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BACKGROUND: While unemployment is known to increase the risk of suicide, its cumulative effect remains underexplored. This study investigates how unemployment affects suicide mortality and whether the effect varies based on the number of unemployment spells using two years of nationwide data. METHODS: Using the data from the National Statistical Office and Employment Insurance Database for 2018 and 2019, we identified an average of 2365 cases of suicide over two years among 7.76 million workers aged 25-64 years who had been employed within one year before their suicide. The number of unemployment spells was counted using the employment history of the past five years. We calculated crude suicide mortality rates per 100 000 population, age- and sex- standardized mortality rates (SMRs), and proportionate mortality rates (PMRs) for suicide. RESULTS: Over the two years, the crude suicide rate was 30.0 per 100 000 among the general population and 30.5 among workers. Workers with no unemployment spells in the past five years had a significantly lower SMR (0.44; 0.42-0.46), while those with four or more unemployment spells had a significantly higher SMR (3.13; 2.92-3.35) than the general population. These findings were consistent across all sex and age groups. Additionally, workers with four or more unemployment spells had a significantly higher PMR than the general population. CONCLUSION: The impact of unemployment on suicide mortality intensifies as the number of unemployment spells increases. These results underscore the necessity for additional social and psychological support along with economic assistance for individuals facing recurrent unemployment.
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BACKGROUND: By analyzing the recent epidemiologic trajectory of head and neck squamous cell carcinoma (HNSCC) in South Korea, we tracked 2 findings that have been reported recently in other countries: the stabilization of human papillomavirus (HPV)-related HNSCC incidence and the acceleration of oral cavity cancer incidence. METHODS: We analyzed data from the comprehensive population-based Korean Central Cancer Registry for the period 1999 to 2017. The age-standardized incidence rate (ASR), annual percent change (APC), and relative survival were calculated. RESULTS: The ASR of total HNSCC decreased from 1999 to 2017 (APC, -0.2 [95% CI, -0.3 to -0.0]), as did the ASR of HPV-unrelated HNSCC (APC, -0.6 [95% CI, -0.8 to -0.5]); however, the ASR of HPV-related HNSCC increased (APC, 2.9 [95% CI, 2.5 to 3.2]). The rapidly increasing incidence of tonsil squamous cell carcinoma, which was the main subsite of HPV-related HNSCC, stabilized after 2011 (APC pre-2011, 6.8 [95% CI, 5.0 to 8.3]; APC post-2011, 1.6 [95% CI, -2.1 to 5.5]), and the difference was significant (P = .017). In contrast, oral cavity cancer incidence demonstrated the only increase among HPV-unrelated subsites, with the increase occurring after 2006 (APC pre-2006, 1.6 [95% CI, 0.3 to 2.8]; APC post-2006, 2.8 [95% CI, 2.2 to 3.5]); the main cause of this change was an increase in the ASR of tongue cancer. CONCLUSION: This study demonstrates the recent stabilization of tonsil cancer incidence and the contrasting increase in oral cavity cancer incidence, unlike other HPV-unrelated cancers. These trends require further surveillance and understanding in terms of tumor biology and prevention.
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Epidemias , Neoplasias de la Boca , Neoplasias Orofaríngeas , Humanos , Neoplasias de la Boca/epidemiología , Neoplasias Orofaríngeas/epidemiología , República de Corea/epidemiologíaRESUMEN
PURPOSE: This study aimed to evaluate tumor characteristics in young age (20-39 years old) breast cancer (YABC) patients in Korea. MATERIALS AND METHODS: We identified 10,897 breast cancer patients from 2010 to 2015. The data were collected through 10% systematic sampling of the Korea National Cancer Incidence Database (KNCI DB). Tumor size, lymph node status, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status were collected according to the Collaborative Stage version 2 (CSv2) Data Collection System. RESULTS: Of the 10,897 patients, 1245 (11.4%) were YABC patients. They were found to have larger tumors (T2: 41.6% in 20-39 age group vs 36.4% in 40-49 age group vs 36.5% in 50-59 age group vs 38.4% in ≥ 60 age group; T3: 10.1% vs 7.3% vs 6.5% vs 6.2%, P < .0001), greater rates of lymph node involvement (41.2% vs 32.7% vs 35.7% vs 32.5%, P < .0001), higher tumor grade (High grade: 26.8% vs 19.4% vs 23.5% vs 22.1%, P < .0001), and a larger proportion of triple-negative subtype (18.2% vs 11.0% vs 12.2% vs 13.5%, P < .0001). Compared to the 40-49 age group, breast cancer-related survival (BCRS) rates were worse (91.74% vs 95.04%, P < .0001), and the characteristics of YABC patients were associated with higher risk of death from breast cancer. CONCLUSION: YABC patients have more aggressive tumor characteristics and worse survival rates. Therefore, we need to identify high-risk groups among YABC patients and support active surveillance in them. These findings from a national cohort provide important information for establishing a national cancer care strategy to manage YABC patients.
