cancer mortality in both men and women. Conclusions: Our study showed a recent decreasing trend in colorectal cancer mortality in women and a stable trend in men after 2003-2004. These changes in colorectal cancer mortality may be attributed to birth cohort effects.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7569-7573
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• 2014

The main objective of this study was to analyze the mortality trends of female breast cancer in Turkey between the years 1987-2008. The rates per 100,000 age-standardized to the European standard population were assessed and time trends presented using joinpoint regression analysis. Average annual percent change (AAPC), anual percent change (APC) and 95% confidence interval (CI) was calculated. Nearly 23,000 breast cancer deaths occurred in Turkey during the period 1987-2008, with the average annual age-standardized mortality rate (ASR) being 11.9 per 100,000 women. In the last five years, significant increases were observed in all age groups, but there was no significant change over the age of 65. In this period, the biggest significant increase was in the 45-54 age group (AAPC=4.3, 95%CI=2.6 to 6.0).

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6391-6396
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• 2015

Background: To analyze cervical cancer mortality trends in China from 1991-2013 and forecast the mortality distribution in future five years (2014-2018), and provide clues for prevention and treatment. Materials and Methods: Mortality data for cervical cancer in China from 1991 to 2013 were used to describe the epidemiological characteristics and distribution, including the trend of the standardized mortality rate, urban-rural differences, and age variation. Trend-surface analysis was used to analyze the geographical distribution of mortality. Curve estimation, time series, gray modeling, and joinpoint regression were performed to predict and forecast mortality trends. Results: In recent years, the mortality rate of cervical cancer has increased, and there is also a steady increase in the incidence from 2003 to 2013 in China. Mortality rates in rural areas are higher than in urban areas. The mortality dramatically increases in the 40+ yr age group, reaching a peak in the >85 yr age group. In addition, geographical analysis showed that the cervical cancer mortality increased from the southwest to west-central and from the southeast to northeast of the country. Conclusions: The incidence rate and the mortality rate are increasing from 1991 to 2013, and the predictions show this will continue in the future. Thus, implementation of prevention and management programs for cervical cancer are necessary in China, especially for rural areas, young women in urban areas, and high risk regions (the west-central).

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1959-1964
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• 2015

Purpose: To investigate the distribution of liver cancer mortality as well as its developing trend from 1991 to 2012, forecast the future five-year trend, and provide a basis for the comprehensive prevention and management. Materials and Methods: Mortality data for liver cancer in China from 1991 to 2012 were used to describe characteristics and distribution of liver cancer mortality. Trend surface analysis was used to study the geographical distribution of liver cancer mortality. Curve estimation, time series modeling, gray modeling (GM) and joinpoint regression were used to predict and forecast future trends. Results: The mortality rate of liver cancer has constantly increased in China since 1991. Rates in rural areas are higher than in urban areas, and in males are higher than in females. In addition, our data predicted that the trend will continue to increase in the next 5 years. The age-specific mortality of liver cancer increases with age and peaks in the group of 80-84 years old. Geographical analysis showed the liver mortality rate was higher in the southeast provinces, such as Jiangsu, Zhejiang and Guangdong, and southwest regions like Guangxi Province. Conclusions: The standardized mortality rate of liver cancer in China has consistently increased from 1991 to 2012, and the upward trend is predicted to continue in the future. Much better prevention and management of liver cancer is needed in high mortality areas (the southwestern and southeastern parts of China) and high mortality age groups (80- to 84-year-olds), especially in rural areas.

• Asian Journal of Atmospheric Environment
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• 제3권1호
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• pp.9-18
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• 2009

This study aimed at assessing the association between exposure to severe air pollution in the past and the subsequent transition in lung cancer mortality among persons who lived in an industrial city. Vital statistics from 1983 to 2006 and the data on air pollution measurements from 1960 to 1990 in Amagasaki City, Japan, were used. Pearson correlation coefficients were calculated between the standardized mortality ratios (SMRs) for lung cancer and the air pollution levels in 6 wards of Amagasaki City. The associations between changes in air pollution levels and the annual SMRs were also evaluated in the light of a potential latency period. The levels of air pollution were extremely high in the 1960s, and they decreased since 1970. The SMRs for lung cancer in 1989-1993 among females for 6 wards were significantly associated with the amounts of both sulfur oxides and dust fall in the past for each ward. The positive associations were observed between the annual SMRs among females and the amounts of both pollutants when the lag time of 20-30 years was taken into account. These results suggest that severe air pollution in the 1960s in an industrial city affected the subsequent increase in lung cancer mortality.

