Temporal improvement in survival of patients with hepatocellular carcinoma in a hepatitis B virus-endemic population.

BACKGROUND AND AIM: Over the past decade, the management of hepatocellular carcinoma (HCC) and viral hepatitis has been improved. We explored survival trends and factors affecting survival of HCC in a hepatitis B virus (HBV)-endemic population. METHODS: From 31 521 and 38 167 HCC registrants to the population-based national cancer registry in Korea, an HBV-endemic country, in the period of 2003-2005 and 2008-2010, we randomly sampled cohorts of 4515 and 4582 patients, respectively, for the investigation of clinical characteristics and survival. RESULTS: Compared with Cohort 2003-2005, Cohort 2008-2010 had significantly better liver function (Child-Turcotte-Pugh class A, 64.2% vs 71.6%; P < 0.001) and had more advanced tumor stages (Barcelona Clinic Liver Cancer stage B-D, 45.8% vs 50.4%; P < 0.001). HBV was the predominant cause of HCC in both cohorts (62.5% vs 62.2%; P = 0.70). Cohort 2008-2010 had significantly better overall survival than Cohort 2003-2005 by age-adjusted univariate, multivariable, and propensity score-matched analyses (median survival time, 17.2 vs 28.4 months; P < 0.001). In a subcohort analysis, a consistently significant inter-cohort improvement in survival was observed only in patients with HBV-related HCC (median survival, 16.1 vs 30.4 months; P < 0.001). The annual number of patients with HCC receiving oral antiviral agents for HBV precipitously increased from 93 in 2005 to 28 520 in 2010 in the country. CONCLUSIONS: The consistent improvement in survival of patients with HCC was confined to HBV-related HCC subcohort over the last decade in an HBV-endemic population. The survival improvement coincided with the exponential use of oral antiviral agents for HBV in the patients.

Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea Central Cancer Registry Database.

BACKGROUND AND AIM: The diagnostic and therapeutic modalities of esophageal cancer have recently improved in Asia, and its prognosis is expected to change. This study provides a population-based report on the epidemiology of esophageal cancer in Korea. METHODS: Cancer incidence data from 1999 to 2013 were obtained from the Korea Central Cancer Registry, covering the entire population. Age-standardized incidence rates and annual percent changes were calculated according to subsites and histological types. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2013. Relative excess rates were compared between patients diagnosed from 2009 to 2013 and 2006 to 2008. RESULTS: The age-standardized incidence rates decreased from 8.8 per 100 000 populations in 1999 to 5.9 in 2013 with an annual percent change of -2.6% in men and -2.2% in women. The most common histological type was squamous cell carcinoma, accounting for 90.2% of all esophageal cancers in 2013, followed by adenocarcinomas (3.1%), and their incidences decreased. The proportion of localized and regional cancer tended to increase compared with that of distant cancer. Five-year relative survival of squamous cell carcinoma improved from 12.1% (1993-1995) to 34.6% (2009-2013). Relative excess rate was 0.72 (95% confidence interval 0.65-0.80) in localized stage and 0.88 (95% confidence interval, 0.82-0.95) in regional stage comparing patients diagnosed from 2009 to 2013 and 2006 to 2008. CONCLUSIONS: The incidence of esophageal cancer has decreased in Korea for the past 15 years, and 5-year survival rates have improved significantly. These increases may be attributable to more effective detection of early-stage disease.

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.

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.

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.

Data Resource Profile: The Cancer Public Library Database in South Korea.

This paper provides a comprehensive overview of the Cancer Public Library Database (CPLD), established under the Korean Clinical Data Utilization for Research Excellence project (K-CURE). The CPLD links data from four major population-based public sources: the Korea National Cancer Incidence Database in the Korea Central Cancer Registry, cause-of-death data in Statistics Korea, the National Health Information Database in the National Health Insurance Service, and the National Health Insurance Research Database in the Health Insurance Review & Assessment Service. These databases are linked using an encrypted resident registration number. The CPLD, established in 2022 and updated annually, comprises 1,983,499 men and women newly diagnosed with cancer between 2012 and 2019. It contains data on cancer registration and death, demographics, medical claims, general health checkups, and national cancer screening. The most common cancers among men in the CPLD were stomach (16.1%), lung (14.0%), colorectal (13.3%), prostate (9.6%), and liver (9.3%) cancers. The most common cancers among women were thyroid (20.4%), breast (16.6%), colorectal (9.0%), stomach (7.8%), and lung (6.2%) cancers. Among them, 571,285 died between 2012 and 2020 owing to cancer (89.2%) or other causes (10.8%). Upon approval, the CPLD is accessible to researchers through the K-CURE portal. The CPLD is a unique resource for diverse cancer research to investigate medical use before a cancer diagnosis, during initial diagnosis and treatment, and long-term follow-up. This offers expanded insight into healthcare delivery across the cancer continuum, from screening to end-of-life care.