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Neoplasias de la Mama , Adulto , Mama , Neoplasias de la Mama/epidemiología , Femenino , Humanos , Receptor ErbB-2 , Receptores de Estrógenos , Receptores de Progesterona , Sistema de Registros , República de Corea/epidemiología , Adulto JovenRESUMEN
Background Full-field digital mammography (FFDM) has been accepted as a superior modality for breast cancer screening compared with conventional screen-film mammography (SFM), especially in women younger than 50 years or with dense breasts. Purpose To evaluate the accuracy of FFDM for breast cancer screening. Materials and Methods Data from January 1, 2011 to December 31, 2013 in the database from a nationwide breast cancer screening program linked with the national cancer registry were retrospectively analyzed. The study included Korean women aged 40-79 years who had undergone screening mammography with SFM, computed radiography (CR), or FFDM. The sensitivity, specificity, positive predictive value (PPV), and absolute and relative differences among these modalities were calculated, followed by pairwise comparison tests with multiple testing corrections. The areas under the receiver operating characteristic curve (AUCs) were also estimated and compared by using the DeLong method with Bonferroni correction. Results Among the 8 482 803 women included (mean age, 55 years ± 10), 34.4% (2 920 279 of 8 482 803), 51.7% (4 385 807 of 8 482 803), and 13.9% (1 176 717 of 8 482 803) underwent SFM, CR, and FFDM, respectively. The sensitivity and PPV were higher for FFDM than for SFM (adjusted odds ratio, 1.77 [95% confidence interval {CI}: 1.62, 1.95] for sensitivity and 1.36 [95% CI: 1.29, 1.43] for PPV) and CR (adjusted odds ratio, 1.70 [95% CI: 1.56, 1.85] for sensitivity and 1.26 [95% CI: 1.20, 1.32] for PPV), whereas specificity was lower with FFDM. The overall AUC for FFDM was 0.80 (95% CI: 0.80, 0.81), which was higher than that for SFM (0.75 [95% CI: 0.75, 0.76]) and CR (0.76 [95% CI: 0.75, 0.76]). P < .05 was found for differences in sensitivity, PPV, and AUC among modalities overall and in most of the subgroups of age, breast density, and screening round. Conclusion Full-field digital mammography allows better discrimination or prediction of breast cancer in the general female population than screen-film mammography or computed radiography, regardless of age, breast density, or screening round. © RSNA, 2019 Online supplemental material is available for this article.
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Neoplasias de la Mama/diagnóstico por imagen , Mamografía/métodos , Adulto , Anciano , Mama/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , República de Corea , Sensibilidad y EspecificidadRESUMEN
Cancer cells have a large amount of ROS (reactive oxygen species) because of disturbed ROS homeostasis. Cancer cells therefore undertake redox adaptation to drive proliferation in tumor environments and even survive during anticancer treatment by upregulating endogenous antioxidants. As one of antioxidant defense systems, heme oxygenase-1 (HO-1) acts as an essential role in tumor development by offering antioxidant bilirubin to protect cancer cells under stress conditions. It can be therefore reasoned that the combination of ROS generation and HO-1 inhibition would exert synergistic anticancer effects through the amplification of oxidative stress and provide a new opportunity for targeted anticancer therapy. To establish targeted anticancer therapy based on amplified oxidative stress, we developed molecularly engineered polymer, termed CZP, which incorporates ROS generating CA (cinnamaldehyde) and HO-1 inhibiting ZnPP (zinc protoporphyrin) in its backbone and could form stable micelles in aqueous solutions. CZP micelles not only elevated oxidative stress but also suppressed the expression of antioxidant HO-1, leading to apoptotic cell death. CZP micelles could also significantly suppress the tumor growth without body weight loss, tumor recurrence, and noticeable toxicity in organs. This study demonstrates that a combination of ROS generation and HO-1inhibition synergistically magnifies oxidative stress to kill cancer cells and oxidative stress amplifying CZP micelles may provide a promising strategy in anticancer treatment.
