Drinking patterns among Korean adults: results of the 2009 Korean community health survey

Comparative Study of Diabetes Knowledge, Attitudes, Family Support, Self-efficacy, and Self-management Behaviors Between Cancer Survivors With Diabetes and Diabetes Patients Without Cancer

BACKGROUND

Studies have compared diabetes management quality indicators, focusing on physiological markers such as hemoglobin A1c, between cancer survivors with diabetes and general diabetes patients. However, research comparing differences in diabetes self-management behaviors and the factors influencing them between these groups is lacking.

OBJECTIVES

This study aimed to compare self-management behaviors, guided by the information-motivation-behavior model, between cancer survivors with diabetes and general diabetes patients. In addition, we aimed to identify differences in factors such as diabetes knowledge, attitudes, family support, and self-efficacy that may influence diabetes self-management behaviors in both groups.

METHODS

A total of 125 cancer survivors with diabetes and 126 general diabetes patients participated in this cross-sectional study. A structured questionnaire assessed demographics, diabetes knowledge, attitudes, self-efficacy, and self-management behaviors.

RESULTS

Regarding diabetes education, 47.0% of cancer survivors and 61.6% of general diabetes patients received education. The cancer survivors had lower diabetes knowledge scores (10.30 ± 4.15, P < .001), a lower perceived value of strict blood glucose control (4.10 ± 0.56, P < .001), and less family support (15.50 ± 7.50, P = .019) than the patients without cancer (13.51 ± 3.84, 4.25 ± 0.65, and 17.57 ± 6.40, respectively).

CONCLUSION

This study reveals significant differences in diabetes self-management between cancer survivors and general diabetes patients. Cancer survivors showed lower diabetes knowledge, glucose control perception, and family support. These findings highlight the need for tailored self-management programs for cancer survivors.

IMPLICATIONS FOR PRACTICE

This study offers insights for developing tailored diabetes self-management programs and educational interventions for cancer survivors.

Health Behaviors of Cancer Survivors According to the Employment Status and Occupation: A Cross-Sectional Study

This study aimed to identify differences in health behaviors according to the employment status and occupation of cancer survivors, as well as to identify risk factors. Using data from the Korea National and Health Nutrition Examination Survey (2008-2018), 1023 cancer survivors aged 19-60 years were classified based on their employment status and occupation, and their health behaviors were comparatively assessed. To investigate the impact of occupational status on the health behaviors of cancer survivors, we performed multivariate adjusted logistic regression analysis. Five hundred fifty-six (54.3%) cancer survivors were engaged in economic activities. After adjusting for various factors, white- and blue-collar workers exhibited an increased risk of obesity. The blue-collar group had a 1.45 times higher risk of non-practice with cancer screening, while the white-collar group had a 0.50 times lower risk of non-practice with health screening. The results provide evidence of the need to support cancer survivors in practicing healthy behaviors according to their employment status and occupation. As cancer survivors' economic activities increase, it is necessary to help them manage their health by predicting any possible health-behavior failures.

Alcohol use recording in adults with depression in English primary care: a cross-sectional study

OBJECTIVES

To investigate alcohol use recording in people with newly diagnosed depression in English primary care and individual characteristics associated with the recording of alcohol use.

DESIGN

A population-based cross-sectional study.

SETTING

Primary care data from English practices contributing to the UK Clinical Practice Research Datalink.

PARTICIPANTS

We included adults (18+ years) diagnosed with depression between 1 January 2011 and 1 January 2017 without previous antidepressant use and at least 1 year of registration before diagnosis.

PRIMARY AND SECONDARY OUTCOME MEASURES

We described the proportion of individuals with alcohol use and level of alcohol use recorded at four time points (the date of depression diagnosis, 3 months before or after depression diagnosis, 12 months before or after depression diagnosis and any point pre or postdepression diagnosis). We used logistic regression to investigate individual characteristics associated with alcohol use recording in the 3 months before or after depression diagnosis.

