Combinations of lifestyle behaviors and cancer risk among Korean adults.

Combinations of lifestyle behaviors may lead to different cancer risks. This study aimed to identify the latent classes based on lifestyle behavior trajectories and to investigate the association between these latent classes and cancer risk. Participants in the 2002-2003 National Health Insurance Service general health examination were included. Data on smoking, alcohol drinking, body mass index (BMI), and physical activity measured four times between 2002 and 2009 were analyzed. Incident cancer cases were tracked from 2010 to 2018. Patterns of alcohol drinking, smoking, BMI, and physical activity and latent classes based on trajectories of smoking, alcohol drinking, BMI, and physical activity were identified. Among 2,735,110 adults (1,787,486 men and 947,624 women), 111,218 (69,089 men and 42,129 women) developed incident cancer. Six latent classes of lifestyle behavior were identified, with Class 1 (healthy class) involving only 0.2% of men and 0.5% of women. The highest risk class in males tended to be steady light drinkers and steady moderate smokers, have steady low frequency of physical activity, and be obese. This class showed a 1.47 times higher (95% CI = 1.29-1.69) risk of all cancers than did the healthy class. Among women, there was only an association between the highest risk class (tendency to be non-drinkers, light smokers) and colorectal cancer (HR = 1.70, 95% CI = 1.02-2.83). Only a small percentage of participants maintained a long-term healthy lifestyle. Identifying classes of behavior combinations and their links to cancer development is therefore critical for cancer prevention.

Mortality risk according to smoking trajectories after cancer diagnosis among Korean male cancer survivors: A population-based cohort study.

INTRODUCTION: Previous research on post-diagnosis smoking among cancer survivors mainly relied on smoking status, which may not fully reflect the impact of changes in smoking levels. This study aimed to evaluate mortality risk according to smoking trajectories among Korean male cancer survivors, using a trajectory approach to comprehensively capture smoking patterns. METHODS: The study included 110555 men diagnosed with cancer between 2002 and 2018 from the Korean National Health Information Database. Group-based trajectory modelling was used to identify post-diagnosis smoking trajectories among pre-diagnosis current smokers (n=45331). Cox hazards models were fitted to evaluate mortality risk according to smoking trajectories for pooled cancers, pooled smoking-related cancers, smoking-unrelated cancers, and gastric, colorectal, liver, and lung cancers. RESULTS: Smoking trajectories included light-smoking quitters, heavy-smoking quitters, consistent moderate smokers, and decreasing heavy smokers. Smoking significantly increased all-cause and cancer mortality risks in cancer patients for pooled cancers, pooled smoking-related cancers, and pooled smoking-unrelated cancers. Compared to non-smokers, all-cause mortality risk for pooled cancers significantly increased according to smoking trajectories:(AHR=1.33; 95% CI: 1.27-1.40), (AHR=1.39; 95% CI: 1.34-1.44), (AHR=1.44; 95% CI: 1.34-1.54), and (AHR=1.47; 95% CI: 1.36-1.60), respectively. Smoking increased all-cause and cancer mortality risks in gastric and colorectal cancer patients and cancer-specific mortality in lung cancer patients. The significant associations of smoking trajectories with all-cause and cancer mortality risks were primarily observed in 5-year survivors but not in short-term survivors. Among heavy smokers, smoking cessation significantly reduced all-cause mortality risk in the long-term. CONCLUSIONS: The post-diagnosis smoking trajectory independently predicts cancer prognosis among male cancer patients. Proactive cessation support should be strengthened, particularly for those who smoke heavily.

Smoking Cessation, Quit Attempts and Predictive Factors among Vietnamese Adults in 2020.

OBJECTIVE: This study aims to describe the updated smoking cessation and quit attempt rates and associated factors among Vietnamese adults in 2020. METHODS: Data on tobacco use among adults in Vietnam in 2020 was derived from the Provincial Global Adult Tobacco Survey. The participants in the study were people aged 15 and older. A total of 81,600 people were surveyed across 34 provinces and cities. Multi-level logistic regression was used to examine the associations between individual and province-level factors on smoking cessation and quit attempts. RESULTS: The smoking cessation and quit attempt rates varied significantly across the 34 provinces. The average rates of people who quit smoking and attempted to quit were 6.3% and 37.2%, respectively. The factors associated with smoking cessation were sex, age group, region, education level, occupation, marital status, and perception of the harmful effects of smoking. Attempts to quit were significantly associated with sex, education level, marital status, perception of the harmful effects of smoking, and visiting health facilities in the past 12 months. CONCLUSIONS: These results may be useful in formulating future smoking cessation policies and identifying priority target groups for future interventions. However, more longitudinal and follow-up studies are needed to prove a causal relationship between these factors and future smoking cessation behaviors.