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Antineoplásicos/química , Antineoplásicos/farmacología , Hemo-Oxigenasa 1/antagonistas & inhibidores , Estrés Oxidativo/efectos de los fármacos , Polímeros/química , Especies Reactivas de Oxígeno/metabolismo , Células A549 , Animales , Antioxidantes/metabolismo , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Sistemas de Liberación de Medicamentos/métodos , Humanos , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Micelas , Oxidación-Reducción/efectos de los fármacos , Protoporfirinas/metabolismoRESUMEN
BACKGROUND AND PURPOSE: Circulating bilirubin, a natural antioxidant, is associated with decreased risk of stroke. However, the nature of the relationship between the two remains unknown. We used a Mendelian randomization analysis to assess the causal effect of serum bilirubin on stroke risk in Koreans. METHODS: The 14 single-nucleotide polymorphisms (SNPs) (<10-7) including rs6742078 of uridine diphosphoglucuronyl-transferase were selected from genome-wide association study of bilirubin level in the KCPS-II (Korean Cancer Prevention Study-II) Biobank subcohort consisting of 4793 healthy Korean and 806 stroke cases. Weighted genetic risk score was calculated using 14 SNPs selected from the top SNPs. RESULTS: Both rs6742078 (F statistics=138) and weighted genetic risk score with 14 SNPs (F statistics=187) were strongly associated with bilirubin levels. Simultaneously, serum bilirubin level was associated with decreased risk of stroke in an ordinary least-squares analysis. However, in 2-stage least-squares Mendelian randomization analysis, no causal relationship between serum bilirubin and stroke risk was found. CONCLUSIONS: There is no evidence that bilirubin level is causally associated with risk of stroke in Koreans. Therefore, bilirubin level is not a risk determinant of stroke.
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Bilirrubina/sangre , Glucuronosiltransferasa/genética , Accidente Cerebrovascular/sangre , Bancos de Tejidos , Adulto , Anciano , Bilirrubina/genética , Estudios de Cohortes , Femenino , Estudio de Asociación del Genoma Completo , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , República de Corea , Riesgo , Accidente Cerebrovascular/genéticaRESUMEN
Among the exposures associated with risk for lung cancer, a history of tuberculosis (TB) is one potentially important factor, given the high prevalence of TB worldwide. A prospective cohort study was conducted to evaluate the associations of preexisting pulmonary TB with lung cancer incidence and mortality. The cohort consisted of 1,607,710 Korean adults covered by the National Health Insurance System who had a biennial national medical examination during 1997-2000. During up to 16 years of follow-up, there were 12,819 incident cases of lung cancer and 9,562 lung cancer deaths. Using Cox proportional hazards models and controlling for age, cigarette smoking and other covariates, the presence of underlying TB was significantly associated with increased risk for lung cancer incidence (HR 1.37 in men with 95% CI 1.29-1.45; HR 1.49 in women with 95% CI 1.28-1.74) and mortality (HR 1.43 in men with 95% CI 1.34-1.52; HR 1.53 in women with 95% CI 1.28-1.83). We also observed a dose-response relationship between number of cigarettes smoked daily and lung cancer risk. There was no evidence for synergism between a history of TB and smoking. The elevation in risk is relatively modest, particularly in comparison to that from smoking, and a prior history of TB is not likely to be useful risk indicator for clinical purposes. In populations with high prevalence of TB, it can be considered for incorporation into models for lung cancer risk prediction.
