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.

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.

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 (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 covid-19 pandemic on cancer statistics needs to be investigated in the future.

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 (age-standardized rate [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.

[Influence of female age on the fresh cycle live birth rate of different controlled ovarian hyperstimulation protocols in poor ovarian response patients]

Objective: To investigate the influence of age on the fresh cycle live birth rate in patients with poor ovarian response in different controlled ovarian hyperstimulation groups. Methods: The clinical data of 3 342 patients in The First Affiliated Hospital of Zhengzhou University from February 2014 to November 2018 were retrospectively collected, including early-follicular phase long-acting gonadotropin-releasing hormone (GnRH) agonist long protocol group (1 375 cases), mid-luteal phase short-acting GnRH agonist long protocol group (1 161 cases) and GnRH antagonist protocol group (806 cases); each group was divided into 4 subgroups according to age: ≤30 years, 31－35 years, 36－40 years and >40 years, the pregnancy outcomes in each age subgroup were analyzed under different controlled ovarian hyperstimulation protocols. Results: In early-follicular phase long-acting GnRH agonist long protocol group, the final live birth rates of each age subgroup were 39.4% (228/579), 36.1% (135/374), 16.6% (48/290) and 3.0% (4/132); in mid-luteal phase short-acting GnRH agonist long protocol group, live birth rates of each age subgroup were 32.1% (99/308), 20.8% (55/264), 13.0% (45/346) and 7.0% (17/243); in GnRH antagonist protocol group, live birth rates of each age subgroup were 22.8% (26/114), 16.3% (25/153), 11.2% (31/278), and 3.8% (10/261); the live birth rate of each group decreased significantly with the increase of age (all P<0.01). When the age≤35 years old, the fresh cycle live birth rate of the early-follicular phase long-acting GnRH agonist long protocol group was significantly better than those of the other two groups (all P<0.01). The multivariate logistic regression analysis of age and live birth rate of the three controlled ovarian hyperstimulation groups showed age was the independent influence factor (OR=0.898, 95%CI: 0.873-0.916, P<0.01; OR=0.926, 95%CI: 0.890-0.996, P<0.01; OR=0.901, 95%CI: 0.863-0.960, P<0.01). Conclusions: Age is an independent influencing factor for the prediction of fresh cycle live birth rate in low ovarian response patients. No matter which controlled ovarian hyperstimulation protocol is adopted, the final live birth rate decreases significantly with the increase of women's age. In addition, the early-follicular phase long-acting GnRH agonist long protocol has the highest fresh cycle live birth rate among all controlled ovarian hyperstimulation groups.

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.

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.

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.

Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry

BACKGROUND/AIMS

Considering the high prevalence and mortality of hepatocellular carcinoma (HCC) in Korea, accurate statistics for HCC are important. We evaluated the characteristics of Korean patients with newly diagnosed HCC.

METHODS

We retrospectively evaluated data from the Korean Primary Liver Cancer Registry (KPLCR). The baseline characteristics, treatment modalities, and overall survival (OS) of 4,572 patients with HCC registered in the KPLCR between 2012 and 2014 were investigated.

RESULTS

At the time of HCC diagnosis, the median age was 60.0 years, with male predominance (79.6%). Hepatitis B virus infection was the most common etiology (59.1%). The rates of Barcelona Clinic Liver Cancer (BCLC) stages 0, A, B, C, and D at diagnosis were 3.9%, 36.9%, 12.5%, 39.4%, and 7.3%, respectively. The proportion of very early or early stage HCC at diagnosis (BCLC stage 0 or A) in the 2012-2014 cohort was significantly lower than that in the 2008-2011 cohort (40.8% vs. 48.3%, P<0.001). Transarterial therapy (37.5%) was the most commonly performed initial treatment, followed by surgical resection (19.8%), best supportive care (19.1%), and local ablation (10.6%). The median OS was 2.9 years, and the 1-, 3-, and 5-year OS rates were 67.7%, 49.3% and 41.9%, respectively. The OS rate of the 2012-2014 cohort was significantly higher than that of the 2008-2011 cohort (log-rank, P<0.001).

CONCLUSIONS

The OS of HCC patients registered in the KPLCR between 2012 and 2014 significantly improved. Nevertheless, as about half of the HCC patients were diagnosed at an advanced stage, vigorous and optimized HCC screening strategies should be implemented.

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.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017

Purpose

This study reports the cancer statistics and temporal trends in Korea on a nationwide scale, including incidence, survival, prevalence, and mortality in 2017.

Materials and Methods

The incidence, survival, and prevalence rates of cancer were evaluated using data from the Korea National Cancer Incidence Database from 1999 to 2017 with follow-up until December 31, 2018. Deaths from cancer were assessed using cause-of-death data from 1983 to 2017, obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence, and 5-year relative survival rates were calculated and trend analysis was performed.

Results

In 2017, newly diagnosed cancer cases and deaths from cancer numbered 232,255 (ASR, 264.4 per 100,000) and 78,863 (ASR, 76.6 per 100,000), respectively. The overall cancer incidence rates increased annually by 3.5% from 1999 to 2011 and decreased by 2.7% annually thereafter. Cancer mortality rates have been decreasing since 2002, by 2.8% annually. The 5-year relative survival rate for all patients diagnosed with cancer between 2013 and 2017 was 70.4%, which contributed to a prevalence of approximately 1.87 million cases by the end of 2017.

