Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2021.

PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2021. MATERIALS AND METHODS: Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2021, with survival follow-up until December 31, 2022. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. RESULTS: The number of new cancer diagnoses in 2021 increased by 27,002 cases (10.8%) compared to 2020. In 2021, newly diagnosed cancer cases and deaths from cancer were reported as 277,523 (age-standardized rate [ASR], 289.3 per 100,000) and 82,688 (ASR, 67.6 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% from 2012 to 2015, thereafter, followed by non-significant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.8% from 2002 to 2013; 3.2% from 2013 to 2021). The 5-year relative survival between 2017 and 2021 was 72.1%, which contributed to prevalent cases reaching over 2.4 million in 2021. CONCLUSION: In 2021, the number of newly diagnosed cancer patients increased as healthcare utilization recovered from the coronavirus disease 2019-related declines of 2020. Revised cancer registration guidelines expanded the registration scope, particularly for stomach and colorectal cancer. Survival rates have improved over the years, leading to a growing population of cancer survivors, necessitating a comprehensive cancer control strategy. The long-term impact of the pandemic on cancer statistics requires future investigation.

Prediction of Cancer Incidence and Mortality in Korea, 2024.

PURPOSE: This study aimed to report the projected cancer incidence and mortality for the year 2024 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2021 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2022 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 multiplying the projected age-specific rates by the anticipated age-specific population for 2024. 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 for prediction. RESULTS: In total, 292,221 new cancer cases and 83,770 cancer deaths are expected to occur in Korea in 2024. The most common cancer site is expected to be the thyroid, followed by the colon and rectum, lung, breast, and stomach. These five cancers are expected to represent 55.7% 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 age-standardized incidence rates for female breast and prostate cancers are estimated to continue to increase. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

Advancing Korean nationwide registry for hepatocellular carcinoma: a systematic sampling approach utilizing the Korea Central Cancer Registry database.

Hepatocellular carcinoma (HCC) presents a substantial public health challenge in South Korea as evidenced by 10,565 new cases annually (incidence rate of 30 per 100,000 individuals), in 2020. Cancer registries play a crucial role in gathering data on incidence, disease attributes, etiology, treatment modalities, outcomes, and informing health policies. The effectiveness of a registry depends on the completeness and accuracy of data. Established in 1999 by the Ministry of Health and Welfare, the Korea Central Cancer Registry (KCCR) is a comprehensive, legally mandated, nationwide registry that captures nearly all incidence and survival data for major cancers, including HCC, in Korea. However, detailed information on cancer staging, specific characteristics, and treatments is lacking. To address this gap, the KCCR, in partnership with the Korean Liver Cancer Association (KLCA), has implemented a systematic approach to collect detailed data on HCC since 2010. This involved random sampling of 10-15% of all new HCC cases diagnosed since 2003. The registry process encompassed four stages: random case selection, meticulous data extraction by trained personnel, expert validation, anonymization of personal data, and data dissemination for research purposes. This random sampling strategy mitigates the biases associated with voluntary reporting and aligns with stringent privacy regulations. This innovative approach positions the KCCR and KLCA as foundations for advancing cancer control and shaping health policies in South Korea.

Regional disparities in major cancer incidence in Korea, 1999-2018.

OBJECTIVES: This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018. METHODS: The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran's I with a spatial weight matrix based on adjacency or distance. RESULTS: Regional disparities varied depending on cancer type and gender during the 20-year study period. For men, the regional disparities of stomach, colon and rectum, lung, and liver cancer declined, and those of thyroid and prostate cancer recently decreased, despite an overall increasing incidence. For women, regional disparities in stomach, colon and rectum, lung, liver, and cervical cancer declined, that of thyroid cancer recently decreased, despite an overall increasing incidence, and that of breast cancer steadily increased. In 2014-2018, breast cancer (I, 0.61; 95% confidence interval [CI], 0.53 to 0.70) showed a high probability of cancer clusters in women, and liver cancer (I, 0.48; 95% CI, 0.40 to 0.56) showed a high probability of cancer clusters in men. CONCLUSIONS: Disparities in cancer incidence that were not seen at the national level were discovered at the municipal level. These results could provide important directions for planning and implementing local cancer policies.