RESULTS

We identified 36 424 adults with depression. 538 (2%) had alcohol use recorded in the 3 months before or after depression diagnosis using formal validated methods such as the Alcohol Use Disorders Identification Test and its abbreviated versions. At each time point, most individuals with alcohol use recorded were low risk drinkers. Alcohol use recording in the 3 months before or after depression diagnosis was associated with male sex (OR=1.38, 95% CI 1.29 to 1.48) and several other individual-level factors.

CONCLUSIONS

Our study shows low levels of alcohol use recording in the 3 months before or after depression diagnosis. Levels of alcohol use recording varied depending on individual characteristics. Incentivised recording of alcohol use will increase completeness, which could improve clinical management and reduce missed opportunities for care in people with depression.

Risk Factors of Binge Drinking in Adults Across Gender and Age Groups: Sixth Korea National Health and Nutrition Examination Survey 2014

Alcohol consumption has significantly increased in South Korea, with binge drinking looming as a serious issue. This study aimed to identify differences in drinking characteristics and the risk factors of binge drinking across three age groups: young adults, middle-aged adults, and seniors. This study was a descriptive, secondary analysis study based on the data from the Korean National Health and Nutrition Examination Survey 2014. In this study, we analyzed data from 5,604 respondents aged 20 years and older using Rao-Scott chi-square and analysis of variance. To analyze the risk factors of binge drinking by gender and age groups, multiple logistic regression analysis was applied. Results indicated that the three age groups were significantly different in terms of sociodemographic characteristics, health-related behaviors, and drinking characteristics. Rates of binge drinking were much higher in young adults in both men and women. The factors influencing binge drinking varied by age group and gender; however, in both men and women, participants who drank alcohol once a month or more showed a significantly higher risk of binge drinking than those who did not across all age groups. Younger initial drinking age and daily smoking were key risk factors of binge drinking among young and middle-aged adults in both men and women. Given the findings from this study, interventions considering the differences in drinking characteristics and risk factors of binge drinking across the age groups as well as focusing on the risk of binge drinking among young adults must be developed in communities and clinical settings.

An Association Rule Mining Analysis of Lifestyle Behavioral Risk Factors in Cancer Survivors with High Cardiovascular Disease Risk

We aimed to assess which lifestyle risk behaviors have the greatest influence on the risk of cardiovascular disease in cancer survivors and which of these behaviors are most prominently clustered in cancer survivors, using logistic regression and association rule mining (ARM). We analyzed a consecutive series of 897 cancer survivors from the Korean National Health and Nutritional Exam Survey (2012-2016). Cardiovascular disease risks were assessed using the atherosclerotic cardiovascular disease score (ASCVDs). We classified participants as being in a low-risk group if their calculated ASCVDs was less than 10% and as being in a high-risk group if their score was 10% or higher. We used association rule mining to analyze patterns of lifestyle risk behaviors by ASCVDs risk group, based upon public health recommendations described in the Alameda 7 health behaviors (current smoking, heavy drinking, physical inactivity, obesity, breakfast skipping, frequent snacking, and suboptimal sleep duration). Forty-two percent of cancer survivors had a high ASCVD. Current smoking (common odds ratio, 11.19; 95% confidence interval, 3.66-34.20, p < 0.001) and obesity (common odds ratio, 2.67; 95% confidence interval, 1.40-5.08, p < 0.001) were significant predictors of high ASCVD in cancer survivors within a multivariate model. In ARM analysis, current smoking and obesity were identified as important lifestyle risk behaviors in cancer survivors. In addition, various lifestyle risk behaviors co-occurred with smoking in male cancer survivors.

