Myung-Il Hahm

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

Prevalence of immediate-type food allergy in Korean schoolchildren: a population-based study.

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.

Personal Background and Cognitive Factors as Predictors of the Intention to be Screened for Stomach Cancer

Although the prevalence and causes of food allergy (FA) vary by geographic location, large well-designed epidemiological studies in Asia are lacking. The purpose of this study was to evaluate the prevalence of immediate-type FA in the general population of Korean schoolchildren. A population-based, cross-sectional study was conducted in 2010 using a stratified two-stage cluster-sampling design. In this survey, children aged 6-7 years and 12-13 years were randomly selected, and the presence of FA was determined by a questionnaire survey and assessment of specific IgE. After adjustment for missing data, 3907 children aged 6-7 years and 3975 students aged 12-13 years who completed the questionnaire were included in this study. In children aged 6-7 years, the prevalence of confirmed immediate-type FA was 0.3%, and the prevalence of possible immediate-type FA was 0.3%. By contrast, 0.6 and 1.0% of children aged 12-13 years had confirmed immediate-type FA and possible immediate-type FA, respectively. In 6- to 7-year-old children, egg was the most frequent causative food associated with a confirmed or possible immediate-type FA. In 12- to 13-year-old children, crustaceans were the most frequent cause of confirmed immediate-type FA, and fruit was most frequently involved in possible immediate-type FA. This is the first nationwide population-based study of FA in Korean schoolchildren. Unlike in western countries, the prevalence of immediate-type FA seems to be low. In 12- to 13 year-old children with confirmed immediate-type FA, peanuts/tree nuts are not common causes, whereas crustaceans are frequent triggers.

Changes in employment status and experience of discrimination among cancer patients: findings from a nationwide survey in Korea.

Although stomach cancer screening is effective for reducing mortality, it is underutilized in Korea. By applying an extended theory of planned behavior model, our objective was to determine how personal background factors influence a patients inclination to be screened for stomach cancer. The study population was derived from the 2006 Korean National Cancer Screening Survey, which was done to investigate the participation of the general population in cancer screening. In total, 1,509 Koreans who were 40 to 70 years old participated in this study. Path analysis was used to test a conceptual model in which (a) factors considered as precursors to be screened (components in theory of planned behavior model) directly predicted the intention to be screened and (b) personal background factors, including sociodemographic factors, previous screening experience, economic status, and perceived risk, indirectly influenced the intention to be screened through their effects on cognitive components such as attitude and subjective norm in the theory of planned behavior model. Most of the personal background factors did not directly influence intention but instead influenced cognitive elements in the theory of planned behavior model. Attitude and perceived behavioral control were well correlated with a patients intention, regardless of the screening cost. (Cancer Epidemiol Biomarkers Prev 2008;17(9):2473–9)

Risk factors of atopic dermatitis in Korean schoolchildren: 2010 international study of asthma and allergies in childhood.

Background: As the number of working cancer patients increases, workplace discrimination and its relationship to changes in employment status among cancer patients is becoming an increasingly important social concern. The aim of this study is to provide a comprehensive overview of the relationship between changes in employment status and discrimination following a diagnosis of cancer.

Socioeconomic Disparities in Colorectal Cancer Screening in Korea: A Nationwide Cross-Sectional Study.

BACKGROUND & OBJECTIVE We aimed to analyse the risk factors of atopic dermatitis (AD) in Korean schoolchildren in 2010. METHODS A nationwide, cross-sectional study was conducted in children aged 6-7 years and adolescents aged 12-13 years who were randomly selected. Information was obtained through a Korean version of the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC), and skin prick tests were performed. AD-diagnosed children were selected for risk factor analysis by using logistic regression. RESULTS We enrolled 4,003 children (M/F = 2,021/ 1,982) in aged 6-7 years and 4,112 children (M/F = 2,029/2,083) in 12-13 years. In children aged 6-7 years, the lifetime prevalence of AD diagnosis was 35.6% (N = 1,424). On the other hand, in the 12 to 13 year age group, the lifetime prevalence of AD diagnosis was 24.2% (N = 981). In the univariate logistic regression analysis in 6-7 year-old children, possible risk factors were atopy, a parental history of allergic disease, the use of antibiotics during infancy, a history of having moved into a newly built house during infancy, the presence of visible mould in the house, and remodelling of house within 12 months. The statistical significance persisted after adjustment. However, antibiotic use during infancy and remodelling within 12 months showed no statistical significance as a risk factor for AD. In contrast, multivariate logistic regression analysis in adolescents demonstrated that female sex, atopy, a parental history of allergic diseases, the presence of visible mould in the house, and a history of having moved into a newly built house during infancy was associated with AD. There was no significant association between AD and other risk factors. CONCLUSION In Korean schoolchildren, risk factors such as atopy, the presence of parental allergic diseases, moving into a newly built house during infancy and visible mould in the house were associated with AD.