Prediction of Cancer Incidence and Mortality in Korea, 2023.

PURPOSE: This study aimed to report the projected cancer incidence and mortality for the year 2023 to estimate Korea's current cancer burden. Materials and Methods: Cancer incidence data from 1999 to 2020 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2021 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 2023. 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, 273,076 new cancer cases and 81,818 cancer deaths are expected to occur in Korea in 2023. The most common cancer site is expected to be the lung, followed by the thyroid, breast, colon and rectum, 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 gallbladder 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.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2020.

PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2020. Materials and Methods: Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2020, with survival follow-up until December 31, 2021. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. RESULTS: The number of new cancer diagnoses in 2020 decreased by 9,218 cases (3.6%) compared to 2019. In 2020, newly diagnosed cancer cases and deaths from cancer were reported as 247,952 (age-standardized rate [ASR], 262.2 per 100,000) and 82,204 (ASR, 69.9 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.0% 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. The 5-year relative survival between 2016 and 2020 was 71.5%, which contributed to prevalent cases reaching over 2.2 million in 2020. CONCLUSION: In 2020, the number of newly diagnosed cancer patients decreased due to the coronavirus disease 2019 pandemic, but the overall trend is on the rise. Cancer survival rates have improved over the past decades. As the number of cancer survivors increases, a comprehensive cancer control strategy should be implemented in line with the changing aspects of cancer statistics. The long-term impact of the coronavirus disease 2019 pandemic on cancer statistics needs to be investigated in the future.

Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021.

OBJECTIVES: This study reports data regarding the awareness and practice of cancer prevention among Koreans in 2021 and behavioral changes during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We collected Cancer Prevention Awareness and Practice Survey data through face-to-face interview surveys using a structured questionnaire completed by 4,000 randomly selected men and women aged between 20 years and 74 years in 17 provinces. We examined the awareness and practice of 10 cancer prevention recommendations and evaluated their associations with potential risk factors through multiple logistic regression analysis adjusted for age, gender, residence, marital status, education, and income. RESULTS: Eighty percent of participants knew that cancer is preventable, while 45% practiced cancer prevention. Cancer prevention practice tended to be more common among older participants (adjusted odds ratio [aOR], 1.39 per 10-year increment; 95% confidence interval [CI], 1.29 to 1.49) and less common among rural inhabitants (aOR, 0.66; 95% CI, 0.51 to 0.86) than among urban residents and among single people (aOR, 0.55; 95% CI, 0.45 to 0.66) than among married people. Practices were the highest for avoiding burned or charred foods (87.6%) and lowest for vaccination against human papillomavirus (14.5%). Refusal to follow recommendations was most common for avoiding alcohol consumption (7.9%). The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%). CONCLUSIONS: The awareness of cancer prevention was high, but the practice was low. Recommendations targeting awareness and practice need to be further promoted.

Epidemiology of Gastric Cancer in Korea: Trends in Incidence and Survival Based on Korea Central Cancer Registry Data (1999-2019).

This study investigated the trends of gastric cancer in Korea by adding the latest updated gastric cancer data from 2019. Gastric cancer incidence between 1999 and 2019 was reviewed using data from the Korea Central Cancer Registry. The study period was divided into 3 periods: period I (1999-2005), period II (2006-2012), and period III (2013-2019). The incidence, mortality, tumor location, histology, stage, and treatment were analyzed. Between 1999 and 2019, 577,502 patients were newly diagnosed with gastric cancer in Korea, accounting for 33.2% of patients aged ≥70 years. The age-standardized incidence rate (per 100,000) significantly decreased from 2011 (43.0) to 2019 (29.6), with an annual percent change of -4.50. Additionally, the age-standardized mortality rate (per 100,000) markedly decreased from 1999 (23.9) to 2019 (6.7). The proportions of patients with cardia and fundus cancers remained consistent. The proportion of localized stage cases increased, while those of regional and distant stages decreased. The rate of surgical treatment increased in localized and regional stages from 2006 to 2019. The overall 5-year relative survival (5YRS) rate of gastric cancer (per 100,000) increased from 55.7% in period I to 77.0% in period III. From 2013 to 2019, the 5YRS rates of patients (per 100,000) who underwent surgical treatment were 100.6% and 70.5% in the localized and regional stages, respectively. The results of this study demonstrated several changes in the epidemiology of gastric cancer in Korea. This study provides information to help understand the current trends in gastric cancer in Korea.