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Neoplasias Pulmonares/epidemiología , Fumar/epidemiología , Tuberculosis/epidemiología , Adulto , Estudios de Cohortes , Femenino , Humanos , Incidencia , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/microbiología , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Fumar/efectos adversos , Fumar/mortalidad , Tuberculosis/mortalidadRESUMEN
Crystalline silica is a widely used industrial material that is readily available worldwide, and is one of the most common types of particulate mineral pollutants. It has been classified as a group 1 human carcinogen of the respiratory system; however, whether it is linked to gastric cancer remains uncertain. We conducted a systemic review and meta-analyses to search for evidence of the relationship between gastric cancer and occupational exposure to crystalline silica. We searched for articles on occupations involving silica exposure and gastric cancer studies up to December 2014. Pooled-risk estimates of the association between occupational crystalline silica exposure and risk of gastric cancer were calculated by a random effects model. Metaregression analyses of industry type and histological confirmation status, study design and industrial subgroup analyses were performed. 29 articles, including 9 case-control and 20 cohort studies, were analysed. The overall summary effects size was 1.25 (95% CI 1.18 to 1.34) for the association of occupational silica exposure with gastric cancer. Both heterogeneity and publication bias were partially attenuated after subgroup analyses. Heterogeneity of studies was attenuated after metaregression by industry. Higher overall effects were observed in the mining and foundry industries. We found a significant relationship between occupational crystalline silica exposure and gastric cancer. Our results were strengthened by various subgroup analyses and, considering the biological plausibility of our premise, further studies are required to better understand this association.
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Contaminantes Ocupacionales del Aire/efectos adversos , Contaminación del Aire/efectos adversos , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Dióxido de Silicio/efectos adversos , Neoplasias Gástricas/inducido químicamente , Carcinógenos , Humanos , Industrias , Minería , Enfermedades Profesionales/epidemiología , Análisis de Regresión , Factores de Riesgo , Neoplasias Gástricas/epidemiologíaRESUMEN
INTRODUCTION: Suicide is a leading cause of death globally and is one of the most exigent health problems, especially in Korea. Individuals think about suicide first before they attempt and possibly complete suicide. If attempted or completed suicide affects suicidal ideation by family members or close individuals, suicide could spread like an infectious disease. We hypothesized that a suicide attempt by a family member could affect suicidal ideation. We analyzed the association between suicidal ideation and previous suicide attempts by family members. METHODS: This study used data from the fourth and fifth Korea National Health and Nutrition Examination Survey (2007-2012). The independent variable of interest is the existence of a cohabitating family member who previously attempted suicide. The dependent variable is self-reported suicide ideation during past year. The data analysis was conducted using the chi-square test and survey logistic regression. RESULTS: Suicidal ideation was reported by 14.3% of the total study population (9.5% of males, 19.0% of females), by 23.6% (22.8% of males, 31.3% of females) of individuals with a family member who attempted suicide, and by 14.1% (9.3% of males, 19.9% of females) of individuals without a family member who attempted suicide. Individuals with a family member who attempted suicide had increased odds of suicidal ideation compared with those without a family member who attempted suicide (odds ratio=2.09, 95% CI 1.48-2.49, p<0.001). CONCLUSIONS: To prevent suicide spreading like an infectious disease, government and policy makers should give thought and consideration to individuals with a family member who attempts suicide.
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Familia , Ideación Suicida , Intento de Suicidio/psicología , Adulto , Anciano , Depresión/epidemiología , Depresión/psicología , Países Desarrollados , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Clase Social , Intento de Suicidio/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
We aimed to compare the gastric cancer screening rates between participants with diabetes and those without diabetes in the Korean population. The data of 4284 participants from the Korea National Health and Nutrition Examination Survey 2019 were used. Cancer-free people aged ≥40 years were included, and cancer screening rates in diabetes and non-diabetes participants were analyzed. Baseline characteristics and screening rates were calculated using weighted frequencies and multivariable regression at a 95% confidence interval in both groups. Screening for gastric cancer was significantly lower (odd ratio [OR]: 0.77, 95% CI: 0.64-0.95) in patients with diabetes than in those without diabetes. The odds of performing the recommended gastric cancer screening were also lower (OR: 0.72, 95% CI: 0.58-0.90) in participants with diabetes than in those without diabetes. After adjusting for socio-demographic factors, the multivariable logistics regression analysis also showed lower odds for gastric cancer screening participation in diabetic patients than in non-diabetes participants. Conclusively, people with diabetes were less likely to have ever had or been recommended screening compared with those without diabetes. Greater efforts need to be made by health specialists to increase the awareness and the need of long-term preventive care including gastric cancer screening in high-risk groups.