• 지역사회간호학회지
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• 제23권1호
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• pp.31-39
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• 2012

Purpose: The purpose of this paper was to compare community health status by region and to investigate related factors using community health and social indicators. Methods: Data were collected from statistics of local districts that were provided by KNSO and KCDC. ANOVA and correlation were analyzed using PASW 18.0. Results: The standardized cancer mortality rate was higher in metropolitan areas than in other areas. On the contrary, the mortality of respiratory disease, traffic accident, and suicide were higher in rural areas. Small cities and county districts showed higher prevalence in obesity prevalence than metropolitan areas. Metropolitan areas presented higher prevalence in alcohol drinking during the previous month, perceived stress, and seat belt use. The age-adjusted standardized mortality rate was correlated with higher prevalence of smoking, obesity, percentage of the elderly, number of beds, number of social welfare facilities, number of registered cars, lower percentage of financial independence, number of doctors, and percentage of water supply service & sewage. Conclusion: Since significant differences in mortality rate and prevalence of health risk behaviors exist between regional areas and the mortality rate was correlated with other social indicators and health indicators, health policies and social policies considering these differences should be develop and implemented to the communities.

• 디지털융복합연구
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• 제11권10호
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• pp.459-467
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• 2013

이 연구의 목적은 질병관리본부의 퇴원손상환자조사 자료를 이용하여 지역의 소득수준에 따른 의료이용의 차이를 규명하는 것이었다. 지역의 경제적 수준은 234개 시 군 구의 재정자립도를 지표로 하여 5분위로 구분하였다. 주요 결과로는 첫째, 소득수준이 낮을수록 연령표준화입원률과 표준화사망률이 증가하였다. 둘째, 16개 주요 질환 중 뇌혈관질환, 심장질환, 폐암, 위암이 소득수준에 따른 표준화사망률의 변화가 큰 것으로 나타났다. 셋째, 소득수준이 낮을수록 응급 경유 입원이 증가하였다. 넷째, 대부분의 주요 질환에서 소득수준이 낮을수록 평균재원일수가 증가하는 것으로 나타났다. 따라서, 지역별 건강 불평등의 격차를 줄이기 위해서는, 지역 및 소득수준별 특성에 맞는 지역보건의료정책이 수립되어야 할 것이다.

• 보건행정학회지
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• 제27권2호
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• pp.114-120
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• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2041-2047
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• 2016

Background: Liver cancer (LC) is the sixth world most common cancer and the second leading cause of cancer death. Due to the importance and necessity of awareness about the incidence and mortality of diseases to perform prevention programs, this study focused on data for LC and its relationship with the human development index (HDI) and its components in Asia in 2012. Materials and Methods: This ecological study was based on GLOBOCAN data for Asian countries. We assessed correlations between standardized incidence rates (SIR) and standardized mortality rates (SMR) of LC with HDI and its components using of SPSS18. Results: A total of 582,420 incident cases and 557,097 deaths were recorded in Asian countries in 2012. The five with the highest SIR were Mongolia, Lao PDR, Vietnam, Republic of Korea and Thailand and those with the highest SMR were Mongolia, Lao PDR, Vietnam, Cambodia and Thailand. A negative relation was observed between HDI and LC for SIR of 0.049 (P=0.748) and for SMR of 0.07 (P=0.645), with life expectancy at birth a positive relation for SIR of 0.061 (P=0.687) and a negative relation for SMR of 0.079 (P=0.603), with the average years of education a negative relation fo SIR of 0.476 (p=0.952) and for SMR of 0.032 (P=0.832), and with the country income level per person a negative relation for SMI of 0.11 (p=0.465) and for SMR of 0.113 (P=0.455). Conclusions: The incidence of LC is more in less developed and developing countries but statistically significant correlations were not found between standardized incidence and mortality rates of LC, and HDI and its dimensions.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7321-7324
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• 2013

Objective: To estimate the incidence and mortality rates for pancreatic cancer in China. Methods: After checking and reviewing the cancer registry data in 2009 from 72 cancer registry centers, we divided cancer registry areas into urban and rural areas. Incidence/mortality rates, age-specific incidence/mortality rates, age-standardized incidence/mortality rates, proportions, and cumulative incidence/mortality rates for pancreatic cancer were calculated. Results: The total number of newly diagnosed pancreatic cancer cases and deaths in 2009 were 6,220 and 5,650, respectively. The crude incidence rate in all cancer registry areas was 7.28/100,000 (males 8.24, females 6.29). The age-standardized incidence rate by Chinese standard population (ASR) was 3.35/100,000, with ranking at 7th among all cancers. Pancreatic cancer incidence rate was 8.19/100,000 in urban areas whereas it was 5.41/100 000 in rural areas. Cancer mortality rate in all cancer registry areas was 6.61/100,000 (males 7.45; females 5.75), with ranking at 6th among all cancers, and 7.42/100 000 in urban but 4.94/100000 in rural areas. Conclusions: Pancreatic cancer incidence and mortality rates have shown a gradual increase in China. Owing to the difficulty of early diagnosis, identification of high-risk population and modification of risk factors are important to reduce the burden of pancreatic cancer.