Association between Alcohol Drinking Status and Depressive Symptoms in Korean Adults

We investigated the association between alcohol drinking status and depressive symptoms in a representative sample of South Korean adults using data from the 2017 Korea Community Health Survey (KCHS), which included 216,771 participants (99,845 men and 116,926 women). Depression was defined as a Patient Health Questionnaire-9 score of ≥10. Multivariate logistic regression using sampling weights was used to assess the relationship between alcohol drinking status and depression after adjusting for potential confounders. Alcohol intake was nonlinearly associated with depression; the risk of depression was the lowest in men who were moderate drinkers and women who were light drinkers. In men, heavy drinkers (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.19–1.67), light drinkers (OR 1.13, 95% CI 0.94–1.36), infrequent drinkers (OR 1.31, 95% CI 1.00–1.73), and lifetime abstainers (OR 1.38, 95% CI 1.09–1.75) were at a higher risk of depression than moderate drinkers. In women, moderate drinkers (OR 1.19, 95% CI 1.02–1.40) and heavy drinkers (OR 1.56, 95% CI 1.33–1.84) were at a higher risk of depression than light drinkers; however, infrequent drinkers and lifetime abstainers were not at a high risk of depression. In both men and women, former drinkers were at a higher risk of depression (OR 1.61, 95% CI 1.34–1.93 and OR 1.25, 95% CI 1.09–1.43, respectively). In conclusion, the association between alcohol drinking status and depression was nonlinear in both sexes. Further investigation of age- and sex-specific factors related to the association between alcohol use and depression is needed.

Predictive inflammatory biomarkers for change in suicidal ideation in major depressive disorder and panic disorder: A 12-week follow-up study

Previous studies have investigated the role of inflammatory markers in suicidality of patients with major depressive disorder (MDD) or panic disorder (PD). However, few studies have investigated associations between serum inflammatory cytokine levels and suicidality. We hypothesized that MDD and PD status might be significantly associated with serum inflammatory cytokines and that we could predict levels of improvement in suicide ideation intensity using serum inflammatory biomarkers in patients with MDD and PD. For this study, 41 patients with MDD, 52 patients with PD, and 59 healthy control (HC) subjects were enrolled. Psychological measurements and serum inflammatory markers such as interleukin (IL) -6, -10, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and C reactive protein (CRP) were examined. A total of five visits were completed during 12 weeks. After controlling for confounding factors, log-transformed IL-6 (ln_IL-6) at baseline (MDD: 0.297 ± 0.626; PD: 0.342 ± 0.723; HC: -0.121 ± 0.858; p = 0.007, >0.0017, 0.05/30) and mean ln_IL-6 (MDD: 0.395 ± 0.550, PD: 0.249 ± 0.544, HC: -0.139 ± 0.622, p = 0.002, >0.0017, 0.05/30) levels were trends towards significantly higher in patients with MDD and PD than in HC. In MDD patients, a higher level of basal ln_TNF-α was a significant predictor of ΔSSI (changes in SSI scores between baseline and week 12) even after controlling for changes of depression symptoms and baseline SSI scores (standardized β = 0.541, p = 0.002 < 0.0028, 0.05/18). In conclusion, we could predict ΔSSI using baseline inflammatory biomarkers for patients with MDD.

The Association between Alcohol Drinking Patterns and Health-Related Quality of Life in the Korean Adult Population: Effects of Misclassification Error on Estimation of Association

The purpose of this study was to investigate the association between drinking patterns and health-related quality of life (HRQoL) in the Korean general population and to validate the estimation of the association of alcohol use on HRQoL when former drinkers are separated from never drinkers and low-risk drinkers depending on gender. Data were collected from 23,055 adults (over 19 years old) who completed the Korean National Health and Nutritional Examination Survey (2010-2013). Multivariate logistic and linear regression analyses were performed to investigate the association between drinking patterns and HRQoL. When former drinkers were separated from never drinkers and low-risk drinkers to control for misclassification bias, there were gender differences in the associations between alcohol use and HRQoL. Although the estimation of the association of alcohol use was not valid in men, the estimation of association was valid in women, as low-risk women drinkers showed better HRQoL than nondrinkers. Therefore, when conducting research related to alcohol and health, analyses should correct for the various confounding variables and minimize the misclassification bias of drinking patterns. It is also necessary to consider gender characteristics when intervening to improve HRQoL related to drinking.