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More than 4 million women undergo breast cancer (BC) screening with mammography each year in Korea. Digital mammography (DM) was introduced in 2000, and it has been reported to have a higher diagnostic accuracy than screen-film mammography (SFM) or computed radiography (CR) in women with dense breasts. According to a study using data from the National Cancer Screening Program for BC, the diagnostic accuracy of DM was higher than those of SFM and CR, regardless of age, breast density, and screening round. Currently, despite high supply rate among OECD countries, the distribution of DM equipment is approximately 35% in Korea. For quick replacement with DM, it will be necessary to improve its fee for the National Health Insurance and support an educational program for radiologists. In addition, efforts should be made to increase the accessibility of DM.
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Ischemia/reperfusion (IR) injury is induced by the restoration of blood flow to the prolonged ischemic tissues and is considered as the paradoxical exacerbation of ischemic damages. A large amount of reactive oxygen species (ROS) such as hydrogen peroxide (H2O2) produced immediately after reperfusion induces oxidative stress, which plays an essential role in the pathogenesis of IR injury. It is therefore critical to suppress oxidative stress for the prevention and treatment of IR injury. Ursodeoxycholic acid (UDCA), one of the tertiary bile acids, promotes the generation of antioxidant glutathione (GSH) and also exerts hepatoprotective, cytoprotective, and antiapoptotic effects. However, the clinical uses of UDCA are limited mainly by its poor water solubility and low bioavailability. In this study, by exploiting the concept of self-assembling disulfide-bridged dimeric prodrugs, we developed a disulfide-bridged UDCA dimer (ssUDCA) as a therapeutic agent of hepatic IR injury. ssUDCA could self-assemble into stable nanospheres under aqueous conditions, scavenge H2O2, and exert anti-inflammatory and antiapoptotic activities. In a mouse model of hepatic IR injury, ssUDCA (5 mg/kg) significantly alleviated the IR injury by suppressing ROS production and inhibiting proinflammatory cytokines. Therefore, our findings offer a promising strategy for the effective treatment of hepatic IR injury and also provide deep insights into the impact of disulfide-bridged UDCA nanoassemblies in pharmaceutical applications.
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Ácidos y Sales Biliares/farmacología , Materiales Biocompatibles/farmacología , Disulfuros/farmacología , Hígado/efectos de los fármacos , Daño por Reperfusión/tratamiento farmacológico , Animales , Ácidos y Sales Biliares/química , Materiales Biocompatibles/síntesis química , Materiales Biocompatibles/química , Supervivencia Celular/efectos de los fármacos , Dimerización , Disulfuros/química , Peróxido de Hidrógeno/antagonistas & inhibidores , Peróxido de Hidrógeno/farmacología , Hígado/patología , Masculino , Ensayo de Materiales , Ratones , Nanopartículas , Estrés Oxidativo/efectos de los fármacos , Tamaño de la Partícula , Células RAW 264.7 , Daño por Reperfusión/patologíaRESUMEN
BACKGROUND: South Korea has the highest incidence of thyroid cancer in the world. Our study examined the trends in thyroid cancer incidence by the histologic type, cancer stage, and age group and explored possible factors that affected thyroid cancer trends. METHODS: We conducted a descriptive epidemiological study using the national cancer registry data and cause of death data from 1999 to 2016 in South Korea. Age-standardized rates were calculated using Segi's world standard population. Joinpoint regression analysis was applied to determine the changing point of thyroid cancer trends according to histologic type; Surveillance, Epidemiology, and End Results (SEER) summary stage; and age groups by sex. RESULTS: The age-standardized incidence of thyroid cancer in both men and women increased from 6.3 per 100,000 people in 1999 to 63.4 per 100,000 in 2012 but declined from 2012 to 2016, before the debates for over diagnosis of thyroid cancer began in 2014. The age-standardized mortality rate of thyroid cancer, incidence of distant thyroid cancer, and incidence of regional and localized thyroid cancer started to decline since early 2000, 2010, and 2012, respectively. In addition, thyroid cancer prevalence in thyroid nodules showed decreasing trends from 1999-2000 to 2013-2014. CONCLUSIONS: The incidence of thyroid cancer began declining from 2012, before the debates for over diagnosis of thyroid cancer began in 2014. Changes in guidelines for thyroid nodule examinations may have affected this inflection point. Moreover, the debates for over diagnosis of thyroid cancer may have accelerated the decline in thyroid cancer.
