Heeyoung Lee

Measuring the burden of major cancers due to smoking in Korea

Morbidity and mortality are classically used to measure disease burden. However, the allocation of limited health‐care resources demands an agreed rational allocation principle and, consequently, the setting of priorities is of considerable importance. We collected data from the national death certificate database, and the national health insurance claim database and life tables. Using this data, we calculated disability adjusted life year (DALY) and health life year (HeaLY) values for smoking‐related cancer. The burden of cancer due to smoking was estimated by multiplying the population attributable risk due to smoking by the DALY and HeaLY results for cancers. The burden of cancer due to smoking for Korean men was 1930.1 person‐years by DALY and 1681.3 person‐years by HeaLY per 100 000 people. Similarly, the burden of cancer due to smoking for Korean women was 352.6 person‐years for DALY and 313.6 person‐years for HeaLY per 100 000 people. Priority rankings for cancer burden due to smoking was somewhat different by DALY and HeaLY. The largest health gap for men was stomach cancer by DALY and lung cancer by HeaLY, whereas for women it was lung cancer by both methods. This study provides a rational basis for national cancer policy planning by presenting the priority burden of cancers caused by smoking. (Cancer Sci 2006; 97: 530 – 534)

Which Stratum of Urban Elderly Is Most Vulnerable for Dementia

Many factors associated with a patients lifestyle may disrupt timely access to dementia diagnosis and management. The aim of this study was to compare characteristics of lifestyle factors at the time of initial evaluation for dementia across degrees of dementia, and to identify risk factors relating to late detection of dementia, in order to understand the various lifestyle barriers to timely recognition of the disease. We reviewed medical records of 1,409 subjects who were diagnosed as dementia among 35,723 inhabitants of Gwangjin-gu. Dementia severity was divided into three degrees. Age, sex, education, income, smoking, heavy drinking, physical activity, religion, and living conditions were evaluated. There was a significantly greater proportion of individuals who were old age, female, less educated, who had never smoked or drank heavily, without physical activity, with no religious activity and living with family other than spouse in the severe dementia group. The lifestyle risks of late detection were old age, lower education, less social interactions, less physical activity or living with family. We can define this group of patients as the vulnerable stratum to dementia evaluation. Health policy or community health services might find ways to better engage patients in this vulnerable stratum to dementia.