Conclusion

The burden of cancer measured by incidence and mortality rates have improved in Korea, with the exception of a few particular cancers that are associated with increasing incidence or mortality rates. However, cancer prevalence is increasing rapidly, with the dramatic improvement in survival during the past several years. Comprehensive cancer control strategies and efforts should continue, based on the changes of cancer statistics.

Pulmonary Tuberculosis is Associated with Elevated Risk of Lung cancer in Korea: The Nationwide Cohort Study

Objective: Although previous studies suggest that previous pulmonary tuberculosis was associated with increased risk of lung cancer. It remains controversial whether pulmonary tuberculosis is a risk factor for lung cancer. Our study was aimed to examine the association between pulmonary tuberculosis and lung cancer risk in Korean.

Methods: The Korean National Health and Nutrition Examination Survey database was linked with the Korean National Cancer Incidence Database to examine the occurrence of pulmonary tuberculosis and lung cancer. The linked databases were also merged with causes of death database of Statistics Korea. The Cox-proportional hazards model was used to estimates the hazard risk of lung cancer for Korean adults aged ≥40 years with pulmonary tuberculosis.

Results: Of 20,252 total participants, 2,640 (13.0%) had old pulmonary tuberculosis (a medical history of pulmonary tuberculosis or radiologically inactive tuberculosis). After adjusting for all covariates, the hazard ratio of lung cancer among patients with old pulmonary tuberculosis was 3.24 (95% CI, 1.87‒5.62) compared to the control group. According to smoking status, the hazard ratios of lung cancer for never smokers, ex-smokers, and current smokers among participants with old pulmonary tuberculosis were 3.52 (95% CI, 1.17‒10.63), 2.16 (95% CI, 0.89‒5.24), and 3.71 (95% CI, 1.49‒9.22) compared to the control group, respectively.

Conclusions: Korean adults with old pulmonary tuberculosis have a higher risk of lung cancer, compared to general population without pulmonary tuberculosis.

Causes of death among cancer patients in the era of cancer survivorship in Korea: Attention to the suicide and cardiovascular mortality

Background

Improved cancer survival is expected to increase noncancer deaths; however, detailed causes of death have rarely been discussed. Changing landscapes in mortality patterns and noncancer mortality risks in patients with cancer require evaluation.

Methods

We identified cancer and noncancer‐related causes of death using data from the 2000‐2016 national cancer registry in Korea (n = 2 707 520), and we characterized the leading causes of death and proportionate mortalities over time. Risks of noncancer deaths relative to the general population were estimated using standardized mortality ratios (SMRs).

Results

Of 1 105 607 identified deaths, 87% were due to the primary cancer. Proportionate mortalities of primary cancer among overall deaths remained high in patients with liver (86%) and lung (70%) cancers and in female patients with breast cancer (77%), even 5 to 10 years following diagnosis, whereas proportionate mortalities reduced to ≤50% in patients with stomach (men, 39%; women, 48%), prostate (47%), and female thyroid (27%) cancers. Despite the predominance of index cancer deaths, the proportion of noncancer deaths among all deaths increased over time. There was a 20‐fold increase in cardiovascular disease deaths among patients with cancer from 2000 to 2016, and the risk of suicide among patients with cancer was higher than that among the general population (SMR: 1.68 [95% confidence interval (CI): 1.63‐1.74] in men, SMR: 1.42 [95% CI: 1.33‐1.55] in women).

Conclusions

Deaths from primary cancer remain a major concern; however, follow‐up is required for both cancer and noncancer‐related health issues in cancer survivors, especially concerning suicide and cardiovascular deaths.

Prediction of Cancer Incidence and Mortality in Korea, 2019

PURPOSE

This study aimed to report on cancer incidence and mortality for the year 2019 to estimate Korea's current cancer burden.

MATERIALS AND METHODS

Cancer incidence data from 1999 to 2016 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2017 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, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly; we used only the data of the latest trend.

RESULTS

A total of 221,347 new cancer cases and 82,344 cancer deaths are expected to occur in Korea in 2019. The most common cancer sites thus far have been the lung, followed by the stomach, colon and rectum, breast, and liver. These five cancers represent half of the overall burden of cancer in Korea. For cancer associated mortality, the most common sites were lung, followed by the liver, colon and rectum, stomach, and pancreas.

CONCLUSION

The incidence rate of all cancer in Korea is estimated to decrease gradually. These up-todate 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 2016

PURPOSE

This study presents the 2016 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality.

Materials and Methods

Cancer incidence data from 1999 to 2016 were obtained from the Korea National Cancer Incidence Database and followed until December 31, 2017. Mortality data from 1983 to 2016 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2017 among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence and 5-year relative survivals were also calculated.