Trajectory of physical activity frequency and cancer risk: Findings from a population-based cohort study.

BACKGROUND: Physical activity (PA) changes throughout an individual's life, but the association between such changes and cancer risk seems to be overlooked in the literature. Thus, this study aimed to examine the association between the trajectories of PA frequency and cancer incidence among middle-aged Korean adults. METHODS: A total of 1,476,335 eligible participants (992,151 men and 484,184 women) aged ≥40 years from the National Health Insurance Service cohort (2002-2018) were included. Assessment of PA frequency was a self-reported measure, based on the question: "How many times per week do you perform exercise that makes you sweat?". PA frequency trajectories (i.e., trajectory classes of change in PA frequency) from 2002 to 2008 were identified using group-based trajectory modeling. Cox proportional hazards regression was used to assess the associations between the PA trajectories and cancer incidence. RESULTS: Five PA frequency trajectories over 7 years were identified: persistently low (men:73.5%; women:74.7%), persistently moderate (men:16.2%; women:14.6%), high-to-low (men:3.9%; women:3.7%), low-to-high (men:3.5%; women:3.8%), and persistently high (men:2.9%; women:3.3%). Compared with persistently low frequency, maintaining a high PA frequency was associated with a lower risk of all cancers (Hazard ratio (HR) = 0.92, 95%CI = 0.87-0.98) and breast cancer (HR = 0.82, 95%CI = 0.70-0.96) among women. There was a lower risk for thyroid cancer among men in the high-to-low (HR = 0.83, 95%CI = 0.71-0.98), low-to-high (HR = 0.80, 95%CI = 0.67-0.96), and high PA trajectories (HR = 0.82, 95%CI = 0.68-0.99). There was a significant association between moderate trajectory and lung cancer in men (HR = 0.88, 95%CI = 0.80-0.95), in both smoking and non-smoking men. CONCLUSION: Long-term persistent high frequency of PA as part of the daily routine should be widely promoted and encouraged to reduce the risk for all cancer development in women.

Estimation of the Acoustic Transducer Beam Aperture by Using the Geometric Backscattering Model for Side-Scan Sonar Systems.

In this paper, we propose an algorithm for estimating the beam aperture of the acoustic transducers by using the geometric backscattering model for side-scan sonar systems. The geometric backscattering model is developed to describe the propagation paths of the signal transmitted from the transducers towards the seabed and backscatters to the hydrophones. To evaluate our proposed algorithm, we have developed a side-scan sonar system. The side-scan sonar system uses two transducers, operating on two different frequencies and focusing on two different wave beams, to scan the images of the seabed. The proposed algorithm provides the estimated beam apertures of each transducer. Our obtained results agree quite well with the parameters provided by the manufacturers. Moreover, these results are used to calibrate the scanned images. We provide the scanned sonar 3D images of the Dong Do lakebed, Vietnam, to justify our proposal.

Alcoholic liver disease in relation to cancer incidence and mortality: Findings from a large, matched cohort study in South Korea.

AIM: To estimate the risk of cancer incidence and mortality among patients with alcoholic liver disease in South Korea. METHODS: A matched cohort study was conducted, including 1,042,185 men (alcoholic liver disease cases: 208,437; controls: 833,748) and 100,400 women (alcoholic liver disease cases: 20,080; controls: 80,320), matched for sex, age, smoking, alcohol consumption, and body mass index at a 1:4 ratio. The risk of cancer incidence and mortality in the alcoholic liver disease group was assessed using Cox proportional hazards regression models. RESULTS: Both men and women with alcoholic liver disease had an elevated risk of all-cancer and liver cancer incidence and mortality in comparison with the control group. In men, alcoholic liver disease was associated with a significantly higher risk of development of 10 cancer types, including lip, oral cavity, and pharynx; esophagus; liver; gallbladder and biliary tract; pancreas; larynx; lung; kidney; thyroid gland; and leukemia. Subgroup analysis by hepatitis B and C infection showed increased hazard ratios of all cancer incidences and mortality in the alcoholic liver disease group, regardless of hepatitis B or C infection status. In both sexes, a higher number and more years of hospital or clinic visits for alcoholic liver disease were associated with an increased risk of incidence and mortality from all cancers and liver cancer. A more profound dose-response relationship between alcoholic liver disease and alcohol consumption was observed in women than in men. CONCLUSIONS: Our findings emphasize the need for a clinical surveillance program and the early detection of cancer in patients with alcoholic liver disease.

