• Journal of the Korean Data and Information Science Society
• /
• 제25권6호
• /
• pp.1531-1538
• /
• 2014

The causes of cancer are diverse, complex, and only partially understood. Many factors including health behaviors, socioeconomic environments and geographical locations can directly damage genes or combine with existing genetic faults within cells to cause cancerous mutations. Collecting the cancer data and reporting the statistics, therefore, are important to help identify health trends and establish normal health changes in geographical areas. In this article, we analyzed cancer data and demon-strated how spatial patterns of the age-standardized rate and health indicators can be examined visually and simultaneously using linked micromap plots. As a result of data analysis, the age-standardized rate has positive correlativity with thyroid and breast cancer, but the rate has negative correlativity with smoking and drinking. In addition, the regions with high age-standardized rate are located in southwest and the areas of high population density while the standardized mortality ratio is higher in southwest and northeast where there are lots of rural areas.

• 보건행정학회지
• /
• 제28권1호
• /
• pp.15-22
• /
• 2018

Background: Health is affected by various local factors. This study aims to investigate the age-standardized mortality variation of Seoul as well as the characteristics of the factors related to the mortality variation. Methods: The Korea Community Health Survey data, Seoul Survey data, Seoul statistics, and e-regional indicators of the National Statistical Office were used. To investigate the basic boroughs standardized mortality variation in Seoul, external quotient, coefficient of variation (CV), and systematic component of variation (SCV) values were suggested; correlation analysis and multiple regression analysis were conducted to investigate the characteristics related to standardized mortality rate. Results: The highest and the lowest standardized mortality rate of Seoul by boroughs had as much as 1.4 times difference; a low level of variation was shown in CV by 8.2; and was shown in SCV by 79. As a result of the multiple regression analysis of the factors that affect standardized mortality variation, the higher the rate of householders with college or higher, the lower the standardized mortality rate, and the higher the high-risk drinking rate, the higher the standardized mortality rate. Of the two, the rate of householder with a degree equivalent or higher than college was shown to have the biggest impact, followed by high-risk drinking rate. Conclusion: We found a variation in age-standardized mortality rate of boroughs in Seoul. The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.

• Journal of Preventive Medicine and Public Health
• /
• 제43권2호
• /
• pp.174-184
• /
• 2010

Objectives: This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. Methods: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. Results: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. Conclusions: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권5호
• /
• pp.1953-1958
• /
• 2015

Background: In India, cancer accounts for 7.3% of DALY's, 14.3% of mortality with an age-standardized incident rate of 92.4/100,000 in men and 97.4/100,000 in women and yet there are no nationwide screening programs. Materials and Methods: We calculated age-standardized and age-truncated (30-69 years) detection rates for men and women who attended the Indian Cancer Society detection centre, New Delhi from 2011-12. All participants were registered with socio-demographic, medical, family and risk factors history questionnaires, administered clinical examinations to screen for breast, oral, gynecological and other cancers through a comprehensive physical examination and complete blood count. Patients with an abnormal clinical exam or blood result were referred to collaborating institutes for further investigations and follow-up. Results: A total of n=3503 were screened during 2011-12 (47.8% men, 51.6% women and 0.6% children <15 years) with a mean age of 47.8 yrs (${\pm}15.1yrs$); 80.5% were aged 30-69 years and 77.1% had at least a secondary education. Tobacco use was reported by 15.8%, alcohol consumption by 11.9% and family history of cancer by 9.9% of participants. Follow-up of suspicious cases yielded 45 incident cancers (51.1% in men, 48.9% in women), consisting of 55.5% head and neck (72.0% oral), 28.9% breast, 6.7% gynecological and 8.9% other cancer sites. The age-standardized detection rate for all cancer sites was 340.8/100,000 men and 329.8/100,000 women. Conclusions: Cancer screening centres are an effective means of attracting high-risk persons in low-resource settings. Opportunistic screening is one feasible pathway to address the rising cancer burden in urban India through early detection.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권15호
• /
• pp.6729-6734
• /
• 2015