RESULTS

Overall, 229,180 and 78,194 Koreans were newly diagnosed and died from cancer in 2016, respectively. The ASRs for cancer incidence and mortality in 2016 were 269.0 and 79.8 per 100,000 individuals, respectively. The all-cancer incidence rate increased significantly by 3.6% annually from 1999 to 2011 and started to decrease after 2011 (2011-2016; annual percent change, -3.1%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2012 and 2016 was 70.6%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995.

CONCLUSION

The cancer prevalence in Korea has increased very fast as survival has improved remarkably. The high prevalence of cancer emphasizes the need for comprehensive cancer control efforts in Korea.

High-Frequency Ultrasound Imaging for Examination of Early Dental Caries

The extent of dental tissue destruction during the treatment of white spot lesions (WSLs) increases with the severity of the lesion. If the depth and shape of WSLs can be predicted with a noninvasive diagnostic method before dental caries treatment, more conservative interventions can be planned. Given the superiority of high-frequency ultrasound (HFUS) imaging in observing the internal structures of the body, the present study aimed to verify the possibility of HFUS imaging to examine the depth and shape of WSLs. We prepared tooth samples and developed a biomicroscopic system with a HFUS transducer to obtain images of normal and WSL regions. HFUS images were compared with conventional ultrasound images and micro-computed tomography images. HFUS distinctly differentiated demineralization within WSL and normal regions. WSL depth calculated in the micro-computed tomography image was similar to that in HFUS. This study revealed that HFUS imaging has the potential to detect early dental caries and offer information on the invasion depth of early dental caries quantitatively.

National Epidemiologic Survey of Thyroid cancer (NEST) in Korea

The Korea Central Cancer Registry conducted the National Epidemiologic Survey of Thyroid cancer (NEST) to investigate changes in the epidemiological and clinical characteristics of thyroid cancer patients between 1999 and 2008. The NEST was designed to collect representative samples of patients with thyroid cancer diagnosed in the years 1999, 2005, and 2008 using a proportionally stratified and systematic random sampling method. Among 42,891 participants diagnosed with thyroid cancer, 5,796 participants were included in the final study population. This survey collected information on diagnostic methods and date, route of diagnosis, prior medical history and history of thyroid-related disease, tumor, lymph node, metastasis and collaborative stage, and treatment. The NEST dataset was also linked to the cause-of-death database from Statistics Korea. The mean age of the study participants was 46.9 years. The ratio of men to women was 1:5.5. In the analysis of the histologic type of cancer, the proportion of papillary thyroid carcinoma showed an increasing trend (p<0.01). In contrast, the proportion of distant metastasis and the mean tumor size of thyroid cancers showed decreasing trends over time (p<0.01, respectively).

Total thyroidectomy's association with survival in papillary thyroid cancers and the high proportion of total thyroidectomy in low-risk patients: Analysis of Korean nationwide data

BACKGROUND

Papillary thyroid cancer has an excellent prognosis, but the appropriate level of treatment is controversial. We compared survival between total thyroidectomy and less-than-total thyroidectomy, and examined the proportion of patients with papillary thyroid cancer in Korea undergoing total thyroidectomy.

METHODS

A nationwide sample of 5,230 papillary thyroid cancer patients was included (total thyroidectomy: 4,262, less-than-total thyroidectomy: 968). Using multivariate Cox regression, we compared overall survival and cause-specific survival by the extent of thyroidectomy (total thyroidectomy versus less-than-total thyroidectomy) for a 1:1 optimal match via the propensity score and for the total study population. We also compared overall survival by extent of thyroidectomy and the proportion of total thyroidectomy in different risk groups using papillary thyroid cancer staging systems.

RESULTS

We saw no difference in overall survival by extent of thyroidectomy in the propensity score matched population and the total study population (hazard ratio for less-than-total thyroidectomy 0.82, 95% confidence interval 0.52-1.29; hazard ratio for less-than-total thyroidectomy 1.03, 95% confidence interval 0.71-1.48, respectively). Similarly, there were no differences in thyroid cancer-specific survival by extent of thyroidectomy. None of the different risk groups showed differences in overall survival by surgical extent, although total thyroidectomy improved overall survival in older females with larger tumors. The proportion of papillary thyroid cancer patients who received a total thyroidectomy was 80% or greater regardless of risk group classification.

CONCLUSION

Total thyroidectomy had no survival advantage over less-than-total thyroidectomy in Korean papillary thyroid cancer patients except in a specific high-risk group. 80% or more of low-risk papillary thyroid cancer patients received a total thyroidectomy. These results suggest that further patient-centered treatment which considers both quality of life and clinical outcome is needed.

Nationwide Trends in the Incidence of Melanoma and Non-melanoma Skin Cancers from 1999 to 2014 in South Korea

PURPOSE

This descriptive study was aimed to examine trends in the incidence of melanoma and nonmelanoma in South Korea.

MATERIALS AND METHODS

The nationwide incidence data for melanoma and non-melanoma skin cancer was obtained from the Korea Central Cancer Registry. Age-standardized rates were calculated and analyzed, using a Joinpoint regression model.

