• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.999-1002
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• 2012

Epirus is a rural area of North-Western Greece. We reviewed data from 4 hospitals for 4.975 patients who underwent prostate biopsy in Epirus in the twelve year period from 1999 to 2010. Two six -year periods were compared (1999-2004 and 2004-2010). All cases of prostate cancer confirmed by biopsy were recorded and age-standardized incidence rates per 100,000 males were calculated. We also recorded the clinical stage for patients diagnosed in our hospital and correlated this with PSA and Gleason scores. Percentage of positive prostate biopsies was also calculated. There were a total of 1714 new cases during 1999-2010 and the mean annual age-adjusted incidence was 34/100.000. The mean incidences during 1999-2004 and 2005-2010 were 26/100,000 and 42/100,000, respectively. The mean age at diagnosis was 74. The most common Gleason score was 6 and the prevalent clinical stage was T2. Median PSA at diagnosis was 10.8 ng/ml. There was a significant difference between stage cT4 and all other stages regarding PSA value (p=0.000). A positive correlation was found between Gleason score and PSA (p=0.013). These results are in accordance with the incidence rise recorded in neighboring countries of South-East Europe. However we should keep in mind the risk of overdiagnosis and the detection of low-risk cancers that would not have caused morbidity or death during a man's lifetime anyway.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6955-6959
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• 2013

The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.843-851
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• 1996

To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation (KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: $16.76\sim17.92$) per 100,000 and the cumulative rates for the ages $0\sim64\;and\;0\sim74$ were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in $1983\sim1987$. The truncated rate for ages $35\sim64$ was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged $55\sim59$ years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.

• Journal of Preventive Medicine and Public Health
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• 제54권5호
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• pp.293-300
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• 2021

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.566-573
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• 2016

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.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.411-420
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• 2012

This paper presents the most recent data on cancer rates and the burden of cancer in the ASEAN region. Epidemiological data were sourced from GLOBOCAN 2008 and disability adjusted life years (DALYs) lost were estimated using the standard methodology developed within the World Health Organization's Global Burden of Disease study. Overall, it was estimated there were over 700,000 new cases of cancer and 500,000 cancer deaths in ASEAN in the year 2008, leading to approximately 7.5 million DALYs lost in one year. The most commonly diagnosed cancers were lung (98,143), breast (86,842) and liver cancers (74,777). The most common causes of cancer death were lung cancer (85,772), liver cancer (69,115) and colorectal cancer (44,280). The burden of cancer in terms of DALYs lost was highest in Laos, Viet Nam and Myanmar and lowest in Brunei, Singapore and the Philippines. Significant differences in the patterns of cancer from country to country were observed. Another key finding was the major impact played by population age distribution on cancer incidence and mortality. Cancer rates in ASEAN are expected to increase with ageing of populations and changes in lifestyles associated with economic development. Therefore, ASEAN member countries are strongly encouraged to put in place cancer-control health care policies, focussed on strengthening the health systems to cope with projected increases in cancer prevention, treatment and management needs.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.526-537
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• 1999

Objectives : It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. Methods : Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years' follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. Results : In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of $\geq$ 110 mg/dl compared with $\leq$ 80 mg/dl, Hazard Ratio[HR]:15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI $\geq$ 25.3 compared with $\leq$ 21.3) was 7.19(95% CI=3,75-13.8); of weight change during middle life(>10kg compared with $\leq$ 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper fertile compared with lower fertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). Conclusion : The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.