Gender Difference in Longitudinal Social and Personal Factors Related to Frequency of Alcohol Consumption of South Korean Adults: A Fixed-Effects Model

The purpose of this study was to examine the longitudinal social and personal factors related to frequency of alcohol consumption by South Korean adults focused on comparisons between men and women. Data came from the 2005-2016 Korea Welfare Panel Study. A fixed-effects model was used to examine the longitudinal correlations between dependent and independent variables. According to the present results, first, life satisfaction except for health satisfaction and marital status were not associated with alcohol consumption patterns by men. On the other hand, higher frequency of alcohol consumption by women was negatively associated with various life satisfaction variables and being married. Second, income levels were positively associated with higher frequency of alcohol consumption by men, whereas income levels were not associated with alcohol consumption by women. Finally, being employed was positively associated with higher frequency of alcohol consumption by both men and women. In conclusion, there were gender differences in how alcohol consumption was influenced by various sociocultural and life satisfaction factors in South Korea.

Heterogenous Effect of Risk Factors on Breast Cancer across the Breast Density Categories in a Korean Screening Population

We evaluated the heterogeneity of the effect of known risk factors on breast cancer development based on breast density by using the Breast Imaging-Reporting and Data System (BI-RADS). In total, 4,898,880 women, aged 40-74 years, who participated in the national breast cancer screening program in 2009-2010 were followed up to December 2018. Increased age showed a heterogeneous association with breast cancer (1-year hazard ratio (HR) = 0.92, 1.00 (reference), 1.03, and 1.03 in women with BI-RADS density category 1, 2, 3, and 4, respectively; P-heterogeneity < 0.001). More advanced age at menopause increased breast cancer risk in all BI-RADS categories. This was more prominent in women with BI-RADS density category 1 but less prominent in women in other BI-RADS categories (P-heterogeneity = 0.009). In postmenopausal women, a family history of breast cancer, body mass index ≥ 25 kg/m², and smoking showed a heterogeneous association with breast cancer across all BI-RADS categories. Other risk factors including age at menarche, menopause, hormone replacement therapy after menopause, oral contraceptive use, and alcohol consumption did not show a heterogeneous association with breast cancer across the BI-RADS categories. Several known risk factors of breast cancer had a heterogeneous effect on breast cancer development across breast density categories, especially in postmenopausal women.

Gastric and rectal cancers in workers exposed to asbestos: a case series

BACKGROUND

The Occupational Safety and Health Research Institute (OSHRI) of the Korea had not recognized gastrointestinal cancer as work-related disease during their evaluation. However, in 2018 OSHRI recognized gastric and rectal cancers as work-related disease in asbestos-exposed workers. We present 2 such cases along supportive evidence of causation.

CASE PRESENTATION

Patient A: A 57-year-old man had worked for about 40 years since 1978 as an oxygen cutter at workplaces that dismantle ships, buildings, boilers, and thermal power plants. In November 2016, endoscopy and biopsy confirmed the diagnosis of advanced gastric cancer, for which he underwent subtotal gastrectomy and chemotherapy; however, he later died of the cancer. Patient B: A 71-year-old man had worked in shipbuilding and repair workplaces for approximately 49 years, being employed in pipe laying, asbestos insulation installation, grinding, and other ship repair work. In 2003, he was diagnosed of rectal cancer by abdominal computed tomography. He accordingly underwent surgical removal of the cancer. Based on the occupational history of the 2 patients and our review of the relevant literature addressing the occupational environment, we concluded that both patients had continuous exposure to high levels of asbestos while performing their jobs for 40 and 49 years, respectively.