Exposure to Electronic Cigarette Advertisements and Use of Electronic Cigarettes: A Meta-analysis of Prospective Studies.

INTRODUCTION: Electronic cigarette (EC) advertisements remain unregulated and approach consumers in TV commercials, print ads, radio, and other forms of digital marketing. AIMS AND METHODS: This study aimed to assess whether exposure to EC advertisements is associated with the use of EC by using a meta-analysis of prospective studies. We searched PubMed, EMBASE, and Web of Science to locate eligible studies in November 2021. Pooled adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis. RESULTS: Out of 1635 articles searched from databases, we included seven prospective studies that met inclusion criteria in the final analysis. Four out of seven studies involved participants under 18 years of age. In the meta-analysis of all studies, exposure to EC advertisements was significantly associated with the increased use of ECs (aOR = 1.53, 95% CI 1.22 to 1.92; I2 = 60.1%). In the subgroup meta-analyses by source of advertisements, there was no significant association between exposure to EC advertisements on TV, radio, or billboards and the use of EC, while exposure to EC advertisements in retail stores and on Internet or social media significantly increased the use of EC. CONCLUSIONS: Exposure to EC advertisements was associated with the increased use of ECs, specifically in retail stores and on Internet or social media among adolescents and young adults. Because EC use could serve as a gateway to cigarette smoking in adolescents and young adults, more strict regulations and restrictions on EC advertisements are needed. IMPLICATIONS: Concurrent with the rise in electronic cigarette (EC) sales, advertising expenditures for ECs have been increased in the past decade, and there is controversy over the association between exposure to EC advertisements and the use of ECs. This meta-analysis of seven prospective studies showed that exposure to EC advertisements was significantly associated with the increased use of ECs, specifically in retail stores and on Internet or social media among adolescents and young adults. Because, EC use could serve as a gateway to cigarette smoking in adolescents and young adults, more strict regulations and restrictions on EC advertisements are needed.

Cancer Risk According to Alcohol Consumption Trajectories: A Population-based Cohort Study of 2.8 Million Korean Men.

BACKGROUND: Alcohol drinking behaviors change temporally and can lead to changes in related cancer risks; previous studies have been unable to identify the association between the two using a single-measurement approach. Thus, this study aimed to investigate the association of drinking trajectories with the cancer risk in Korean men. METHODS: A trajectory analysis using group-based trajectory modeling was performed on 2,839,332 men using data on alcohol drinking levels collected thrice during the Korean National Health Insurance Service's general health screening program conducted between 2002 and 2007. Cox proportional hazards regression was performed to evaluate the associations between drinking trajectories and cancer incidence, after adjustments for age, income, body mass index, smoking status, physical activity, family history of cancer, and comorbidities. RESULTS: During 10.5 years of follow-up, 189,617 cancer cases were recorded. Six trajectories were determined: non-drinking, light, moderate, decreasing-heavy, increasing-heavy, and steady-heavy. Light-to-heavy alcohol consumption increased the risk for all cancers combined in a dose-dependent manner (adjusted hazard ratio [aHR] 1.03; 95% confidence interval [CI], 1.02-1.05 for light drinking, aHR 1.06; 95% CI 1.05-1.08 for moderate drinking, aHR 1.19; 95% CI, 1.16-1.22 for decreasing-heavy drinking, aHR 1.23; 95% CI, 1.20-1.26 for increasing-heavy drinking, and aHR 1.33; 95% CI, 1.29-1.38 for steady-heavy drinking [P-trend <0.001]). Light-to-heavy alcohol consumption was linked to lip, oral cavity, pharyngeal, esophageal, colorectal, laryngeal, stomach, and gallbladder and biliary tract cancer risks, while heavy alcohol consumption was associated with hepatic, pancreatic, and lung cancer risks. An inverse association was observed for thyroid cancer. The cancer risks were lower for decreasing-heavy drinkers, compared to steady-heavy drinkers. CONCLUSION: No safe drinking limits were identified for cancer risks; reduction in heavy intake had protective effects.

Weight-change trajectory in relation to cancer risk: findings from a nationwide cohort study in South Korea.