RESULTS

The incidence of basal cell carcinoma has increased dramatically both in men (average annual percentage change [AAPC], 8.0 [95% confidence interval (CI), 6.0 to 10.1]) and women (AAPC, 9.0 [95% CI, 7.5 to 10.4]). Squamous cell carcinoma has also steadily increased both in men (AAPC, 3.3 [95% CI, 2.6 to 4.0]) and women (AAPC, 6.8 [95% CI, 5.3 to 8.4]). Cutaneous melanoma increased continuously from 1999 to 2014 inwomen (AAPC, 3.5 [95% CI, 2.4 to 4.6]), whilst rapidly increasing in men until 2005 (APC, 7.9 [95% CI, 2.4 to 13.7]) after which no increase has been observed (APC, ‒0.2 [95% CI, ‒2.3 to 2.0]).

CONCLUSION

The incidence rates of melanoma and non-melanoma skin cancer have increased over the past years, with the exception of melanoma in men. Further studies are required to investigate the reasons for the increased incidence of these skin cancers in South Korea.

Prediction of Cancer Incidence and Mortality in Korea, 2018

PURPOSE

This study aimed to report on cancer incidence and mortality for the year 2018 to estimate Korea's current cancer burden.

MATERIALS AND METHODS

Cancer incidence data from 1999 to 2015 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2016 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, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly, we only used the data of the latest trend.

RESULTS

A total of 204,909 new cancer cases and 82,155 cancer deaths are expected to occur in Korea in 2018. The most common cancer sites were lung, followed by stomach, colorectal, breast and liver. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites were lung cancer, followed by liver, colorectal, stomach and pancreas.

CONCLUSION

The incidence rate of all cancer in Korea are estimated to decrease gradually, mainly due to decrease of thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2015

Purpose

This study presents the 2015 nationwide cancer statistics in Korea, including the incidence, survival, prevalence, and mortality.

Materials and Methods

Cancer incidence data from 1999 to 2015 was obtained from the Korea National Cancer Incidence Database and followed until December 31, 2016. Mortality data from 1983 to 2015 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2016, among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality and prevalence and 5-year relative survivals were also calculated.

Results

Herein, 214,701 and 76,855 Koreans were newly diagnosed and died from cancer in 2015, respectively. The ASRs for cancer incidence and mortality in 2015 were 258.9 and 82.0 per 100,000, respectively. The overall cancer incidence rate has increased significantly by 3.4% annually from 1999 to 2012, and started to decrease after 2012 (2012-2015, annual percent change, –6.1%). However, the overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2011 and 2015 was 70.7%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995.

Conclusion

Age-standardized cancer incidence rates have decreased since 2012 and mortality rates have declined since 2002; however, the 5-year survival rates have improved remarkably from 1993-1995 to 2011-2015 in Korea.

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.

Geographical Variations and Trends in Major Cancer Incidences throughout Korea during 1999-2013

Purpose

We aimed to describe the temporal trends and district-level geographical variations in cancer incidences throughout Korea during 1999-2013.

Materials and Methods

Data were obtained from the Korean National Cancer Incidence Database. We calculated the age-standardized cumulative cancer incidences according to sex and geographical region (metropolitan cities, provinces, and districts) for three 5-year periods (1999-2003, 2004-2008, and 2009-2013). Each quintile interval contained the same number of regions. Disease maps were created to visualize regional differences in the cancer incidences.

Results

Substantial differences in cancer incidences were observed according to district and cancer type. The largest variations between geographical regions were found for thyroid cancer among both men and women. There was little variation in the incidences of stomach, colorectal, and lung cancer according to geographical region. Substantially elevated incidences of specific cancers were observed in Jeollanam-do (thyroid); Daejeon (colorectum); Jeollanam-do, Gyeongsangbuk-do, and Chungcheongbuk-do (lung); Seocho-gu, Gangnam-gu and Seongnam, Bundang-gu (breast and prostate); Chungcheong and Gyeongsang provinces (stomach); Ulleung-gun and the southern districts of Gyeongsangnam-do and Jeollanam-do (liver); and along the Nakdonggang River (gallbladder and biliary tract).

Conclusion

Mapping regional cancer incidences in Korea allowed us to compare the results according to geographical region. Our results may facilitate the development of infrastructure for systematic cancer incidence monitoring, which could promote the planning and implementation of region-specific cancer management programs.

Prediction of Cancer Incidence and Mortality in Korea, 2017

PURPOSE

This study aimed to report on cancer incidence and mortality for the year 2017 in Korea in order to estimate the nation's current cancer burden.

MATERIALS AND METHODS

Cancer incidence data from 1999 to 2014 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2015 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observe age-specific cancer rates against observed years, and then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly; we only used data of the latest trend.

RESULTS

A total of 221,143 new cancer cases and 80,268 cancer deaths are expected to occur in Korea in 2017. The most common cancer sites are the colorectum, stomach, lung, thyroid, and breast. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites are the lung, liver, colorectal, stomach, and pancreas.

CONCLUSION

The incidence rate of all cancers in Korea appears to have decreased mainly because of a decrease in thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs.

Nationwide Statistical Analysis of Lymphoid Malignancies in Korea

Purpose

Regional differences in the incidence of lymphoid malignancies have been reported worldwide, but there has been no large-scale epidemiologic analysis in Korea. The aim of this study was to provide a nationwide population-based statistical analysis of Korean patients with lymphoid malignancies.