CONCLUSION

Both patients had a history of smoking and drinking (non-occupational personal risk factors). However, the possibility of an increased risk of gastric and rectal cancers from asbestos exposure cannot be excluded. Therefore, we considered that occupational exposure to asbestos had contributed to the cancer diagnosis in these cases. Workers exposed to asbestos should be made aware of the possibility of gastric or rectal cancer, and should undergo monitoring and medical examinations. Appropriate compensation for gastric and rectal cancers that occur in workers exposed to asbestos are anticipated in future.

Incidence of Diabetes Mellitus in Male Moderate Alcohol Drinkers: A Community-Based Prospective Cohort Study

BACKGROUND/AIM

Although alcohol consumption is known to affect the incidence of diabetes mellitus (DM), reports on the effects of moderate alcohol consumption on DM incidence have been inconsistent. This community-based prospective cohort study was performed to investigate the incidence of DM in male Korean moderate alcohol drinkers.

METHODS

The Ansan and Ansung cohort was used for the analysis. The study population included a total of 3,492 men with no history of DM. The subjects were classified as mild (1-14 g/d), moderate (15-29 g/d), and heavy (≥30 g/d) drinkers based on their amount of alcohol consumption. The incidence rates of DM in the three groups were compared and analyzed over a 10 year follow-up period.

RESULTS

The hazard ratios (HRs) for DM incidence were 25.12 (95% confidence interval [CI], 21.73-28.90) per 1,000 person years (PY) in mild drinkers, 31.13 (26.11-36.83) per 1,000 PY in moderate drinkers, and 31.68 (26.81-37.18) per 1,000 PY in heavy drinkers (p for trend, p = 0.043). Multivariate regression analysis showed that the HRs (95% CI) for DM were 1.25 (0.97-1.61, p = 0.086) in moderate drinkers and 1.30 (1.01-1.68, p = 0.045) in heavy drinkers compared to mild drinkers. The changes in pancreatic insulin secretion were more remarkable than those in insulin resistance in all three groups.

CONCLUSIONS

The incidence of DM in male Korean moderate drinkers did not increase significantly over the observation period. However, the incidence of DM tended to increase with increasing alcohol consumption. Pancreatic insulin secretion may play a more important role than insulin resistance in the relationship between alcohol and incidence of DM.

The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior: Study rationale, methodology, and baseline sample characteristics of a long-term, large-scale, multi-center, prospective, naturalistic, observational cohort study

BACKGROUND

The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study is a prospective, naturalistic, observational cohort study, aiming to identify predictors of suicide attempt and suicide characteristics in the Korean suicidal population. The findings intend to contribute to a thorough understanding of suicidal phenomena and development of suicide prevention guidelines. The present cross-section study examines the study rationale, methodology, and baseline characteristics of the participants.

METHODS

Participants were enrolled via the hospital and community gateways, establishing the hospital-based cohort (HC) and community-based cohort (CC), respectively. Baseline assessment was conducted on sociodemographic, clinical, diagnostic, and psychopathological aspects. The Columbia-Suicide Severity Rating Scale was used to investigate suicidality.

RESULTS

A total of 800 suicidal people aged 15 years or older were enrolled from 8 university hospitals and 8 community mental health welfare centers (CMHWCs), among whom 480 (60%) were suicidal ideators and 320 (40%) were attempters. The ideators comprised 207 CC and 273 HC participants, whereas the attempters, 34 CC and 286 HC participants. Despite their lower severity in some measures, including suicidal ideation, compared with their HC counterparts, the CC participants within each group of ideators or attempters presented clinically significant psychopathology. Moreover, alcohol use problems and past suicide attempt were more likely to be found in CC participants. Only 11.1% to 21.6% of the participants in each of the four groups (defined by the cohorts and the ideators/attempters) were on any type of psychiatric treatment.