• Clinical and Experimental Pediatrics
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• 제50권12호
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• pp.1206-1211
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• 2007

목 적 : 사회경제적 환경의 변화로 첫 아이를 출산하는 어머니의 연령이 늦어지고 있다. 많은 연구자들이 첫 아이를 출산하는 어머니의 연령이 늦어지는 것과 저체중출생아의 출생율과의 관계에 대해 연구하였으나 아직 일치된 연구결과를 얻지 못하고 있다. 이에 따라 본 연구자들은 산모의 연령이 저체중출생아의 출생률에 미치는 영향을 알아보고자 본 연구를 시행하였다. 방 법 : 2001년부터 2003년까지 통계청의 인구동태자료 중 출생기록에 등록된 1,545,338명 중 단태아면서 첫 번째 아이인 736,167명을 대상으로 저체중출생아와 극소저체중출생아의 출생률에 대해 어머니의 나이, 직업, 학력, 결혼유무, 거주지, 결혼 기간, 아버지의 직업과의 관계를 다중 로지스틱 회귀분석을 이용하여 분석하였다. 결 과 : 산모의 연령에 따라 저체중출생아가 출생할 위험률은 30-34세, 35-40세, 40세 이상의 초산부는 25세에서 29세의 초산부에 비해 각각 1.3배, 2.1배, 2.4배 높게 나타났으며 어머니의 직업, 학력, 결혼유무, 거주지, 결혼 기간, 아버지의 직업 등을 감안하여도 1.3배, 1.9배, 2.0배로 모두 유의하게 높게 나타났다. 산모의 연령에 따라 극소체중출생아가 출생할 위험률은 30-34세, 40-44세, 45세 이상의 초산부는 25세에서 29세의 초산부에 비해 각각 1.8배, 3.3배, 3.7배 높게 나타났으며 어머니의 직업, 학력, 결혼유무, 거주지, 결혼 기간, 아버지의 직업 등을 보정하여도 1.6배, 2.7배, 2.6배로 모두 유의하게 높게 나타났다. 각각의 산모의 연령과 교육 정도, 결혼유무에 따른 저체중출생아의 출생률을 비교하였을 때 30대의 고등학교 졸업 이상이고 기혼인 산모에서 저체중출생아의 출생률(3.7%)은 20대의 고등학교 졸업이상이고 기혼인 산모보다 더 낮았다. 결 론 : 본 연구에서 산모가 나이가 많아질수록 저체중출생아와 극소저체중출생아가 출생할 위험률이 높으며 어머니의 직업, 학력, 결혼유무, 거주지, 결혼 기간, 아버지의 직업 등을 고려하여도 높다. 하지만 나이가 많은 산모라도 사회경제적 환경이 개선된 다면 저체중출생아의 출생률을 줄일 수 있고 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.733-738
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• 2016

Background: Ardabil, a Northwestern province of Iran, was found to have the highest rate of gastric cancer (GC) in the country (ASRs = 51.8/100,000 for males and 24.9/100,000 for females) and one of the highest gastric cardia cancer rates in the world. The aim of the present study was to assess the associations of the cagA and babA2 status of Helicobacter pylori with GC in the Ardabil population. Materials and Methods: A total of 103 patients with non-atrophic gastritis (56) and GC (47), who underwent endoscopy at the Imam Khomeini Hospital in Ardabil, were assessed. The status of 16S rDNA, cagA and babA2 genes was determined using PCR and histopathological assessment was performed. Results: The following genotypic frequency was observed: cagA+ (50.6%), cagA-(49.4%), babA2+ (26.5%), babA2- (73.5%) cagA+/babA2+ (19.3%), cagA-/babA2+ (7.2%), cagA+/babA2-(31.3%), cagA-/babA2-(42.2%). Although the frequency of the cagA+, cagA+/babA2+ and cagA-/babA2+ genotypes in patients with GC (55.6%, 25.9%, and 14.8%, respectively) was higher than in those with NAG (48.2%, 16.1%, and 3.6%, respectively), the difference did not reach significance. In contrast, the presence of the babA2 gene (40.7% vs 19.6%) significantly increased the risk of GC; the age-sex-adjusted odds ratio (95% confidence interval) was 5.068 (1.506-17.058; P=0.009), by multiple logistic regression. Conclusions: It is proposed that the H. pylori babA2 positivity might be considered as an important determinant of GC risk in Ardabil.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2841-2846
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• 2016

Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.