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Adenocarcinoma Folicular/epidemiología , Carcinoma Medular/epidemiología , Cáncer Papilar Tiroideo/epidemiología , Carcinoma Anaplásico de Tiroides/epidemiología , Neoplasias de la Tiroides/epidemiología , Adenocarcinoma Folicular/diagnóstico , Adulto , Distribución por Edad , Anciano , Carcinoma Medular/diagnóstico , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Sobrediagnóstico/tendencias , Sistema de Registros/estadística & datos numéricos , Análisis de Regresión , República de Corea/epidemiología , Programa de VERF , Distribución por Sexo , Cáncer Papilar Tiroideo/diagnóstico , Carcinoma Anaplásico de Tiroides/diagnóstico , Neoplasias de la Tiroides/clasificación , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Nódulo Tiroideo/diagnóstico , Nódulo Tiroideo/epidemiología , Factores de Tiempo , Adulto JovenRESUMEN
OBJECTIVE: We aimed to determine the differences in stage at diagnosis of cervical cancer among Korean women according to screening history. METHODS: Using linkage data from the Korean Central Cancer Registry and Korean National Cancer Screening Program (KNCSP), we included 18,388 women older than 30 years who were newly diagnosed with cervical cancer between 2013 and 2014 and examined their screening history. Between individuals, age group and socioeconomic status were matched to control for potential confounders. RESULTS: Significantly more cases of carcinoma in situ (CIS) were diagnosed in the ever-screened (71.77%) group than in the never-screened group (54.78%), while localized, regional, distant, and unknown stage were more frequent in the never-screened group. Women in the ever-screened group were most likely to be diagnosed with CIS than with invasive cervical cancer (adjusted odds ratio [aOR]=2.40; 95% confidence interval [CI]=2.18-2.65). The aOR for being diagnosed with CIS was highest among women who were screened 3 times or more (aOR=5.10; 95% CI=4.03-6.45). The ORs were highest for women screened within 24 months of diagnosis and tended to decrease with an increasing time since last screening (p-trend <0.01). CONCLUSION: The KNCSP for cervical cancer was found to be positively associated with diagnosis of cervical cancers at earlier stages among women aged 30 years or older. The benefit of screening according to time was highest for women screened within 24 months of diagnosis.
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Neoplasias del Cuello Uterino , Detección Precoz del Cáncer , Femenino , Humanos , Prueba de Papanicolaou , República de Corea/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Frotis VaginalRESUMEN
PURPOSE: This study aimed to report the projected cancer incidence and mortality for the year 2021 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2018 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2019 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2021. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend. RESULTS: In total, 259,999 new cancer cases and 81,567 cancer deaths are expected to occur in Korea in 2021. The most common cancer site is expected to be the lung, followed by the thyroid, colon and rectum, breast, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and stomach cancers. CONCLUSION: The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.
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Neoplasias/epidemiología , Femenino , Historia del Siglo XXI , Humanos , Incidencia , Masculino , República de Corea , Análisis de SupervivenciaRESUMEN
PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2018. MATERIALS AND METHODS: Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2018, with survival follow-up until December 31, 2019. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, prevalence, and 5-year relative survival rates were calculated, and temporal trends for incidence and mortality rates were evaluated, with annual percentage changes. RESULTS: In 2018, newly diagnosed cancer cases and deaths from cancer were reported as 243,837 (ASR, 270.4 per 100,000) and 79,153 (ASR, 73.3 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.4% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2007 to 2014; 3.7% from 2014 to 2018). The 5-year relative survival between 2014 and 2018 was 70.3%, which contributed to prevalent cases reaching over 2 million by the end of 2018. CONCLUSION: Cancer statistics have improved significantly during the past two decades. However, there remain important challenges to be solved, such as controlling cancers with low survival rates. Cancer statistics can be used to discover blind spots in cancer control, and as evidence for developing and implementing future cancer control strategies.
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Neoplasias/epidemiología , Femenino , Historia del Siglo XXI , Humanos , Incidencia , Masculino , Neoplasias/mortalidad , Prevalencia , República de Corea , Análisis de SupervivenciaRESUMEN
PURPOSE: The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004-2018. MATERIALS AND METHODS: KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40-74 years and women aged 20-74 years with no cancer histories. RESULTS: Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively. CONCLUSION: Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.