CONCLUSIONS

Suicidal visitors to CMHWCs need to be as closely monitored as suicidal patients in university hospitals, especially considering their association with problem drinking and past suicide attempt. A cautious assumption is that the high suicide rate in Korea might be partly attributable to the low proportion of patients receiving psychiatric services.

Developing the High-Risk Drinking Scorecard Model in Korea

Objectives

This study aimed to develop a high-risk drinking scorecard using cross-sectional data from the 2014 Korea Community Health Survey.

Methods

Data were collected from records for 149,592 subjects who had participated in the Korea Community Health Survey conducted from 2014. The scorecard model was developed using data mining, a scorecard and points to double the odds approach for weighted multiple logistic regression.

Results

This study found that there were many major influencing factors for high-risk drinkers which included gender, age, educational level, occupation, whether they received health check-ups, depressive symptoms, over-moderate physical activity, mental stress, smoking status, obese status, and regular breakfast. Men in their thirties to fifties had a high risk of being a drinker and the risks in office workers and sales workers were high. Those individuals who were current smokers had a higher risk of drinking. In the scorecard results, the highest score range was observed for gender, age, educational level, and smoking status, suggesting that these were the most important risk factors.

Conclusion

A credit risk scorecard system can be applied to quantify the scoring method, not only to help the medical service provider to understand the meaning, but also to help the general public to understand the danger of high-risk drinking more easily.

Serum ferritin level is associated with liver steatosis and fibrosis in Korean general population

BACKGROUND

Elevation of serum ferritin levels is frequently observed in non-alcoholic fatty liver disease (NAFLD) patients. Our study aims to examine the association between serum ferritin levels and NAFLD in Korean population.

METHODS AND RESULTS

A total of 25,597 participants were selected from Korean National Health and Nutritional Examination Surveys 2007-2012. The NAFLD liver fat score (NLFS) was used to define NAFLD. Elevation of ALT levels was defined as ALT level > 40 IU/L for male and ALT level > 31 IU/L for female. Multiple logistic regression was used to examine the association of serum ferritin levels and NAFLD by sex. After adjusting for multiple covariates, the ORs (95% CI) of the elevated ALT levels were 1.56 (95% CI: 1.17-2.07), 1.84 (95% CI: 1.39-2.45), and 4.08 (95% CI: 3.08-5.40) for the second, third and fourth serum ferritin quartiles in male (p for trend < 0.01), 1.67 (95% CI: 1.24-2.23), 2.23 (95% CI: 1.68-2.96), and 5.72 (95% CI: 4.32-7.60) for the second, third and fourth serum ferritin quartiles in female (p for trend < 0.01). Serum ferritin levels were also significantly associated with NAFLD and liver fibrosis both in male and female.

CONCLUSIONS

Elevation of serum ferritin level is significantly associated with NAFLD and blood ALT elevation in Korean general population.

Trends and Correlates of High-Risk Alcohol Consumption and Types of Alcoholic Beverages in Middle-Aged Korean Adults: Results From the HEXA-G Study

Background

We aimed to report the prevalence and correlates of high-risk alcohol consumption and types of alcoholic beverages.

Methods

The baseline data of the Health Examinees-Gem (HEXA-G) study participants, including 43,927 men and 85,897 women enrolled from 2005 through 2013, were used for analysis. Joinpoint regression was performed to estimate trends in the age-standardized prevalence of alcohol consumption. Associations of demographic and behavioral factors, perceived health-related effects, social relationships, and the diagnostic history of diseases with alcohol consumption were assessed using multinomial logistic regression.

Results

The prevalence of alcohol consumption remained higher in men during the study period and increased in women. The amount of alcohol consumed has increased in women, especially that from beer and makgeolli, a traditional Korean fermented rice wine. Older participants were less likely to be high-risk drinkers (men and women who drink more than 40 or 20 g/day of alcohol, respectively) and drink Soju, a distilled liquor, and beer, and more likely to drink makgeolli. Educational level was negatively associated with high-risk drinking. However, it was positively associated with the consumption of strong spirits and wine. Smoking was associated with high-risk drinking and the consumption of soju and strong spirits. Engaging in regular exercise and having stress were associated with drinking all types of beverages except for soju.