Incidence, mortality and survival of gallbladder, extrahepatic bile duct, and pancreatic cancer using Korea central cancer registry database: 1999-2019.

Backgrounds/Aims: In Korea, pancreatic cancer and "gallbladder and extrahepatic bile duct cancer" were ranked the 8th and 9th most frequent cancers in 2019 and the 4th and 6th most common causes of cancer deaths in 2020, respectively. Methods: This review provides national cancer statistics and secular trends of 207,521 patients with gallbladder (n = 44,178), extrahepatic bile duct (n = 61,856), and pancreatic cancer (n = 101,487) between 1999 and 2019 in Korea. Results: The crude incidence rate in both sexes increased in the gallbladder (2.8 to 5.4 per 100,000), extrahepatic bile duct (3.6 to 9.0), and pancreatic cancer (5.5 to 15.8). The age-standardized incidence rate in both sexes significantly increased in the extrahepatic bile duct (3.7 to 4.1) and pancreatic (5.6 to 7.6) cancers but decreased in gallbladder cancer (2.9 to 2.4). The overall 5-year relative survival rate increased in the gallbladder (21.8% to 30.6%), extrahepatic bile duct (23.1% to 27.5%), and pancreatic (8.5% to 13.3%) cancers. Between 2006 and 2019, the proportion of localized or regional stages remained stable. The proportion of surgical treatment within the first 4 months after diagnosis was relatively higher in the gallbladder (42.2%) and extrahepatic bile duct (45.9%) cancers than in pancreatic cancer (22.2%). Conclusions: The crude incidence and mortality rates of the gallbladder, extrahepatic bile duct, and pancreatic cancer are steadily increasing in Korea, and the prognosis remains poor. Early detection, active application of surgical treatment, and minimization of the proportion of untreated patients are required to improve the survival rates of these cancers.

The Positive Effects of Cancer Survivor Support Service on Distress in South Korea: A Nationwide Prospective Study.

BACKGROUND AND AIM: Cancer survivors are gradually increasing, however, they suffer from various difficulties. We aimed to investigate the characteristics of cancer survivors and the effects of the services of the Korean Cancer Survivorship Center Pilot Project launched by the South Korean government on distress. METHODS: A prospective observational cohort study was performed on cancer survivors who completed primary treatment. Cancer survivors' distress and symptoms such as fatigue, pain, depressive mood, anxiety, and insomnia were evaluated by well-trained nurses. Regarding their needs, medical and psychosocial support services were provided. RESULTS: This study included 1,921 cancer survivors, with a mean age of 57.3 years (68.7% females). Breast cancer was most common, followed by stomach and colorectal cancer. Psychosocial and medical support decreased the percentage of the high-distress group from 50.9 to 30.5% and decreased the percentage of cancer survivors with high scores in fatigue, pain, anxiety, depressive mood, and insomnia. The independent predictors of a low distress level after the use of the services were older age, the relief of fatigue, pain, and insomnia. CONCLUSION: This study showed that psychosocial and medical support is associated with the lower distress and physical and mental symptoms of cancer survivors. Psychosocial and medical support could contribute to distress relief in cancer survivors. Further management strategies for fatigue, pain and insomnia are required.

A Comparative Analysis of the Perception of Cancer Patients and Healthcare Providers (Oncology Physicians, Nurses, Social Workers) in Support of Integrated Community-Linked Cancer Plans.