The Cancer Clinical Library Database (CCLD) from the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) Project.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea's cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

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.

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.

Population-based survival data for brain tumors in Korea.

Primary brain tumors are relatively uncommon but particularly lethal cancers. Although survival is useful for monitoring the effects of early cancer detection and treatment, there are few population-based estimates of survival for subjects with brain tumors, especially in Asian countries. Using the Korea National Cancer Incidence Database, 4,721 newly diagnosed cases of histologically confirmed malignant primary brain tumors from 1999 to 2004 were analyzed for observed survival. For trend analyses of glioblastomas, we included 2,751 glioblastoma cases diagnosed between 1999 and 2007. We compared survival by age group and histological type by use of the Kaplan-Meier method. For all ages and all brain tumor types in Korea, five-year survival was 37.5 %. For each histological type of brain tumor survival of pediatric and younger adult populations was much better than that of older adults. Five-year survival for glioblastoma, astrocytoma, anaplastic astrocytoma, and oligodendroglioma was 8.9, 51.6, 25.2, and 73.5 %, respectively. Two-year survival for glioblastoma increased from 18.6 % for cases diagnosed in 1999-2001 to 21.3 % for cases diagnosed in 2002-2004 and to 24.7 % for cases diagnosed in 2005-2007. These results may help clinicians and patients to assess long-term prognoses for brain tumors, and the data presented here could serve as master control data set for single-arm clinical trials, especially in Asian populations.

Prediction of Cancer Incidence and Mortality in Korea, 2022.

PURPOSE: This study aimed to report the projected cancer incidence and mortality for the year 2022 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2019 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2020 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 2022. 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, 274,488 new cancer cases and 81,277 cancer deaths are expected to occur in Korea in 2022. The most common cancer site is expected to be the thyroid, followed by the lung, 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 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 2019.

PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2019. MATERIALS AND METHODS: Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2019, with survival follow-up until December 31, 2020. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. RESULTS: In 2019, newly diagnosed cancer cases and deaths from cancer were reported as 254,718 (ASR, 275.4 per 100,000) and 81,203 (ASR, 72.2 per 100,000), respectively. For the first time, lung cancer (n=29,960) became the most frequent cancer in Korea, excluding thyroid cancer. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. The incidence of thyroid cancer increased again from 2016 (annual percentage change, 6.2%). Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2002 to 2013; 3.3% from 2013 to 2019). The 5-year relative survival between 2015 and 2019 was 70.7%, which contributed to prevalent cases reaching over 2 million in 2019. CONCLUSION: Cancer survival rates have improved over the past decades, but the number of newly diagnosed cancers is still increasing, with some cancers showing only marginal improvement in survival outcomes. As the number of cancer survivors increases, a comprehensive cancer control strategy should be implemented in line with the changing aspects of cancer statistics.

Prediction of Cancer Incidence and Mortality in Korea, 2021.

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.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2018.

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.

Hepatocellular Carcinoma in Korea: an Analysis of the 2015 Korean Nationwide Cancer Registry.

Background/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2015. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative sample of patients newly diagnosed with HCC in Korea, were analyzed. A total of 1,558 patients with HCC registered in the KPLCR in 2015 were investigated. Results: The median age was 61.0 years (interquartile range, 54.0-70.0 years), and men accounted for 79.7% of the subjects. Hepatitis B virus infection was the most common underlying liver disease (58.1%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stage 0, A, B, C, and D HCCs accounted for 14.2%, 31.5%, 7.6%, 39.0%, and 7.8% of patients, respectively. Transarterial therapy (32.1%) was the most commonly performed initial treatment, followed by surgical resection (23.2%), best supportive care (20.2%), and local ablation therapy (10.7%). Overall, 34.5% of patients were treated in accordance with the BCLC guidelines: 59.2% in stage 0/A, 48.4% in stage B, 18.1% in stage C, and 71.6% in stage D. The 1-, 3-, and 5-year OS rates were 67.1%, 50.9%, and 27.0%, respectively. Conclusions: In 2015, approximately 45% of Korean HCC cases were diagnosed at a very early or early stage, and 35% of patients underwent potentially curative initial treatment. BCLC guidance was followed in 34.5% of patients; in patients with stage B or C disease, there was relatively low adherence.