Conclusions

Sex-specific trends in alcohol consumption were influenced by demographic, behavioral, and perceived health-related factors. The findings will help improve the understanding of alcohol-related problems and provide evidence for establishing country-specific policies and campaigns in Korea.

Alcohol-induced disinhibition is associated with impulsivity, depression, and suicide attempt: A nationwide community sample of Korean adults

BACKGROUND

Alcohol-induced disinhibition (AID) is defined as a "loss of restraint over some form of behavior after drinking alcohol regardless of its amount". Although many previous studies have investigated on alcohol use disorder and suicide attempt, few studies have focused on AID and suicide.

METHODS

A total of 9461 adults who had a history of drinking completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) with the Suicide Module, and Barratt Impulsiveness Scale 11 (BIS-11). In this study, we defined the AID group as those who had been involved with the two antisocial behaviors, including fights, being arrested or dangerous driving, according to the K-CIDI.

RESULTS

Among 9461 subjects, 564 were classified as the AID group (5.96%). The AID group had a significantly higher number of lifetime suicidal ideation, plan, attempt, and multiple attempts, and higher BIS-11 scores than non-AID group. The total scores of BIS-11 of the AID group reported the highest score compared with other psychiatric disorders. The AID group experienced more frequently three types of alcohol withdrawal symptoms, including nervousness, heart beating fast, and feeling weak. Compared with subjects without both AID and MDD, subjects with both AID and MDD showed significant association with a lifetime suicide attempt (AOR = 6.86, p < 0.001) and showed stronger association with multiple attempts (AOR = 10.38, p < 0.001).

CONCLUSION

AID was associated with suicide attempt and impulsivity, and the both AID and MDD showed much stronger association with lifetime suicide attempt and multiple attempts.

Recent Trend and Associated Factors of Harmful Alcohol Use Based on Age and Gender in Korea

BACKGROUND

Previous studies suggest that the impact of social factors on harmful alcohol use between men and women may be different. We aimed to explore the gender-based difference in temporal trend and social risk factors associated with harmful alcohol use.

METHODS

The Korea National Health and Nutrition Examination Survey (2007-2014) was used to explore the recent trend of harmful alcohol use in the general population. Among all current alcohol drinkers aged 20-64 years, the frequencies of harmful alcohol use in each age group, year of birth, marriage, income, education, and occupation were analyzed based on gender.

RESULTS

A total of 34,478 people (14,544 men and 19,834 women) who reported drinking alcohol in the last month at the time of interview were included in the analysis. The proportion of harmful alcohol use in men decreased (P for trend = 0.002) during the study period, whereas significant change was not observed in women (P for trend = 0.173). The prevalence of harmful alcohol use was highest in men aged 35-49 years and women aged 20-34 years. For both men and women, lower level of education and service occupation were the common risk factors of harmful alcohol use. Additionally, low income was a risk factor of harmful alcohol use in women but not in men. Marriage increased the risk of harmful alcohol use in women but decreased in men.

CONCLUSION

Public health interventions in reducing harmful alcohol use should consider the different high-risk groups between men and women.

Stomach Cancer Disparity among Korean Americans by Tumor Characteristics: Comparison with Non-Hispanic Whites, Japanese Americans, South Koreans, and Japanese