Materials and Methods

The Korea Central Cancer Registry analyzed the incidence and survival of patients with lymphoid malignancies from the Korean National Cancer Incidence Database. Diseases were grouped by clinically relevant categories based on the 2008 World Health Organization classification.

Results

Overall 65,948 lymphoid diseases were identified between 1999 and 2012. The incidence of most subtypes increased with age, except for precursor cell neoplasms. Male predominance (male:female ratio=1.28:1) was observed. In 2012, annual age-standardized incidence rates per 100,000 persons of Hodgkin’s lymphoma, mature B-cell neoplasm, mature T/natural killer (NK)–cell neoplasm, and precursor cell neoplasm were 0.46, 6.60, 0.95, and 1.50, respectively, and they increased yearly from 1999. Composite Hodgkin’s and non-Hodgkin’s lymphomas were extremely rare. Survival improvement estimated using 5-year relative survival rate was observed in patients with Hodgkin’s lymphoma (71.1%-83.0%), diffuse large B-cell lymphoma (49.5%-61.5%), plasma cell neoplasms (20.2%-36.9%), and lymphoblastic lymphoma/leukemia (41.5%-56.3%) between 1993 and 2012. However, survival rates of T/NK-cell lymphoma (excluding cutaneous T-cell lymphoma) ranged from 40.5%-43.5% during the study period. Survival rates decreased with age in most subtypes.

Conclusion

This report presented the subtype-specific statistical analysis of lymphoid malignancies in the Korean population, showing increasing incidences and survival rates in most subtypes.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2014

PURPOSE

This study presents the 2014 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality.

MATERIALS AND METHODS

Cancer incidence data from 1999 to 2014 was obtained from the Korea National Cancer Incidence Database and followed until December 31, 2015. Mortality data from 1983 to 2014 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2015, among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, prevalence, and 5-year relative survivals were also calculated.

RESULTS

In 2014, 217,057 and 76,611 Koreans were newly diagnosed and died from cancer respectively. The ASRs for cancer incidence and mortality in 2014 were 270.7 and 85.1 per 100,000, respectively. The all-cancer incidence rate has increased significantly by 3.4% annually from 1999 to 2012, and started to decrease after 2012 (2012-2014; annual percent change, -6.6%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2010 and 2014 was 70.3%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995.

CONCLUSION

Age-standardized cancer incidence rates have decreased since 2012 and mortality rates have also declined since 2002, while 5-year survival rates have improved remarkably from 1993-1995 to 2010-2014 in Korea.

Association between screening and the thyroid cancer "epidemic" in South Korea: evidence from a nationwide study

OBJECTIVE

 To investigate whether screening for thyroid cancer led to the current "epidemic" in South Korea.

DESIGN

 Review of the medical records of nationally representative samples of patients with a diagnosis of thyroid cancer in 1999, 2005, and 2008.

SETTING

 Sample cases were randomly selected from South Korea's nationwide cancer registry, using a systematic sampling method after stratification by region.

PARTICIPANTS

 5796 patients with thyroid cancer were included (891 in 1999, 2355 in 2005, and 2550 in 2008).

MAIN OUTCOME MEASURES

 The primary outcome was age standardised incidence of thyroid cancer and the changes in incidence between 1999 and 2008 according to the methods used to detect tumours (screen detection versus clinical detection versus unspecified).

RESULTS

 Between 1999 and 2008, the incidence of thyroid cancer increased 6.4-fold (95% confidence interval 4.9-fold to 8.4-fold), from 6.4 (95% confidence interval 6.2 to 6.6) per 100 000 population to 40.7 (40.2 to 41.2) per 100 000 population. Of the increase, 94.4% (34.4 per 100 000 population) were for tumours less than 20 mm, which were detected mainly by screening. 97.1% of the total increase was localised and regional tumours according to the Surveillance, Epidemiology, and End Results (SEER) summary stage. Where cases were clinically detected, 99.9% of the increased incidences (6.4 per 100 000 population) over the same period were tumours less than 20 mm.

CONCLUSION

 The current "epidemic" of thyroid cancer in South Korea is due to an increase in the detection of small tumours, most likely as a result of overdetection. Concerted efforts are needed at a national level to reduce unnecessary thyroid ultrasound examinations in the asymptomatic general population.

Prediction of Cancer Incidence and Mortality in Korea, 2016

PURPOSE

To estimate of Korea's current cancer burden, this study aimed to report on projected cancer incidence and mortality rates for the year 2016.

MATERIALS AND METHODS

Cancer incidence data from 1999 to 2013 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2014 were acquired from Statistics Korea. Cancer incidence in 2016 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly.

RESULTS

A total of 254,962 new cancer cases and 75,172 cancer deaths are expected to occur in Korea in 2016. The five leading primary cancer incident sites in 2016 were estimated colorectal, stomach, lung, liver and thyroid cancer in men; thyroid, breast, colorectal, stomach, and lung cancer in women.