Do newly built homes affect rhinitis in children? The ISAAC phase III study in Korea

AbstractColorectal cancer (CRC) is a common cancer worldwide. The incidence and mortality rates of CRC are higher among lower socioeconomic status (SES) populations.We investigated the association between different indicators of SES and CRC screening rates in Korea. The eligible study population included males and females aged 50 to 74 years who participated in a nationwide cross-sectional survey (2010–2012). The “compliance with recommendation” category was applicable to participants who had undergone a fecal occult blood test (FOBT), double-contrast barium enema, or colonoscopy within 1, 5, or 10 years, respectively.In total, 6221 subjects (51.4% female, 55.6% aged 50 years) were included in the final analysis. Lower household income was significantly negatively related to compliance with screening recommendations (P for trend < 0.01) and marginally significantly related to noncompliance with recommendations (P for trend = 0.07). Older age and poor self-reported health were associated with the screening rate using the FOBT; male sex, older age, higher household income, having supplemental insurance, family history of cancer, and poor self-reported health were associated with a higher screening rate using colonoscopy.Lower household income was associated with a higher screening rate using the FOBT and with a lower screening rate using colonoscopy. To increase the rate of CRC screening using colonoscopy, efforts should be made toward improving the education and promotion of screening to the low household income target population.

The association between hypovitaminosis D and pediatric allergic diseases: A Korean nationwide population-based study.

As Korea has experienced rapid economic development, the lifestyles of Koreans have become more Westernized, in terms of urbanization and dietary habits. Also, the prevalences of allergic diseases, such as rhinitis, asthma, and dermatitis, have increased rapidly. This study aimed to identify the factors influencing the symptoms of rhinitis conditions, including rhinitis, allergic rhinitis, overlapped rhinitis, and overlapped allergic rhinitis, among Korean children aged 6–7 years.

Risk of suicidal ideation in diabetes varies by diabetes regimen, diabetes duration, and HbA1c level

BACKGROUND There is still considerable disagreement regarding the role of vitamin D in the development or exacerbation of allergic diseases. OBJECTIVE To investigate the association between serum vitamin D levels and recent symptoms of allergic diseases in elementary schoolchildren. METHODS A nationwide cross-sectional survey was conducted in children ages 6-7 years from 45 randomly selected elementary schools. The presence of atopic dermatitis (AD) or asthma was defined as medical treatment of children for AD or asthma within 12 months of the survey. The presence of allergic rhinitis (AR) was defined as medical treatment for AR during the past 12 months and a positive skin test response. Current AD was defined as confirmed eczema on physical examination. Serum 25-hydroxyvitamin D (25[OH]D) was measured by chemiluminescent immunoassay. RESULTS Questionnaire data and blood samples were collected from 3720 children. The overall prevalence rates of vitamin D insufficiency (20-29 ng/mL) and deficiency (<20 ng/mL) were 64.0% and 18.4%, respectively. For a 1 ng/mL decrease in 25(OH)D, the adjusted odds ratio (aOR) for AR was 1.020 (95% confidence interval [CI], 1.002-1.040) and the aOR for current AD was 1.027 (95% CI, 1.006-1.047). For each 1 ng/mL decrease in 25(OH)D, the aOR for positive skin-prick test reactivity was 1.013 (95% CI, 1.000-1.027). No significant association between vitamin D level and the prevalence of asthma was observed. CONCLUSIONS A high prevalence of vitamin D deficiency and insufficiency was found in Korean elementary schoolchildren, and low vitamin D levels were associated with recent symptoms of AD and AR.

Why Do Some People Choose Opportunistic Rather Than Organized Cancer Screening? The Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2012

OBJECTIVE To investigate patient subgroups based on the clinical characteristics of diabetes to evaluate risk factors for suicidal ideation using a large population-based sample in South Korea. METHODS Data from the Fifth Korea National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey, were analyzed. The participants were 9159 subjects aged ≥40years. We defined patients with diabetes based on self-reported physician-diagnosed diabetes. We evaluated clinical risk factors for suicidal ideation according to diabetes regimen, diabetes duration, and glycated hemoglobin (HbA1c) level compared with no diabetes. Given the complex sample design and unequal weights, we analyzed weighted percentages and used survey logistic regression. RESULTS Diabetes per se was not associated with suicidal ideation. However, suicidal ideation was significantly more prevalent among patients who had injected insulin, had a duration of diabetes ≥5years and had HbA1c levels ≥6.5 compared with those without diabetes. Depressive symptoms were the most prominent predictor of suicidal ideation. CONCLUSIONS Insulin therapy, diabetes of long duration, and unsatisfactory glycemic control were identified as risk factors for suicidal ideation; thus, patients with these characteristics warrant special attention. Our findings suggest the need to integrate efforts to manage emotional distress into diabetes care.