• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3469-3476
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• 2016

Background: The cancer research literature suggests that women, especially premenopausal women, have lower cancer mortality rates than men. However, it is unclear if that is true for populations at all age levels in all countries and what factors affect such sex differences. This paper attempts to fill that gap. Materials and Methods: Sex- and country-specific cancer mortality data were statistically analyzed with particular attention to geographic, social, and economic factors that may affect the sex differences. Results: The sex differences were age and country specific, rather than universal. Premenopausal women actually tend to have a disadvantage compared to men or postmenopausal women. Male cancer mortality appears to be the affecting factor in explaining variations in sex differences. Latitude of residence and literacy rate are the affecting factors in cancer mortality and sex differences. African and Latin American countries tend to have a female disadvantage, while East Asian and Eastern European countries are more likely to have a female advantage. Conclusions: The findings challenge the cancer mortality literature and indicate that the sex differences and their possible causes are more complicated than the current literature suggests. They also highlight the urgency of adapting age- and country- specific health systems and policies to better meet the needs of younger women.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.95-109
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• 2024

Background/Aims: Sex differences in the prognosis of heart failure (HF) have yielded inconsistent results, and data from Asian populations are even rare. This study aimed to investigate sex differences in clinical characteristics and long-term prognosis among Korean patients with HF. Methods: A total of 5,625 Korean patients hospitalized for acute HF were analyzed using a prospective multi-center registry database. Baseline clinical characteristics and long-term outcomes including HF readmission and death were compared between sexes. Results: Women were older than men and had worse symptoms with higher N-terminal pro B-type natriuretic peptide levels. Women had a significantly higher proportion of HF with preserved ejection fraction (HFpEF). There were no significant differences in in-hospital mortality and rate of guideline-directed medical therapies in men and women. During median follow-up of 3.4 years, cardiovascular death (adjusted hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.07-1.78; p = 0.014), and composite outcomes of death and HF readmission (adjusted HR, 1.13; 95% CI, 1.01-1.27; p = 0.030) were significantly higher in men than women. When evaluating heart failure with reduced ejection fraction (HFrEF) and HFpEF separately, men were an independent risk factor of cardiovascular death in patients with HFrEF. Clinical outcome was not different between sexes in HFpEF. Conclusions: In the Korean multi-center registry, despite having better clinical characteristics, men exhibited a higher risk of all-cause mortality and readmission for HF. The main cause of these disparities was the higher cardiovascular mortality rate observed in men compared to women with HFrEF.

• Communications for Statistical Applications and Methods
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• 제28권2호
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• pp.119-134
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• 2021

Lung cancer is one of the leading causes of cancer deaths in the world. Investigation of mortality rates is pivotal to adequately understand the determinants causing this disease, allocate public health resources, and apply different control measures. Our study aims to analyze and forecast age-specific US lung cancer mortality trends. We report functions of mortality rates for different age groups by incorporating functional principal component analysis to understand the underlying mortality trend with respect to time. The mortality rates of lung cancer have been higher in men than in women. These rates have been decreasing for all age groups since 1990 in men. The same pattern is observed for women since 2000 except for the age group 85 and above. No significant changes in mortality rates in lower age groups have been reported for both gender. Lung cancer mortality rates for males are relatively higher than females. Ten-year predictions of mortality rates depict a continuous decline for both gender with no apparent change for lower age groups (below 40).

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.604-615
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• 1998

Although previous studies revealed the association of physical activity with mortality rate, it is unclear whether there is a linear trend between physical activity and mortality rate. In this study, the association of physical activity with the risk of all-cause mortality was analysed using Cox's proportional hazard model for a cohort of 14,204 healthy Korean men aged 40-59 years followed up for 4 years(Jan. 1993-Dec. 1996). Physical activity and other life style were surveyed by a postal questionnaire in December 1992. Total of 14,204 subjects were grouped into quartiles by physical activity. Using death certificate data, 123 deaths were identified. The second most active quartile had a lowest mortality .ate with relative risk of 0.44(95% C.I. : 0.23-0.84) compared with most sedentary quartile, showing a J-shape pattern of physical activity-mortality curve. By examining the difference in proportion of cause of the death between most active quartile and the other quartiles, there was no significant difference of proportional mortality from cardiovascular deaths, cerebrovascular deaths or deaths from trauma. The covariates were stratified into two group between which the trend of RR was compared to test the effect modification. There was no remarkable effect modification by alcohol intake, smoking, body mass index, calorie consumption, percent fat consumption. In conclusion, moderate activity was found to have more protective effect on all-cause mortality than vigorous activity and that the J-shape pattern of physical activity-mortality curve was not due to the difference of mortality pattern or effect modification by alcohol intake, smoking, body mass index, calorie consumption and percent fat consumption.