This study aimed to examine the awareness and status of cancer patients and healthcare providers (physicians, nurses and social workers) regarding community linkage, in order to establish a desirable care plan model in a future research project. The survey was conducted via two methods: face-to-face for cancer patients (n = 308) and oncology physicians (n = 210), and due to COVID-19 circumstances, online for nurses (n = 200) and social workers (n = 313). As a result, more than 95% of the healthcare providers responded that cancer patients required community-linked services and discharge plans, whereas 50.7% and 79.2% of cancer patients noted the importance of community-linked services and discharge plans, respectively. Social workers, among healthcare providers, showed the most positive experience about connecting patients to community services since 69.7% of them responded as "excellent". However, as a group, cancer patients considered the necessity of community-linked service as less important, as only 50.7% responded as agreeing it was necessary. The barriers to community linkage were the lack of communication among the different professions of healthcare providers, and the ambiguity in their roles. The findings of this study will inform future community-linked health research, policies and systems for cancer patients. In particular, an in-depth interview with cancer patients will be required to explore their lack of acknowledgment about the necessity of community-linked services. Therefore, this study is expected to contribute to the improvement and supplementation of cancer policies.

Factors associated with psychological stress and distress among Korean adults: the results from Korea National Health and Nutrition Examination Survey.

The prevalence of stress and distress has been increasing and being important public health issues; nevertheless, few studies have assessed the factors associated at the population level. This study identified factors associated and how they differentially influence stress and distress. A total of 35,105 individuals aged 19 years and older using nationally representative data from the Korea National Health and Nutrition Examination Survey (2007-2012) were included in the study. Subjects were differentiated by gender and psychological state (no symptoms, stress, distress). The associations of socio-demographics, psychosocial factors, health behaviours, and chronic illness with psychological states were analysed by gender. Socio-demographics and psychosocial factors such as lower household income, lower education level, living alone or negative outcome of marriage, and unemployment were associated with distress in both genders. Male and female educated higher and with short sleep duration, male living alone and with higher household income, and female married and with a lower household income was associated with stress. A perceived body image of slim or fat was associated with distress and stress in both genders. Behavioural factors, such as smoking, higher alcohol consumption, and abnormal calorie intake, were associated with stress and distress in both genders, with the exception of alcohol consumption in distress and abnormal calorie intake in stress of male. Socio-economic deprivation and negative psychosocial and behavioural factors were differently associated with psychological distress or stress by gender. Intervention strategies for distress and stress should be specifically tailored regarding these differences.

Cancer News Coverage in Korean Newspapers: An Analytic Study in Terms of Cancer Awareness.

OBJECTIVES: Cancer diagnoses have a tremendous impact on individuals and communities, drawing intense public concern. The objective of the current research was to examine news coverage and content related to cancer-related issues in Korean newspapers. METHODS: Primarily using the database system of the Korea Press Foundation, we conducted a content analysis of 2806 articles from 9 Korean daily newspapers during a recent 3-year period from 2015 to 2017. Thematic categories, the types of articles, attitudes and tone, and the number of sources in each article were coded and classified. RESULTS: Many news articles dealt with a diverse range of themes related to cancer, including general healthcare information, the latest research and development, specific medical institutions and personnel, and technology and products, which jointly accounted for 74.8% of all articles. Those thematic categories differed markedly in terms of article type, tone, and the number of cited sources. News articles provided extensive information about healthcare resources, and many articles seemed to contain advertising content. However, the content related to complex social issues such as National Health Insurance did not include enough information for the reader to contextualize the issues properly or present the issues systematically. CONCLUSIONS: It can be assumed that the media exert differential influence on individuals through news coverage. Within the present reporting framework, the availability and usefulness of information are likely to depend solely on individuals' capabilities, such as financial and health literacy; this dependency has a negative impact on knowledge gaps and health inequities.

Mothers' Perceptions of Quality of Family-Centered Care and Environmental Stressors in Neonatal Intensive Care Units: Predictors of and Relationships with Psycho-emotional Outcomes and Postpartum Attachment.

