• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4723-4727
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• 2016

Background: There are substantial differences in the mortality rates of stomach cancer among the 47 prefectures in Japan, and Aomori prefecture is one of the most severely impacted. The aims of this study were to determine the incidence and mortality rates of stomach cancer in Aomori prefecture in comparison with Japan as a whole and cast light on reasons underlying variation. Methods: Data on stomach cancer cases were extracted from the Aomori Cancer Registry Database. Incidence rates for specific stages at the time of diagnosis were cited from Monitoring of Cancer Incidence in Japan, and mortality rates for stomach cancer in Aomori prefecture and the whole of Japan were obtained from Vital Statistics. Age-standardised incidence and mortality rates were calculated using the direct method. Results: The age-standardised incidence rate of stomach cancer in Aomori prefecture was higher than in the whole of Japan for males but lower for females. However, the age-standardised mortality rates were higher in Aomori prefecture in both sexes. The proportion of localised cancers was lower in Aomori prefecture than in the whole of Japan for most age groups. Conclusions: The lower rate for localised cancer suggests that higher age-standardised mortality rates are due to delays in diagnosis, despite an attendance rate for stomach cancer screening was higher in Aomori prefecture than in the whole of Japan. One plausible explanation for the failure of successful early detection might be poor quality control during screening implementation that impedes early detection.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5681-5685
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• 2013

Background: To compare breast cancer incidence and mortality trends in Central Serbia between males and females in the period 1999-2009. Materials and Methods: In this descriptive study, mortality data were obtained from the National Statistics Institute and morbidity data were derived from Institute of Public Health of Serbia for the period of interest. Results: Breast cancer is a leading cancer in the female population of Central Serbia, whereas in male population it is not on the list of 10 leading localizations, concerning both incidence as well as mortality. In the period 1999-2009 the average standardized incidence rates of breast cancer were 60.5/100,000 in women and 1.4/100,000 in men, while average standardized mortality rates were 20.4/100,000 and 0.4/100,000. The average standardized incidence and mortality rates were about 45 times higher in females than males. Male breast cancer comprises approximately 2.1% of all breast cancer cases. The average age-specific mortality and incidence rates increased with age in both sexes. In the observed period standardized mortality rates of breast cancer increased significantly only in men ($y=0.320+0.0215{\times}$, p=0.044). Conclusions: The increase of breast cancer incidence in both sexes and mortality in men, indicate an urgent need for Serbian health professionals to apply existing cancer control and preventive measures. Male breast cancer is more present than in other world regions, with an outstanding increase of mortality, which demands a timely identification (screening) and adequate treatment. A national policy including mammography should be considered in the light of the newest findings.

• Communications for Statistical Applications and Methods
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• v.4 no.1
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• pp.33-39
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• 1997

Tsutakawa(1988) proposed a mixed model for using empirical Bayes method to study the geographic variability in mortality rates of a disease. In particular cases of the analysis in mortality rate, we need to consider the effect of time. If observed data are collected annually for the time period, then time effect will be emphasized. Here, an extended model for estimating the geographic effect and the mortality rates of the disease with time effect is proposed.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.10-39
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• 1987

Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972, 069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major groups (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to S times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Busan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Busan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/l,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/l,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in high school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I ($1968{\sim}1974$), period II ($1975{\sim}1979$), and period III ($1980{\sim}1985$). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and posions was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by $4{\sim}10$ years. However, the mean age at death of the teachers was $2{\sim}5$ years lower than that of the general population in all causes of death and the sex difference in the mean a2e at death was smaller ($2{\sim}3$ years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.

• East Asian mathematical journal
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• v.35 no.3
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• pp.305-318
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• 2019

Over the past decades, the Lee-Carter model [1] has attracted much attention from various demography-related fields in order to project the future mortality rates. In the Lee-Carter model, the speed of mortality improvement is stochastically modeled by the so-called mortality index and is used to forecast the future mortality rates based on the time series analysis. However, the modeling is applied to long time series and thus an important structural change might exist, leading to potentially large long-term forecasting errors. Therefore, in this paper, we are interested in detecting the structural change of the Lee-Carter model and investigating the actuarial implications. For the purpose, we employ the tests proposed by Coelho and Nunes [2] and analyze the mortality data for six countries including Korea since 1970. Also, we calculate life expectancies and whole life insurance premiums by taking into account the structural change found in the Korean male mortality rates. Our empirical result shows that more caution needs to be paid to the Lee-Carter modeling and its actuarial applications.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.147-153
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• 2005