• 보건행정학회지
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• 제10권2호
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• pp.120-130
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• 2000

Studies on the relation between socio-economic factors and metermal and child health have found that poverty, lack of edcation, inappropriate health serives are affecting to maternal and child health. The Gender Related Development Index (GDI) focuses on equality between men and women as well as on the average achiement of all people taken together, using same cariables as the Human Development Index (HDI) which are life expectancy, literacy rate, and per capita GDP. This research is to inverstigate whether HDI and GDI are useful determinants for maternal infant mortality. Using 146 UN member countries date, we condented multiple regression analysis for maternal and infant mortality with three models which are Model(individual variables-literacy rate, per capita GDP), Model(HDI) and Model(GDI). The results showed that HDI and GDI are powerful determinants of both maternal and infant mortality, respectively HDI($\beta$=-1.18, t=3.3; $\beta$=1.04, t=5.1) GDI($\beta$=-1.44, t=3.9; $\beta$=1.28, t=6.5) The higher power in model with GDI for both maternal and infant mortalities represented that GDI was more powerful determinant of maternal and infant mortality, than HDI respectively HDI($R^2$=0.824, $R^2$=0.842), GDI($R^2$=0.834, $R^2$=0.865). In conclusion, the maternal and infant mortalities are explained by GDI than HDI and may be lower in the societies where there are less discimination between men and women.

• Journal of Radiation Protection and Research
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• 제47권1호
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• pp.22-29
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• 2022

Background: A comprehensive, traceable, and easy-to-understand radiation risk indicator is desired for radiological protection. The early-onset hypothesis could be used for this purpose. Materials and Methods: An indicator for early death (IED) was developed and calculated using the epidemiological dataset from the 14^th Report of the Life Span Study (LSS) of Hiroshima and Nagasaki. By clarifying the calculation process, IED for all-cause mortality was estimated. In addition, the characteristics of IED for solid cancer mortality and cardiovascular mortality as well as those of men and women, and their dependence on age at exposure were investigated for detailed analysis. Results and Discussion: The IED for all-cause mortality was estimated to be approximately 4 years for an acute radiation exposure of 1 Gy regardless of the fitting dose range. The cumulative death rate for all solid cancers also indicated the early-death tendency (approximately 7-10 years at 1 Gy). Although, there is a slight difference in the characteristics of the risk obtained from the LSS study and this study, it is considered that the IED in a unit of years can also be used to show the overall picture of risk due to radiation exposure. Conclusion: We developed and calculated the indicator for early death, IED, for the cumulative mortality rate of all causes of death, all solid cancers, and circulatory diseases. The quantitative values of IED were estimated to be 4 years for all causes of death, 7-10 years for all solid cancers. IED has an advantage for intuitively understanding the meaning of radiation risk since it can be obtained by a simple and traceable method.

• 한국응급구조학회지
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• 제3권1호
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• Journal of Preventive Medicine and Public Health
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• 제30권2호
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• pp.293-307
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• 1997

In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U. N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for work-men(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade, of work-men was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for' cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.

• 보건의료산업학회지
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• 제8권4호
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• pp.81-94
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• 2014

The purpose of this study is to investigate factors affecting cancer mortality inequality in Busan according to demographic characteristics identified based on the region's mortality data including cancer incidence and mortality rates, ultimately helping the region improve its existing health policies and establish a more effective cancer prevention policy. To achieve this purpose, this researcher surveyed data about all persons who died in Busan from 2006 to 2009. Data were analyzed with an SPSS 18.0 program using descriptive statistics, Chi-Square(${\chi}^2$), and Logistic Regression analysis. Findings of the study can be summarized as follows. First, in Busan, men were about two times higher in cancer mortality rate than women. Second, persons who died of cancer in Busan were significantly different from one another in terms of demographic characteristics, especially, age, marital status, and job. Third, factors affecting cancer mortality inequality in Busan included such demographic characteristics as gender, age at the time of death, marital status, educational background, and job.

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