OBJECTIVES: Maternal attachment to promote role development in mothers of preterm infants is critical for babies' optimal growth and development. However, few models specify how neonatal intensive care units (NICUs) and their environments work to foster postpartum attachment (PPA) after preterm birth. We investigated relationships of quality of family-centered care and NICU environmental stressors with maternal PPA, to determine whether these are mediated by mothers' psycho-emotional response and whether pathways to PPA are moderated by developmental immaturity (gestation, birthweight). METHODS: A cross-sectional study using structural equation modeling was conducted on 294 mothers of premature infants with experience in NICUs in over 49 tertiary hospitals in 12 cities or provinces of South Korea. Data were collected using Korean versions of instruments including the Quality of Family-centered Care, Parental Stressor Scale: NICU, and Maternal Postpartum Attachment Scale. RESULTS: Maternal self-representation was a key predictor of PPA (ß = .68), accounting for 42.2% of variance. Multi-group analysis indicated that NICU environmental stressor sensitivity (ß = .26) and maternal self-representation (ß = .67) were predictive of PPA in mothers of moderately preterm and low birthweight (32-36 weeks' gestation, 1500-2499 g birthweight) infants. Quality of family-centered developmental care (ß = .11) and NICU environmental stressor sensitivity (ß = - .16) had significant indirect effects on PPA through psycho-emotional responses. CONCLUSIONS FOR PRACTICE: Healthcare professionals should be aware of the importance of family-centered interventions focusing on psychosocial support and family participation in baby care, based on their environmental role in promoting PPA.

Trends in Participation Rates of the National Cancer Screening Program among Cancer Survivors in Korea.

The study aimed to describe the participation rates of the National Cancer Screening Program (NCSP) among cancer survivors in Korea. The NCSP protocol recommends that all Korean men and women should be screened for cancer. Cancer survivors were defined as those registered for any cancer in the Korea Central Cancer Registry by December 31 of the year prior to being included in the target population of the NCSP. In this study, the participation rates for the NCSP were calculated as the percentage of people who participated in four kinds of cancer screening programs, independently. The average annual percentage change was assessed. The participation rates of the general population and cancer survivors were higher than 40% in stomach, breast, and cervical cancer screening. These rates were higher than that of colorectal cancer screening in 2014. In addition, the participation rates in the NCSP in 2002-2014 increased for all cancer types. The NCSP participation rates of the cancer survivors indicate the high demand for cancer screening. Further research may investigate the effect of the NCSP on second cancer occurrence or mortality in cancer survivors and the significance of cancer screening guidelines for cancer survivors.

Influence of new tobacco control policies and campaigns on Quitline call volume in Korea.

INTRODUCTION: While tobacco control policies have been adopted and enforced, and anti-smoking campaigns have been conducted, the evaluation of their impact on tobacco quitting is lacking in Korea. Therefore, the effectiveness of tobacco control policies and mass media campaigns to encourage use of the Quitline were evaluated by monitoring call volume on Quitline, which has been in operation since 2006, in Korea. METHODS: Tobacco control policies and mass media campaigns, from 1 January of 2007 to 31 December of 2016, were assessed from the review of government documents and the history of law and regulation changes. The corresponding period incoming call volumes of the Quitline were assesed. The average monthly call volume, when policies and anti-smoking advertising were implemented, was compared with that of the whole year or baseline years (2007 and 2008). RESULTS: Peak call volume occurred in 2010 when the Quitline was directly promoted on television. The call volume in the month the TV campaign aired was 5.5 times higher than the average monthly call volume in the year 2010. A relatively gradual rise in call volume was found from 2013 to 2016 when the tobacco control policies and campaigns, such as Quitline number included on cigarette packs, a fear-oriented anti-tobacco campaign on mass media, and a tax increase on tobacco was implemented, were introduced sequentially. In that period, the average monthly call volume was about five times higher than in 2007 and 2008. CONCLUSIONS: Continuous efforts to contribute to tobacco control policies and campaigns by the promotion of the Quitline is a most effective approach to raise quitting attempts. Based on the Korean experience, Quitline data may be useful for assessing the impact of tobacco control policies and campaigns in Asian Pacific countries.

User characteristics of national smoking cessation services in Korea: who chooses each type of tobacco cessation program?