CONCLUSION

Currently cancer is one of the foremost public health concerns in Korea. Although cancer rates are anticipated to decrease the nation's cancer burden will continue to increase as the population ages.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2013

Purpose:

This study described the 2013 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality.

Materials and Methods:

Cancer incidence data from 1999-2013 were obtained from Korea National Cancer Incidence Database and followed until December 31, 2014. Mortality data from 1983-2013 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2014 among all cancer patients diagnosed since 1999. Crude, and age-standardized and 5-year relative survival rates were also calculated.

Results:

In 2013, a total of 225,343 and 75,334 Koreans were newly diagnosed and died from cancer, respectively. The age-standardized rates for cancer incidence and mortality in 2013 were 290.5 and 87.9 per 100,000, respectively. The age-standardized cancer incidence rate increased 3.1% annually between 1999 and 2013. However, the overall cancer incidence rates have decreased slightly in recent years (2011 to 2013). The age-standardized rate for all-cancer mortality has decreased 2.7% annually since 2002. Overall, the 5-year relative survival rate for people diagnosed with cancer between 2009 and 2013 was 69.4%, which represents an improved survival rate as compared with 41.2% for people diagnosed between 1993 and 1995.

Conclusion:

Age-standardized cancer incidence rates have decreased between 2011 and 2013; mortality rates have also declined since 2002, while 5-year survival rates have improved remarkably from 1993-1995 to 2009-2013 in Korea.

Nationwide statistical analysis of myeloid malignancies in Korea: incidence and survival rate from 1999 to 2012

BACKGROUND

Large-scale epidemiologic analysis for hematologic malignancies will be helpful to understand the trends in incidence and survival.

METHODS

The Korea Central Cancer Registry (KCCR) updated the nationwide analysis on the incidence and survival of myeloid malignancies, from the Korean National Cancer Incidence Database between 1999 and 2012. Myeloid malignancies were classified based on the International Classification of Diseases for Oncology 3(rd) edition (ICD-O-3).

RESULTS

Overall 3,771 cases of myeloid diseases, which was 1.7% of all cancers, were identified in 2012. The highest incidence of myeloid malignancies was observed in age 70s and male predominance was noted (1.3:1). Acute myeloid leukemia (AML) was the most frequent subtype, followed by myeloproliferative neoplasms (MPN), myelodysplastic syndrome (MDS) and MDS/MPN: age-standardized incidence rates (ASR) in 2012 for each disease were 2.02, 1.95, 1.13, and 0.12 per 100,000 persons, respectively. The ASR for all myeloid malignancies was increased from 3.31 in 1999 to 5.70 in 2012 with the annual percentage change (APC) of 5.4 %. Five-year relative survival rate (RS) for myeloid malignancies has gradually improved for decades. RS changed from 26.3% to 34.8% in AML, specifically from 51.6% to 69.6% in acute promyelocytic leukemia (APL) and from 23.8% to 29.9% in non-APL AML, between 1996-2000 and 2008-2012. RS also increased from 81.8% to 87.1% in MPN, with a significant improvement in CML (from 74.5% to 85.5%), and from 27.3% to 31.7% in MDS/MPN between 2001-2005 and 2008-2012. However, there was no survival improvement in MDS during the study period (45.6% in 2001-2005 to 44.4% in 2008-2012).

CONCLUSION

This report updated the nationwide statistical analysis on myeloid malignancies since 2008, showing increasing incidence and improving trends in survival.

Lung cancer risk in professional drivers in Korea: A population-based proportionate cancer incidence ratio study

OBJECTIVES

Professional drivers are exposed to diesel engine exhaust and outdoor air pollution while driving. Diesel engine exhaust and outdoor air pollution are known carcinogens causing lung cancer. However, previous epidemiological studies examining lung cancer risk in professional drivers have not shown a consistent association. In the present study, we evaluated lung cancer risk among Korean professional drivers.

METHODS

Subjects consisted of male drivers aged 30-59 registered in the Korea Central Cancer Registry for lung cancer between 1999 and 2011. Proportionate cancer incidence ratios (PCIRs) for lung cancer were calculated and indirectly age standardized with the male general population. Additional PCIRs were calculated by indirectly adjusting for the effect of cigarette smoking.

RESULTS

The PCIR for lung cancer in professional drivers during the study period increased significantly (1.20, 95% CI: 1.13-1.26). The increased risk was generally consistent throughout study years and age categories. Adjusting for the effect of cigarette smoking did not change the significance of the associations (1.09, 95% CI: 1.03-1.15).

CONCLUSIONS

Our findings support an association between lung cancer and driver jobs in the Korean male population. However, the association should be further evaluated in a study with a longitudinal design and a quantitative exposure assessment.

Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012

PURPOSE

The aim of this study was to report nationwide cancer statistics in Korea, including incidence, mortality, survival, and prevalence, and their trends.

MATERIALS AND METHODS

Incidence data from 1993 to 2012 were obtained from the Korea National Cancer Incidence Database, and vital status was followed through December 31, 2013. Mortality data from 1983 to 2012 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, and prevalence, and relative survival were calculated.