Objectives: Studies on the geographical differences in mortality tend to use a census population, rather than a registration population, as the denominator of mortality rates in South Korea. However, an administratively determined registration population would be the logical denominator, as the geographical areas for death certificates (numerator) have been determined by the administratively registered residence of the deceased, rather than the actual residence at the time of death. The purpose of this study was to examine the differences in the total number of a district population, and the associated district-specific mortality indicators, when two different measures as a population denominator (census and registration) were used. Methods: Population denominators were obtained from census and registration population data, and the numbers of deaths (numerators) were calculated from raw death certificate data. Sex- and 5-year age-specific numbers for the populations and deaths were used to compute sex- and age-standardized mortality rates (by direct standardization methods) and standardized mortality ratios (by indirect standardization methods). Bland-Altman tests were used to compare district populations and district-specific mortality indicators according to the two different population denominators. Results : In 1995, 9 of 232 (3.9%) districts were not included in the 95% confidence interval (CI) of the population differences. A total of 8 (3.4%) among 234 districts had large differences between their census and registration populations in 2000, which exceeded the 95% CI of the population differences. Most districts (13 of 17) exceeding the 95% CI were rural. The results of the sex- and age-standardized mortality rates showed 15 (6.5%) and 16 (6.8%) districts in 1995 and 2000, respectively, were not included in the 95% CI of the differences in their rates. In addition, the differences in the standardized mortality ratios using the two different population denominators were significantly greater among 14 districts in 1995 and 11 districts in 2002 than the 95% CI. Geographical variations in the mortality indicators, using a registration population, were greater than when using a census population. Conclusion: The use of census population denominators may provide biased geographical mortality indicators. The geographical mortality rates when using registration population denominators are logical, but do not necessarily represent the exact mortality rate of a certain district. The removal of districts with large differences between their census and registration populations or associated mortality indicators should be considered to monitor geographical mortality rates in South Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2201-2204
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• 2014

Russian rates for melanoma incidence and mortality are relatively low as compared to some other white populations but the tumor is of increasing importance. In this paper, data are based on a retrospective descriptive analysis of melanoma epidemiology and clinicopathological characteristics in Krasnoyarsk Territory belonging to the Siberian Federal District of the Russian Federation. The age-adjusted incidence and mortality rates for the period 1996-2009 were determined with subsequent retrospective analysis of clinicopathological data of 103 primary melanoma cases. Our results showed that incidence and mortality rates in the region under consideration match the Russian national trends and correspond to epidemiological data of the countries of Eastern Europe. Stratification of melanoma cases by age, sex, clinicopathological state and localization revealed a prevalence of lesions on the trunk and lower extremities. Most melanomas diagnosed were of superficial spreading type and the third Clark's level of tumor invasion and stage II according to AJCC. In spite of comparatively low rates of incidence and mortality the trend to increase of melanoma cases in the region under consideration obviously calls for more attention and further investigation.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.515-522
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• 2023

Objectives: The pandemic caused by coronavirus disease 2019 (COVID-19) has exerted an unprecedented impact on the health of populations worldwide. However, the adverse health consequences of the pandemic in terms of infection and mortality rates have varied across countries. In this study, we investigate whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries. Methods: To achieve the study objective, we distinguished healthcare systems based on the extent of healthcare decommodification. Using available daily data from 2020, 2021, and 2022, we applied quantile regression with non-additive fixed effects to estimate mortality rates across quantiles. Our analysis began prior to vaccine development (in 2020) and continued after the vaccines were introduced (throughout 2021 and part of 2022). Results: The findings indicate that higher testing rates, coupled with more stringent containment and public health measures, had a significant negative impact on the death rate in both pre-vaccination and post-vaccination models. The data from the post-vaccination model demonstrate that higher vaccination rates were associated with significant decreases in fatalities. Additionally, our research indicates that countries with healthcare systems characterized by high and medium levels of decommodification experienced lower mortality rates than those with healthcare systems involving low decommodification. Conclusions: The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic's adverse health impacts, more so than emergency containment measures and social restrictions.