• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.213-218
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• 2016

Cancer is a major health problem in the Arab region including Iraq. An adequate database is essential for effective cancer control strategies. Such a database may be provided through cancer registration but supportive household surveys may be useful. This article reports selected results on the feasibility of household surveys to support and validate cancer registration in Basrah governorate - southern Iraq. A large scale multi-stage cluster sample household survey was carried out in Basrah during 2013. It covered 6,999 households and involved gathering data on demographic characteristics and both incident cancer cases and cancer-related deaths among members of these households during a three-year recall period (2010-2012). The data obtained yielded an average annual incidence rate of 91 per 100,000 population (age-standardized incidence rate of 148.8 /100,000) and cancer specific mortality rate of 68 per 100,000 population (age-standardized mortality rate of 126.3/100,000). The results showed an overall pattern of cancer similar to that reported according to cancer registration but the household survey results were consistently higher than those of the cancer registration by a margin of approximately 20- 30% with respect to incident cancer and about 70 % with respect to cancer-specific mortality. Household surveys on cancer, while costly and time consuming, are a very useful additional source of information on cancer at the population level. They can be performed for specific purposes with effective resource mobilization.

• Korean Journal of Health Education and Promotion
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• v.30 no.1
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• pp.41-52
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• 2013

Objectives: Rural-urban differences in suicide have been observed in many settings. However, there has been little research addressing what factors can explain these differences. The purpose of this study was to analyze which compositional factors and contextual factors in local areas might be related to local suicide. Methods: The study design was cross-sectional. The data for 251 primary local governments on their age-standardized suicide mortality and their predefined indicators of compositional factors and contextual factors were obtained from Korean Statistical Information Service as of year 2010. Bivariate analysis including one-way ANOVA and chi-square test were used to identify the differences in local features by area type. Seven poisson regression models for each of total, males, and females were used to analyze which compositional and contextual factors were related to suicide. Results: There were differences in suicide between gu and goon in total, male, and female groups. For total, compositional factors including divorce and smoking rate, and contextual factors including financial independency, water and waterwaste coverage, and number of wastewater discharge factories were found to explain the urban-rural differences. Conclusions: This study provided some evidence that contextual factors at the local level as well as compositional factors are useful for predicting local suicide mortality.

• Journal of Preventive Medicine and Public Health
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• v.43 no.2
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• pp.185-192
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• 2010

Objectives: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. Methods: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. A publication bias was tested for using Egger's test. The homogeneity test was performed before the integration of each of the standardized mortality ratios (SMRs) and the result proved that the studies were heterogeneous. Results: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. Conclusions: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

• Journal of Preventive Medicine and Public Health
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• v.47 no.4
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• pp.206-215
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• 2014

Objectives: The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. Methods: All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. Results: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. Conclusions: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.233-238
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• 2007

Objectives : We aimed to assess the relationship between long-term exposure to air pollution and lung cancer in the Republic of Korea. Methods : Using the Annual Report of Ambient Air Quality in Korea, Annual Report of National Cancer Registration, and Annual Report on the Cause of Death Statistics, we calculated the standardized mortality ratio (SMR) and standardized incidence ratio (SIR) of lung cancer for both sexes in 74 areas from 7 Korean metropolitan cities. We performed random intercept, Poisson regression using empirical Bayes method. Results : Both SMRs and SIRs in the 7 metropolitan cities were higher in women than in men. Mean SIRs were 99.0 for males and 107.0 for females. The association between $PM_{10}$ and lung cancer risk differed according to gender. $PM_{10}$ was not associated with the risk of lung cancer in males, but both incidence and mortality of lung cancer were positively associated with $PM_{10}$ in females. The estimated percentage increases in the rate of female lung cancer mortality and incidence were 27% and 65% at the highest $PM_{10}$ category $({\geq}70\;{\mu}g/m^3)$, compared to the referent category $({\geq}50\;{\mu}g/m^3)$. Conclusions : Long-term exposure to $PM_{10}$ was significantly associated with female lung cancer incidence in 7 Korean metropolitan cities. Further study is undergoing to estimate the relative risk of $PM_{10}$ using multi-level analysis for controlling individual and regional confounders such as smoking and socioeconomic position.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8455-8460
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• 2014