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Detección Precoz del Cáncer/métodos , Tamizaje Masivo/métodos , Neoplasias/epidemiología , Adulto , Anciano , Estudios Transversales , Femenino , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , República de Corea , Adulto JovenRESUMEN
PURPOSE: This study aimed to report the projected cancer incidence and mortality for the year 2020 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2017 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2018 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years and then by multiplying the projected age-specific rates by the age-specific population. A Joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend. RESULTS: In total, 243,263 new cancer cases and 80,546 cancer deaths are expected to occur in Korea in 2020. The most common cancer site is expected to be the lung, followed by the stomach, thyroid, colon/rectum, and breast. These five cancers types are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer among people who die is expected to be lung cancer, followed by liver, colon/rectal, pancreatic, and stomach cancers. CONCLUSION: The incidence rates for all types of cancer in Korea are estimated to decrease gradually. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.
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Neoplasias/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Historia del Siglo XXI , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , República de Corea/epidemiología , Tasa de Supervivencia , Adulto JovenRESUMEN
OBJECTIVES: This study aimed to examine the effect of underlying individual preferences for the present over that for the future on lung cancer screening participation. SETTING: We analysed the data from the Korean National Cancer Screening Survey in 2018. PARTICIPANTS: 4500 adults aged 20-74 years old participated in the study. DESIGN: In this cross-sectional survey, multivariate logistic regression analysis was carried out to examine the association between subjects' intention to participate in lung cancer screening and individual preferences. The underlying individual preferences were measured on the basis of the self-reported general willingness to spend money now in order to save money in the future and general preferences with regard to financial planning. PRIMARY OUTCOME MEASURE: Intention to participate in lung cancer screening. RESULTS: Individuals eligible for lung cancer screening who place less value on their future were around four times less likely to report an intention to participate in lung cancer screening than were those who valued their future (OR 3.86, 95% CI 1.89 to 7.90). A present-biassed individual (one with a tendency for immediate gratification) was also about four times less likely to report an intention to participate in screening than an individual with no present bias (OR 0.26, 95% CI 0.12 to 0.57). CONCLUSIONS: Underlying individual preferences regarding the present and future significantly affect individuals' intention to participate in lung cancer screening. Hence, provision of incentives may be necessary to encourage the targeted heavy smokers who may have a strong preferences for the present over future.
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Comportamiento del Consumidor/estadística & datos numéricos , Neoplasias Pulmonares/diagnóstico , Tamizaje Masivo/normas , Participación del Paciente/psicología , Encuestas y Cuestionarios/normas , Adulto , Anciano , Estudios Transversales , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/psicología , Detección Precoz del Cáncer/normas , Femenino , Humanos , Intención , Neoplasias Pulmonares/psicología , Masculino , Tamizaje Masivo/métodos , Tamizaje Masivo/psicología , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Participación del Paciente/métodos , República de CoreaRESUMEN
INTRODUCTION: The prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality. Despite guidelines for HIV-infected patients to be immunized against HBV, the immunogenicity of the HBV vaccination in HIV-infected patients is lower than that in the HIV-seronegative population. METHOD: In this study, we performed a systematic review of the literature and meta-analysis of randomized clinical trials to investigate the response rate to an increased dose of HBV vaccination in HIV-infected patients. A fixed-effects model, with heterogeneity and sensitivity analyses, was used. We identified nine studies involving 970 HIV-positive vaccine recipients. RESULTS: The study results were divided into two groups, depending on the time when antibody against hepatitis surface antigen was measured. Results showed a significant increase in response rates among patients who received a double dose of the vaccine versus the standard dose in both subgroups; the pooled odds ratio (OR) was 1.76 (95% confidence interval [CI]: 1.36-2.29) and 2.28 (95% CI: 1.73-3.01) for the rate that was measured 4-6 weeks and >12 months after completion of vaccination, respectively. The total OR was 1.99 (95% CI: 1.64-2.41). No heterogeneity was found. DISCUSSION: Our meta-analysis shows that a double dose of the HBV vaccine may significantly improve the immune response in HIV-infected patients. Higher immunogenicity was observed, when it was measured 4-6 weeks and >12 months after completion of the vaccination.