RESULTS

A total of 224,177 cancer cases and 73,759 cancer deaths were reported in 2012, and there were 1,234,879 prevalent cases identified in Korea as of January 1, 2013. Over the past 14 years (1999-2012), overall incidence rates have increased by 3.3% per year. The incidence rates of liver and cervical cancers have decreased, while those of thyroid, breast, prostate, and colorectal cancers have increased. Notably, incidence of thyroid cancer increased by 22.3% per year in both sexes and has been the most common cancer since 2009. The mortality for all cancers combined decreased by 2.7% per year from 2002 to 2012. Five-year relative survival rates of patients diagnosed in the last 5 years (2008-2012) have improved by 26.9% compared with those from 1993 to1995.

CONCLUSION

Overall cancer mortality rates have declined since 2002 in Korea, while incidence has increased and survival has improved.

Prediction of cancer incidence and mortality in Korea, 2015

Purpose

For estimation of Korea’s current cancer burden, this study aimed to report on the projected cancer incidence and mortality rates for the year 2015.

Materials and Methods

Cancer incidence data from 1999 to 2012 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2013 were acquired from Statistics Korea. The cancer incidence in 2015 was projected by fitting a linear regression model to the observed age-specific cancer incidence rates against the observed years and then multiplying the projected age-specific rates by the age-specific population. A similar procedure was used for cancer mortality, except a Joinpoint regression model was used to determine at which year the linear trend changed significantly.

Results

A total of 280,556 new cancer cases and 76,698 cancer deaths are expected to occur in Korea in 2015. The crude incidence rate per 100,000 of all sites combined will likely reach 551.6 and the age-standardized incidence rate, 347.6. The estimated five leading primary cancer incidence sites are the stomach, colorectum, lung, prostate, and liver in men; and thyroid, breast, colorectum, stomach, and lung in women. The projected crude mortality rate of all sites combined and age-standardized rate is 150.8 and 82.4, respectively.

Conclusion

Cancer is currently one of the foremost public health concerns in Korea, and as the population ages, the nation’s cancer burden will continue to increase.

Age-Period-Cohort Analysis of Thyroid Cancer Incidence in Korea

Purpose

South Korea has the highest incidence rate of thyroid cancer in the world, and the incidence rate continues to increase. The aim of this study was to determine the age-period-cohort effects on the incidence of thyroid cancer in Korea.

Materials and Methods

Using the Korean National Cancer registry database, age-standardized incidence rates and annual percent changes (APCs) in thyroid cancer according to sex and histologic type were analyzed between 1997 and 2011. Age-period-cohort models were applied using an intrinsic estimator method according to sex.

Results

In both men and women, the incidence of thyroid cancer showed a sharp increase from 1997 through 2011. Among the histologic types, papillary carcinoma showed the greatest increase, with APCs of 25.1% (95% confidence interval [CI], 22.7% to 27.5%) in men and 23.7% (95% CI, 21.9% to 25.5%) in women, whereas anaplastic carcinoma did not show a significant increase in either sex. An increase in overall thyroid cancer incidence over time was observed in all birth cohorts. An age-period-cohort model indicated a steeply increasing period effect, which increased prominently from 1997 to 2011 in both men and women. The age effect showed an inverted U-shaped trend. The cohort effect tended to show a slight increase or remain constant from 1952 to 1977, followed by a decrease.

Conclusion

The period effect can explain the sharp increase in thyroid cancer incidence, strongly suggesting the role of thyroid screening.

Characterization of novel microsatellite markers derived from Korean rose bitterling (Rhodeus uyekii) genomic library

Korean rose bitterling (Rhodeus uyekii) is a freshwater fish endemic to Korea. Natural populations of this species have experienced severe declines as a result of habitat fragmentation and water pollution. To conserve and restore R. uyekii, the genetic diversity of this species needs to be assessed at the population level. Eighteen novel polymorphic microsatellite loci for R. uyekii were developed using an enriched partial genomic library. Polymorphisms at these loci were studied in 150 individuals collected from three populations. The number of alleles at each locus ranged from 3 to 47 (mean = 17.1). Within the populations, the observed heterozygosity ranged from 0.032 to 1.000, expected heterozygosity from 0.082 to 0.967, and polymorphism information content from 0.078 to 0.950. Six loci showed significant deviation from Hardy-Weinberg equilibrium after Bonferroni's correction, and no significant linkage disequilibrium was detected between most locus pairs, except in three cases. These highly informative microsatellite markers should be useful for genetic population structure analyses of R. uyekii.

Increased prevalence of chronic lymphocytic thyroiditis in Korean patients with papillary thyroid cancer

Background

In recent years, some reports have suggested that papillary thyroid cancers are more frequently associated with lymphocytic thyroiditis or Hashimoto's thyroiditis. This study investigated a potential increase in the prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients.

Materials and Methods

We used national epidemiological survey data on thyroid cancer patients diagnosed in 1999, 2005, and 2008. A retrospective medical record survey was conducted by representative sampling of a national cancer incidence database. The analysis included 5,378 papillary thyroid cancer patients aged 20–79 years. We calculated the age-standardized prevalence and age-adjusted prevalence ratios using a binomial regression model with a log link for the prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients by sex for each year.

