Eun Cheol Park

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2008

PURPOSE This paper overviews the nationwide cancer statistics including incidence, mortality, survival and prevalence, and their trends in Korea based on the year 2008 cancer incidence data. MATERIALS AND METHODS Incidence data from 1993 to 2008 were obtained from the Korea National Cancer Incidence Database, and the vital status was followed through December 31, 2009. Mortality data from 1983 to 2008 were obtained from the Korea National Statistics Office. Crude rates and age-standardized rates for incidence, mortality, prevalence and relative survival were calculated. RESULTS There were 178,816 cancer cases and 68,912 cancer deaths observed during year 2008 and 724,663 10-year cancer prevalent cases as of January 1, 2009 in Korea. The incidence rate for all cancer combined showed an annual increase of 3.1% from 1999 to 2008. CONCLUSION With significantly increasing cancer incidence, Korea faces a large cancer burden and efficient cancer control programs are essential.

Cancer Statistics in Korea: Incidence, Mortality and Survival in 2006-2007

Cancer has been the leading cause of death in Korea. Korea is facing a very rapid change and increase in cancer incidence, which draws much attention in public health. This paper overviews the nationwide cancer statistics, including incidence, mortality, and survival rates, and their trends in Korea based on the cancer incidence data from The Korea Central Cancer Registry (KCCR) in year 2006 and 2007. In Korea, there were 153,237 cancer cases and 65,519, cancer deaths observed in 2006, and 161,920 cancer cases and 67,561 cancer deaths in 2007, respectively. The incidence rate for all cancer combined showed an annual increase of 2.8% from 1999 to 2007. Specifically, there was significant increase in the incidence of colorectal, thyroid, female breast, and prostate cancers. The number of cancer deaths has increased over the past two decades, due mostly to population aging, while the age-standardized mortality rates have decreased in both men and women since 2002. Notable improvement has been observed in the 5-yr relative survival rates for most major cancers and for all cancer combined, with the exception of pancreatic cancer. The nationwide cancer statistics in this paper will provide essential data for cancer research and evidence-based health policy in Korea.

Prediction of Cancer Incidence and Mortality in Korea, 2011

Purpose To estimate the current cancer burden in Korea, cancer incidence and mortality were projected for the year 2011. Materials and Methods The cancer incidence data from 1999-2008 were obtained from the Korea National Cancer Incidence Database, and the cancer mortality data from 1993-2009 were obtained from the Korea National Statistics Office. Cancer incident cases and rates in 2011 were projected from fitting a linear regression model on observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was applied for projection except that a Joinpoint regression model was used to determine at which year the linear trend significantly changed. Results A total of 216,809 new cancer cases and 71,036 cancer deaths are projected to occur in Korea in 2011. For all sites combined, the crude incidence rates are projected to be 437.9 and 420.5 and the age-standardized incidence rates are projected to be 336.5 and 279.7 per 100,000 for men and women, respectively. Conclusion Cancer has become an important public health concern in Korea, and as Korea becomes an aged society, the cancer burden will continue to increase.

Nationwide Cancer Incidence in Korea, 2003-2005

PURPOSE To estimate the current cancer burden in Korea, newly diagnosed cancer cases and cancer incidence rates were calculated for the years 2003~2005. MATERIALS AND METHODS The cancer incidence cases and rates were calculated from the Korea National Cancer Incidence Database. Crude and age-standardized incidence rates were calculated by gender for specified cancer sites in 5-year age groups. RESULTS From 2003 to 2005, 398,824 cases of cancer were newly diagnosed in Korea (218,856 in men and 179,968 in women). For all sites combined, the crude incidence rate (CR) was 300.0 and 248.2 for men and women and the age-standardized incidence rate (ASR) was 297.0 and 191.2 per 100,000, respectively. Among men, five leading cancers were stomach (CR 66.0, ASR 64.2), lung (CR 48.5, ASR 50.3), liver (CR 44.9, ASR 42.1), colon and rectum (CR 37.9, ASR 37.2), and prostate cancer (CR 12.7, ASR 13.8). Among women, five leading cancers were breast (CR 37.3, ASR 29.0), thyroid (CR 36.2, ASR 28.8), stomach (CR 34.1, ASR 25.4), colon and rectum (CR 28.0, ASR 21.1), and lung cancer (CR 17.9, ASR 12.8). In the 0~14-year-old group, leukemia was the most common in both sexes; in the 15~34 group, the most common cancer was stomach cancer for men and thyroid cancer for women; in the 35~64 group, stomach cancer for men and breast cancer for women; among those 65 and over, lung cancer for men and stomach cancer, for women, respectively. CONCLUSION The cancer incidence rates have increased in recent years, and more cancers are expected to develop as Korea is quickly becoming an aged society. The cancer incidence statistics in this report can be used as an important source to effectively plan and evaluate the cancer control program in Korea.

Trends in cancer screening rates among Korean men and women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2010

Purpose The Korean National Cancer Screening Survey (KNCSS) is a continuous nationwide survey implemented by the National Cancer Center in Korea since 2004. The purpose of the present study was to report trends in cancer screening rates for the five major cancers (stomach, liver, colorectal, breast, and cervix uteri) in Korean men and women. Materials and Methods The study used KNCSS data collected between 2004 and 2010. The survey was conducted on Korean men aged 40-74 years and Korean women aged 30-74 years with no history of cancer diagnosis. The annual percentage change and corresponding 95% confidence intervals were used to examine changes in annual screening rates. Results Screening rates with recommendation increased by 4.4% annually for stomach cancer, 1.5% for liver cancer, 2.8% per year for colorectal cancer, 4.5% for breast cancer, and 1.2% for cervix uteri cancer. The increasing trend in cancer screening rates, with the exception of liver cancer, was significant. Conclusion Cancer screening rates have increased consistently from 2004 to 2010 among Korean men and women. Stomach and breast cancer screening rates in particular have increased markedly.