Background: Stomach cancer incidence shows substantial racial-ethnic disparity in the United States, with Korean Americans experiencing by far the highest incidence. We examined stomach cancer incidence trends in Korean Americans by tumor subsite, histology, and stage and compared them with incidence rates in racial-ethnic groups with the second highest rate (Japanese Americans) and the lowest rate (non-Hispanic whites; NHWs) as well as populations in South Korea and Japan.Methods: We calculated age-adjusted incidence rates by racial-ethnic groups, sex, and tumor characteristics, using the 1988-2012 California Cancer Registry data. Data on South Korea and Japan were obtained from the literature and other resources.Results: Between 1988 and 2012 in California, Korean Americans had about five times greater incidence than NHWs and twice that of Japanese Americans. Tumor characteristics differed by ethnic group and gender. The incidence in Korean Americans has declined during recent years, for both cardia and noncardia sites and for both intestinal- and diffuse-type histology. Although Korean Americans were diagnosed at an earlier stage than other Californians, the proportion with localized disease (43%) was much smaller than in South Korea (57%), where population-based screening is available.Conclusions: Stomach cancer incidence declined in the highest risk ethnic groups. However, the persistent disparity between Korean Americans and other racial-ethnic groups warrants additional strategies for prevention and earlier diagnosis.Impact: Analysis of California Cancer Registry data identified a racial-ethnic subgroup with stomach cancer disparity that may benefit from targeted prevention and screening efforts. Cancer Epidemiol Biomarkers Prev; 26(4); 587-96. ©2016 AACR.

Alcohol Consumption during Pregnancy: Analysis of Two Direct Metabolites of Ethanol in Meconium

Alcohol consumption in young women is a widespread habit that may continue during pregnancy and induce alterations in the fetus. We aimed to characterize prevalence of alcohol consumption in parturient women and to assess fetal ethanol exposure in their newborns by analyzing two direct metabolites of ethanol in meconium. This is a cross-sectional study performed in September 2011 and March 2012 in a series of women admitted to an obstetric unit following childbirth. During admission, socio-demographic and substance use (alcohol, tobacco, cannabis, cocaine, and opiates) during pregnancy were assessed using a structured questionnaire and clinical charts. We also recorded the characteristics of pregnancy, childbirth, and neonates. The meconium analysis was performed by liquid chromatography—tandem mass spectrometry (LC-MS/MS) to detect the presence of ethyl glucuronide (EtG) and ethyl sulfate (EtS). Fifty-one parturient and 52 neonates were included and 48 meconium samples were suitable for EtG and EtS detection. The median age of women was 30 years (interquartile range (IQR): 26–34 years); EtG was present in all meconium samples and median concentration of EtG was 67.9 ng/g (IQR: 36.0–110.6 ng/g). With respect to EtS, it was undetectable (<0.01 ng/g) in the majority of samples (79.1%). Only three (6%) women reported alcohol consumption during pregnancy in face-to-face interviews. However, prevalence of fetal exposure to alcohol through the detection of EtG and EtS was 4.2% and 16.7%, respectively. Prevention of alcohol consumption during pregnancy and the detection of substance use with markers of fetal exposure are essential components of maternal and child health.

Genetic variants in 3'-UTRs of methylenetetrahydrofolate reductase (MTHFR) predict colorectal cancer susceptibility in Koreans

Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) play important roles in tumor development, progression, and metastasis. Moreover, recent studies have reported that a number of 3′-UTR polymorphisms potentially bind to specific microRNAs in a variety of cancers. The aim of this study was to investigate the association of four MTHFR polymorphisms, 2572C>A [rs4846049], 4869C>G [rs1537514], 5488C>T [rs3737967], and 6685T>C [rs4846048] with colorectal cancer (CRC) in Koreans. A total of 850 participants (450 CRC patients and 400 controls) were enrolled in the study. The genotyping of MTHFR 3′-UTR polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism analysis or TaqMan allelic discrimination assay. We found that MTHFR 2572C>A, 4869C>G, and 5488C>T genotypes were substantially associated with CRC susceptibility. Of the potentially susceptible polymorphisms, MTHFR 2572C>A was associated with increased homocysteine and decreased folate levels in the plasma based on MTHFR 677CC. Our study provides the evidences for 3′-UTR variants in MTHFR gene as potential biomarkers for use in CRC prevention.