Cancer statistics in Korea: incidence, mortality and survival in 2006-2007.

Cancer has been the leading cause of death in Korea. Korea is facing a very rapid change and increase in cancer incidence, which draws much attention in public health. This paper overviews the nationwide cancer statistics, including incidence, mortality, and survival rates, and their trends in Korea based on the cancer incidence data from The Korea Central Cancer Registry (KCCR) in year 2006 and 2007. In Korea, there were 153,237 cancer cases and 65,519, cancer deaths observed in 2006, and 161,920 cancer cases and 67,561 cancer deaths in 2007, respectively. The incidence rate for all cancer combined showed an annual increase of 2.8% from 1999 to 2007. Specifically, there was significant increase in the incidence of colorectal, thyroid, female breast, and prostate cancers. The number of cancer deaths has increased over the past two decades, due mostly to population aging, while the age-standardized mortality rates have decreased in both men and women since 2002. Notable improvement has been observed in the 5-yr relative survival rates for most major cancers and for all cancer combined, with the exception of pancreatic cancer. The nationwide cancer statistics in this paper will provide essential data for cancer research and evidence-based health policy in Korea.

Descriptive epidemiology of cholangiocarcinoma and clonorchiasis in Korea.

In 2009, infection with the liver fluke Clonorchis sinensis (C. sinensis) was classified as "carcinogenic to humans" (Group 1) based on its involvement in the etiology of cholangiocarcinoma by the International Agency for Research on Cancer. However, little is known about the descriptive epidemiology of cholangiocarcinoma in Korea. We examined incidence trends of intrahepatic and extrahepatic cholangiocarcinomas, using data from the Korea National Cancer Incidence database for 1999-2005. The prevalence of C. sinensis infection was estimated from a recent population-based survey in rural endemic areas. Cholangiocarcinoma incidence rates are currently rising, even while primary liver cancer incidence rates are decreasing. Annual percent changes in cholangiocarcinoma incidence rates were 8% for males and 11% in females. Known areas of C. sinensis endemicity showed high incidence rates of cholangiocarcinoma. The positivity of C. sinensis eggs in stool samples from endemic areas was more than 25% of adults tested during 2005-2008. From a meta-analysis, the summary odds ratio for cholangiocarcinoma due to C. sinensis infection was 4.7 (95% confidence interval: 2.2-9.8). Approximately 10% of cholangiocarcinomas in Korea were caused by chronic C. sinensis infections. More specific policies, including health education and an extensive effort for early detection in endemic areas, are needed.

Prediction of Cancer Incidence and Mortality in Korea, 2020.

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.

Antioxidant and Anti-Inflammatory Activities of Agrimonia pilosa Ledeb. Extract.

The purpose of this study is to investigate the effect of Agrimonia pilosa Ledeb. extract (APLE) on lipopolysaccharide- (LPS-) induced cell damage in hepatocytes with a focus on antioxidant and anti-inflammatory activities. Total antioxidant and anti-inflammatory activities of APLE itself were analyzed and phytochemical analysis was performed. Moreover, inhibitory effects of APLE on LPS-induced oxidative stress and inflammation were assessed in human HepG2 hepatocytes. APLE was found to exert α,α-diphenyl-ß-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), and nitrite scavenging activities and reducing power in a dose-dependent manner. The total phenolic and flavonoid contents of APLE were 44.30 ± 1.61 mg GAE/g and 29.65 ± 1.81 mg QE/g, respectively. HPLC analysis revealed that gallic acid is the major phenolic compound in APLE, followed by rutin, genistein, taxifolin, quercetin, luteolin, and apigenin, in descending order. Treatment of 100 and 200 µg/mL APLE significantly reduced LPS-stimulated intracellular reactive oxygen species production to the basal level without any cytotoxicity. Oppositely, APLE reversed LPS-suppressed expression of glutathione peroxidase gene and protein. Consistent with this result, APLE suppressed LPS-triggered expression of proinflammatory cytokine genes in a dose-dependent manner. These results reinforce the fact that the antioxidant and anti-inflammatory activity of APLE helps protect hepatocytes from LPS. Thus, APLE may be utilized as a bioactive ingredient in functional foods.