Gastric cancer screening in Korea: report on the national cancer screening program in 2008.

Purpose The National Cancer Screening Program (NCSP) began in 1999. The objective of this report is to evaluate the results of the NCSP in 2008 and provide essential evidence associated with the gastric cancer screening program in Korea. Materials and Methods Data was obtained from the National Cancer Screening Information System; participation rates in gastric cancer screening were calculated. According to screening modalities, recall rates were estimated with 95% confidence intervals (CIs). Results The target population of the gastric cancer screening program in 2008 was 7,132,820 Korean men and women aged 40 and over, 2,076,544 of whom underwent upper endoscopy or upper gastrointestinal (UGI) series as screening tools (participation rate, 29.1%). Disparities in participation rates were observed relating to gender and health insurance type. Overall, recall rates of upper endoscopy and UGI series were 3.1% (95% CI, 3.0 to 3.1) and 33.3% (95% CI, 33.3 to 33.4), respectively. Conclusion According to our research, efforts to facilitate participation and to reduce disparities in gastric cancer screening among Korean men and women are needed. These results will provide essential data for evidence-based strategies in gastric cancer control in Korea.

Smoking, alcohol and gastric cancer risk in Korean men: the National Health Insurance Corporation Study

We investigated the risk of gastric cancer by subsite in relation to cigarette smoking and alcohol in a large population-based cohort of 669 570 Korean men in an insurance plan followed for an average 6.5 years, yielding 3452 new cases of gastric cancer, of which 127 were cardia and upper-third gastric cancer, 2409 were distal gastric cancer and 1007 were unclassified. A moderate association was found between smoking, cardia and upper-third (adjusted relative risk (aRR) 2.2; 95% confidence interval (CI) 1.4–3.5) and distal cancers (aRR=1.4; 95% CI=1.3–1.6). We also found a positive association between alcohol consumption and distal (aRR=1.3; 95% CI=1.2–1.5) and total (aRR=1.2; 95% CI=1.1–1.4) gastric cancer. Combined exposure to high levels of tobacco and alcohol increased the risk estimates further; cardia and upper-third gastric cancers were more strongly related to smoking status than distal gastric cancer.

Quality of life in Korean patients with inflammatory bowel diseases : ulcerative colitis, Crohn's disease and intestinal Behçet's disease

Abstract Health-related quality of life (HRQOL) is an important outcome factor in chronic diseases such as inflammatory bowel disease (IBD). This study used the Korean translation of the disease-specific, self-administered Inflammatory Bowel Disease Questionnaire (IBDQ) to compare HRQOL in ulcerative colitis (UC; n=98), Crohns disease (CD; n = 49), and intestinal Behçets disease (BD; n = 34). In addition to the current status, patients were asked retrospectively to recall their symptoms at the beginning and during the worst period of their disease. Disease activity was measured by St. Marks Activity Index, Crohns disease Activity Index (CDAI), and the Harvey-Bradshaw Index (HBI). In all IBD patients, including those with BD, the IBDQ total score during the worst period was significantly lower than that at present and that at the beginning of the disease. However, there were no significant differences between groups regarding the total IBDQ score or its various dimensions. In UC a strong correlation between IBDQ scores and St. Marks Activity Index was observed (r = –0.708, P<0.001). IBDQ scores were also highly correlated with CDAI and HBI in both CD (r=–0.506, P<0.001 for CDAI; r = –0.600, P<0.001 for HBI) and BD (r = –0.687, P<0.001 for CDAI; r = –0.531, P<0.001 for HBI). However, the current IBDQ score was not related to demographic parameters such as gender, age, educational status, economic status, and marital status as well as disease factors such as duration of disease, history of operation or hospital admission, extent of disease in UC, involved region in CD, and clinical type in BD. We conclude that the Korean IBDQ is a responsive and promising instrument for measuring HRQOL of IBD patients in clinical trials. In addition, the IBDQ can be helpful in developing a disease-specific activity index in BD.

The economic burden of cancer in Korea in 2002

Cancer is the leading cause of death and one of the most significant healthcare expenses in Korea. The purpose of this study was to estimate the economic burden of cancer on Korean society. We studied the medical, non-medical, morbidity and mortality costs related to cancer treatment, lost productivity and premature death. Healthcare claims for 2002 obtained from the Health Insurance Review Agency were used to estimate medical expenditures; these were linked with the Korean Central Cancer Registry database to identify cancer patients. The number of deaths used to estimate mortality costs was obtained from the Annual Report of Mortality from the National Statistics Office of Korea. Moreover, data from the Korean National Statistics Office and Ministry of Labor were used to calculate life expectancy at the age of death, labour force participation, and average age- and gender-specific earnings. In 2002, the estimated total economic cost of cancer amounted to

Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008

9.4 billion (1.72% of GDP) at a 3% discount rate. Medical care costs amounted to 13.7% of total costs, non-medical costs 6.5%, morbidity costs 14.5%, and mortality costs accounted for 65.3%. Increased prevention, earlier diagnosis, new therapies and effective cancer control policies are needed to reduce the economic burden of cancer in Korea.