BACKGROUND: Relatively little is known about which characteristics of smokers are related to choosing a specific type of smoking cessation service. The user characteristics of different smoking cessation services were compared to determine the service preferred by user characteristics. METHODS: The characteristics of adult smokers from Korea National Health and Nutrition Examination Survey (3762) and registered users of national smoking cessation services operated through the web (14,762), at Public Health Center-based Smoking Cessation Clinics (PHC-based SCCs) (335,532), and by telephone (Quitline) (2983) were compared. RESULTS: Females and younger aged were more in web and telephone-based cessation service users, while aged 50 years or older were more in PHC-based SCCs users. Although manufacturing and production workers were the most prevalent among smokers in the general population, office workers and others including housewives and unemployed were most prevalent among the users of Quitline and PHC-based SCCs, respectively. The number of cigarettes smoked per day was twice as high among cessation service users as in general population. Smokers with greater nicotine dependency were most prevalent in the web-based service. Overseas users were in the web-based cessation service. CONCLUSION: Identifying user-specific characteristics by the type of cessation services looks necessary to develop and offer appropriate cessation services.

Influences of Tobacco-Related Knowledge on Awareness and Behavior towards Smoking.

BACKGROUND: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. METHODS: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. RESULTS: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ≥ 9 correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ≤ 4 correct answers). Interestingly, among current smokers, only those who correctly responded to ≥ 9 of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. CONCLUSION: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.

Towards smoke-free cars in the Republic of Korea: Evidence from environmental and biochemical monitoring of third-hand smoke exposure in taxis.

INTRODUCTION: To evaluate the level of tobacco smoke exposure in taxis in Korea using tobacco specific environmental markers. METHODS: From June to September 2012, cross-sectional measurements of air nicotine levels and dust nicotine-derived nitrosamine ketone (NNK) concentrations were conducted in 17 taxis in Goyang, Korea. Field investigators completed an observational questionnaire on building characteristics, smoking policies and evidence of smoking. Descriptive statistics including geometric means (GMs) ± standard deviations were produced for air nicotine levels and dust NNK concentrations. RESULTS: There was no evidence of active smoking in the 17 taxis monitored, despite the fact that 10 drivers were current smokers. The overall GMs of air nicotine and dust NNK concentration were 0.42 µg/m3 and 6.78 pg/mg, respectively. These levels were 3.4-fold and 2.6-fold higher in taxis whose drivers were current smokers compared to the taxis of nonsmokers (GM of air nicotine: 0.65 µg/m3 vs 0.19 µg/m3; GM of dust NNK: 10.07 pg/mg vs 3.85 pg/mg). CONCLUSIONS: The present study shows that air nicotine and dust NNK were detected in all taxis regardless of whether the taxi driver was smoking or not, which indicates the potential for exposure to SHS or THS. It suggests that an appreciable level of SHS and TSH exposure might occur if the environment is not completely smoke-free and enforcement is lacking. ABBREVIATIONS: THS: third-hand smoke, SHS: second-hand smoke, FCTC: Framework Convention Alliance for Tobacco Control, NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, LOD: limit of detection, GM: geometric mean, GSD: geometric standard deviation.

Awareness of and Attitudes toward Human Papillomavirus Vaccination among Adults in Korea: 9-Year Changes in Nationwide Surveys.

PURPOSE: Human papillomavirus (HPV) vaccination has been included in the National Immunization Program in Korea since 2016. We aimed to evaluate changes in the awareness of and attitudes toward HPV vaccination, among adults in Korea since the first introduction of the vaccines in 2007. MATERIALS AND METHODS: A nationwide population-based survey was conducted in 2016 for 1,200 nationally representative Korean men and women; the data obtained were compared with the data from the nationwide survey conducted in 2007. RESULTS: A significant increase in the awareness of HPV infection (35.8%) and vaccination (36.9%) was observed in 2016 from 13.3% and 8.6% in 2007, respectively. Willingness to be vaccinated against HPV decreased from 55.0% in 2007 to 25.8% in 2016, and the proportion of respondents expressing uncertainty increased from 28.3% in 2007 to 43.3% in 2016. Only 12.1% of men and 22.0% of women knew about the free national HPV vaccination program for girls, launched in June 2016. Younger women, with higher income level, awareness of the HPV vaccine, and perception of the seriousness of infections had a higher willingness to be vaccinated. A high education level, awareness of HPV infection and vaccination, and perception of the seriousness of infection were positively associated with the willingness of respondents to vaccinate their daughters. CONCLUSION: Raising the awareness of HPV infection and vaccination with appropriate knowledge is necessary for the successful implementation of the national HPV vaccination program.