OBJECTIVE: This study examined relationships between weight-change trajectories and all cancers and obesity-related cancer risks. METHODS: A total of 1,882,304 men and 899,912 women from the 2002 to 2017 National Health Insurance Service cohort were included. Weight-change trajectories in 2002 to 2009, according to BMI, were determined using group-based trajectory modeling. Cox proportional hazards regression assessed associations between trajectories and cancer incidence. RESULTS: Overall, >50% of individuals maintained stable weight, as did two-thirds of those in the overweight and obesity groups. A total of 64,725 men and 37,608 women developed incident cancer. Weight stability in overweight or obesity groups was associated with greater cancer risk. In both sexes, higher weight across BMI groups increased risks of all cancers, obesity-related cancers and thyroid, colorectal, stomach, liver, prostate, and postmenopausal breast cancer. Stratified by BMI, weight gain increased risks of all cancers and obesity-related cancers in men with obesity class I and women with overweight. Weight loss decreased risks of obesity-related cancers, thyroid cancer, and kidney cancer among men with overweight, premenopausal breast, endometrial, and ovarian cancer in women with overweight, and obesity-related cancers and thyroid cancer in women with class I obesity. CONCLUSIONS: Maintaining weight and avoiding weight gain are crucial for reducing cancer risk, but achieving a stable, normal BMI optimizes cancer prevention.

Progression of liver fibrosis and associated factors among chronic hepatitis B patients at a general hospital in Northern Vietnam.

Evaluation of liver fibrosis is necessary to make the therapeutic decision and assess the prognosis of CHB patients. The current study aimed to describe the progression and identify some influencing factors in patients with chronic hepatitis B at a General Hospital in Northern Vietnam. The longitudinal study included 55 eligible subjects diagnosed Hepatitis-B-virus. Dependent variable was the aspartate aminotransferase/platelet ratio index and we collected some demographic variables and disease related and behaviour variables. Bayesian Model Averaging was used to select variables into model. Mixed-effect linear models were used to evaluate the change of the aspartate aminotransferase/platelet ratio index over time and identify related factors. the aspartate aminotransferase/platelet ratio index differences between examinations, age of participants, working status were statistically significant. This pattern indicated that the average the aspartate aminotransferase/platelet ratio index of the population decreased by 0.005 (95% CI=-0.009; -0.001) after each patient's visit, and increased by 0.013 if the patient's age increased by 1 year (95% CI=0.005; 0.0219). For non-working patients, the aspartate aminotransferase/platelet ratio index was lower, coefficient was -0.054 (95% CI=-0.108; 0.001). Other variables such as gender, education level, time for disease detection, drinking tea, alcohol consumption, forgetting to take medicine and the aspartate aminotransferase/platelet ratio index were not significantly different. The study showed that the majority of study subjects had average the aspartate aminotransferase/platelet ratio index, and were relatively well controlled and treated during the study. Age and working status are factors that influence the the aspartate aminotransferase/platelet ratio index.

Adherence to Antiplatelet Therapy after Coronary Intervention among Patients with Myocardial Infarction Attending Vietnam National Heart Institute.

Adherence to antiplatelet therapy is critical to successful treatment of cardiovascular conditions. However, little has been known about this issue in the context of constrained resources such as in Vietnam. The objective of this study was to examine the adherence to antiplatelet therapy among patients receiving acute myocardial infarction interventions and its associated factors. In a cross-sectional survey design, 175 adult patients revisiting Vietnam National Heart Institute diagnosed with acute myocardial infarction were approached for data collection from October 2014 to June 2015. Adherence to antiplatelet therapy was assessed by asking patients whether they took taking antiplatelet regularly as per medication (do not miss any dose at the specified time) for any type of antiplatelet (aspirin, clopidogrel, ticlopidine...) during the last month before the participants came back to take re-examinations. The results indicated that the adherence to antiplatelet therapy among patients was quite high at 1 month; it begins to decline by 6 months, 12 months, and more than 12 months (less than 1 month was 90.29%; from 1 to 6 months 88.0%, from 6 to 12 months 75.43%, and after 12 months only 46.29% of patients). Multivariable logistic regression was utilized to detect factors associated with the adherence to antiplatelet therapy. It showed that patients with average income per month of $300 or more (OR=2.92, 95% CI=1.24-6.89), distance to the hospital of less than 50km (OR=2.48, 95% CI: 1.12-5.52), taking medicine under doctor's instructions (OR=3.65; 95% CI=1.13-11.70), and timely re-examination (OR=3.99, 95% CI=1.08-14.73) were more likely to follow the therapy. In general, the study suggested that to increase the likelihood of adherence to antiplatelet therapy it is important to establish a continuous care system after discharging from hospital.