Background: To analyze the mortality distribution of nasopharyngeal carcinoma in China from 1991 to 2013, to predict the mortality in the ensuing five years, and to provide evidence for prevention and treatment of nasopharyngeal carcinoma. Materials and Methods: Mortality data for Nasopharyngeal Carcinoma in China from 1991 to 2013 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, sex and age differences, urban-rural differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the ensuing five years in the future. Results: In China, the standardized mortality rate of Nasopharyngeal Carcinoma increased with time from 1996, reaching the peak values of $1.45/10^5$ at the year of 2002, and decreased gradually afterwards. With males being 1.51 times higher than females, and the city had a higher rate than the rural during the past two decades. The mortality rate increased from age 40. Geographical analysis showed the mortality rate increased from middle to southern China. Conclusions: The standardized mortality rate of Nasopharyngeal Carcinoma is falling. The regional disease control for Nasopharyngeal Carcinoma should be focused on Guangdong province of China, and the key targets for prevention and treatment are rural men, especially after the age of 40. The mortality of Nasopharyngeal Carcinoma will decrease in the next five years.

• Journal of Korean Neurosurgical Society
• /
• 제63권1호
• /
• pp.56-68
• /
• 2020

Objective : To analyze the incidence and treatment trends of hemorrhagic stroke (HS), according to HS subtypes, using nationwide data in Korea from January 2008 to December 2016. Methods : We used data from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of each disease associated with HS, which included intracranial aneurysm (IA), hypertensive intracerebral hemorrhage (ICH), and arteriovenous malformation (AVM), were calculated and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and number of treatments were analyzed for each cerebrovascular disease using the Korean Classification of Diseases procedure codes. Results : In 2016, the total number of newly diagnosed adult patients with HS was 24169, showing a decrease by 7.0% since 2008; the age-standardized incidence of HS was 46.2 per 100000 person-years. The age-standardized incidence of unruptured IA (UIA) in adults was 71.4 per 100000 person-years-increased by 2.6-fold since 2008-while that of ruptured IA (RIA) was 12.6 per 100000 person-years, which had decreased at a rate of 20.3% since 2008. The number of coil embolization (CE) for UIA increased by 3.4-fold over 9 years and exceeded that of clipping since 2008. With respect to RIA, CE increased by 2.0-fold over 9 years and exceeded that of clipping from 2014. As for spontaneous ICH in adults, the age-standardized incidence was 31.3 per 100000 person-years in 2016-decreased by 34.7% since 2008-and 14.6% of patients diagnosed with ICH were treated in 2016, which was not significantly different from the proportion of patients treated since 2008. The age-standardized incidence of unruptured AVM (UAVM) was 2.0 per 100000 person-year in 2016, while that of ruptured AVM (RAVM) was 2.4 per 100000 person-years in 2016, showing a decreasing rate of 17.2% from 2008. The total number of treated patients with AVM declined since 2014. Conclusion : In Korea, age-related cerebral vascular diseases, such as RIA, ICH, and RAVM, demonstrated a declining trend in age-standardized incidence; meanwhile, UIA and UAVM demonstrated an increased trend in both crude incidence and age-standardized incidence for 9 years. The increase in the elderly population, management of hypertension, and development of diagnostic and endovascular techniques appear to have influenced this trend.

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

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

• 보건교육건강증진학회지
• /
• 제32권2호
• /
• pp.27-37
• /
• 2015

Objectives: As the increasing of the length of the lifespan, more recent policy interest are concerned with how many years of life are lived without functional disability or activity limitation. We investigated the relationship between deprivation and activity limitation at the 251 local authority level. Methods: The data were derived from the 2010 Census 10% sample data. Crude and age-standardized activity limitation rates by gender at the ages of 50 or over and deprivation index were calculated. Mapping and multiple linear regression analysis were applied to explore relationship between area activity limitation and area deprivation. Results: There were considerable differences in activity limitation rate across the 251 local authorities. Age-standardized activity limitation rate in both male and female were strongly associated with the level of area deprivation. Especially, low social class, male unemployment, or non-apartment residents at the local level were strong positive association with local authorities' age-standardized activity limitation. Conclusion: More policy attention is needed for tackling regional inequality in activity limitation among older adults.

• Journal of Preventive Medicine and Public Health
• /
• 제56권3호
• /
• pp.248-254
• /
• 2023

Objectives: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. Methods: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. Results: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. Conclusions: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.