Background: The National Central Cancer Registry of China (NCCR) affiliated to the Bureau of Disease Control, National Health and Family Planning Commission of China is responsible for cancer surveillance in the entire country. Cancer registration data from each local registry located in each province are collected by NCCR annually to be analyzed and published to provide useful information for policy makers and cancer researchers. Materials and Methods: Until 1st June, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 145 cancer registries were selected after quality evaluation for this study. Colorectal cancer cases were selected from the database according to ICD-10 coded as "C18-C20". We calculated the crude incidence and mortality rates by sex, age groups and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. The 6th National Population Census data of China was used to combined with the cancer registries' data to estimate the colorectal cancer burden in China in 2010. Results: Colorectal cancer was the sixth most common cancer in China. It was estimated that there were 274,841 new cases diagnosed in 2010 (157,355 in males and 117,486 in females), with the crude incidence rate of 20.1/100,000, highest in males in urban areas. Age-standardized rates by China standard population of 2000 (ASRcn) and World standard population (Segi's population, ASRwld) for incidence were 16.1/100,000 and 15.9/100,000 respectively. There were 132,110 cases estimated to have died from colorectal cancer in China in 2010 (76,646 men and 55,464 women) with the crude mortality rate of 10.1/100,000. The ASRcn and ASRwld for mortality were 7.55/100,000 and 7.44/100,000 respectively, higher in males and urban areas than in females and rural areas. The incidence and mortality rates increased with age, reaching peaksin the 80-84 year old, and oldest age groups, respectively. Conclusions: Colorectal cancer is one of the most common incident cancers and cause of cancer death in China. Primary and secondary prevention, with attention to a health lifestyle, physical activity and screening should be enhanced in the general population.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.249-259
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• 2011

Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

• Communications for Statistical Applications and Methods
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• v.13 no.1
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• pp.177-190
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• 2006

The aim of this study is to propose a Bayesian model for fitting mortality rate of colon cancer. For the analysis of mortality rate of a disease, factors such as age classes of population and spatial characteristics of the location are very important. The model proposed in this study allows the age class to be a random effect in addition to its conventional role as the covariate of a linear regression, while the spatial factor being a random effect. The model is fitted using Metropolis-Hastings algorithm. Posterior expected predictive deviances, standardized residuals, and residual plots are used for comparison of models. It is found that the proposed model has smaller residuals and better predictive accuracy. Lastly, we described patterns in disease maps for colon cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7365-7374
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• 2015

Background: Over the past decade, bladder cancer was associated with a significant increase. Given the importance of the impact of socioeconomic status on the distribution of cancer incidence and mortality, and the need to information on these parameters for prevention planning, the aim of this study was to evaluate data for bladder cancer and their relationship with human development index (HDI) and its components in Asia in 2012. Materials and Methods: The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). The incidence and mortality rates were drawn for Asian countries. To analyze data, correlation tests between incidence and death rates, and HDI and its components were employed with a significance level of 0.05 using SPSS software. Results: A total incidence of 696,231 cases (68.7% in males and 31.3% in females, sex ratio of 2.19:1) and 524,465 deaths (67.0% in men and 32.9% in women, sex ratio was 2.03:1) were recorded in Asian countries in 2012. Correlation between HDI and standardized incidence rate was 0.241 overall (p=0.106), 0.236 in men (p=0.114) and -0.250 in women (p=0.094). Also between HDI and standardized mortality rate 0.025 (p=0.871) in men 0.118 (p=0.903) and in women 0.014 (p=0.927). Conclusions: Bladder cancer incidence is higher in developed countries, but the rate is declining, and in less developed and developing countries it is growing. There was no statistically significant correlation between the standardized incidence rate of bladder cancer and the HDI and its dimensions in Asia, except for the level of education.

• Journal of Korean Academy of Nursing
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• v.35 no.1
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• pp.47-55
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• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.