Results

The prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients was 4.0% and 12.8% for men and women in 1999, 6.5% and 24.6% in 2005, and 10.7% and 27.6% in 2008, respectively. Between 1999 and 2008, the age-standardized prevalence of chronic lymphocytic thyroiditis increased 4.1-fold in male patients and 2.0-fold in female patients with papillary thyroid cancer. The prevalence of other thyroid diseases, however, did not increase in either gender.

Conclusions

Among Korean papillary thyroid cancer patients, the prevalence of chronic lymphocytic thyroiditis increased between 1999 and 2008, whereas the prevalence of other thyroid disorders did not change.

Trends in the incidence of and survival rates for oral cavity cancer in the Korean population

OBJECTIVE

This study assessed trends in the incidence of and survival rates for oral cavity cancer in the Korean population.

MATERIALS AND METHODS

Data from the Korea Central Cancer Registry were extracted for 10,282 patients diagnosed with oral cavity cancer (C01-C06) between 1999 and 2010 to evaluate the age-standardised incidence rate, annual percentage change (APC) and 5-year relative survival rate (RSR) according to gender and age.

RESULTS

In males, the incidence rate slightly decreased [APC of -0.2% (P = 0.6427)]; in females, the incidence rate increased [APC of 3.1% (P < 0.05)]. In males and females, the incidence of oral tongue cancer (C02) significantly increased [APC of 2.2% and 4.1%, respectively (P < 0.05)]. This increase in oral tongue cancer incidence was most prominent in the younger age group (<40 years, APC = 6.1%, P < 0.05). The incidence of buccal cheek cancer increased only among males [APC of 4.8% (P < 0.05)]. The 5-year RSR improved from 42.7% (1993-1995) to 59.5% (2006-2010), corresponding to an increase of 16.8% from 1993 to 2010 (P < 0.05).

CONCLUSION

The incidence of oral cavity cancer in females increased, whereas it stabilised or decreased in males. However, the incidence of oral tongue cancer increased in both males and females, especially in the younger age group.

Prediction of cancer incidence and mortality in Korea, 2014

Purpose

We studied and reported on cancer incidence and mortality rates as projected for the year 2014 in order to estimate Korea's current cancer burden.

Materials and Methods

Cancer incidence data from 1999 to 2011 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2012 were acquired from Statistics Korea. Cancer incidence in 2014 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was employed, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly.

Results

A total of 265,813 new cancer cases and 74,981 cancer deaths are expected to occur in Korea in 2014. Further, the crude incidence rate per 100,000 of all sites combined will likely reach 524.7 and the age-standardized incidence rate, 338.5. Meanwhile, the crude mortality rate of all sites combined and age-standardized rate are projected to be 148.0 and 84.6, respectively. Given the rapid rise in prostate cancer cases, it is anticipated to be the fourth most frequently occurring cancer site in men for the first time.

Conclusion

Cancer has become the most prominent public health concern in Korea, and as the population ages, the nation's cancer burden will continue to increase.

Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2011

PURPOSE

This study aimed to report nationwide cancer statistics in Korea, including incidence, mortality, survival, and prevalence, and their trends.

MATERIALS AND METHODS

Incidence data from 1993 to 2011 were obtained from the Korea National Cancer Incidence Database, and vital status was followed through December 31, 2012. Mortality data from 1983 to 2011 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, and prevalence, and relative survival were calculated.

RESULTS

A total of 218,017 cancer cases and 71,579 cancer deaths were reported to have occurred in 2011, and there were 1,097,253 prevalent cases identified in Korea as of January 1, 2012. Over the past 13 years (1999-2011), overall incidence rates have increased by 3.4% per year. The incidence rates of liver and cervical cancers have decreased, while those of thyroid, breast, prostate, and colorectal cancers have increased. Notably, thyroid cancer increased by 23.3% per year in both sexes, and became the most common cancer since 2009. The mortality for all cancers combined decreased by 2.7% per year from 2002 to 2011. Five-year relative survival rates of patients diagnosed in the last 5 years (2007-2011) have improved by 25.1% compared with those from 1993 to 1995.

CONCLUSION

Overall cancer mortality rates have declined since 2002 in Korea, while incidence has increased rapidly and survival has improved.

Initial design method based on an iterative calculation of aberration and its application to an objective lens for imaging spectrometer

An initial optical design method based on an iterative calculation of third-order aberration is presented to overcome the problems of the conventional method. The aberrations of each lens group in the optical system are calculated individually and iteratively under the constraint that aberrations of one group compensate for those of the other groups. The stabilities of initial design results have been confirmed and the iterative design method has been applied for the design of optical system with an external entrance pupil for imaging spectrometer. The designed lens corresponds to an objective lens with the aperture of F/1.5 and the focal length of 30 mm.

3D fabrication of biological machines

Cell-based biological machines can be defined as a set of sub-components consisting of living cells and cell-instructive micro-environments that interact to perform a range of prescribed tasks. The realization of biological machines and their sub-components will require a number of suitable cell sources, biomaterials, and enabling technologies. Here, we review our group's recent accomplishments and continuing efforts toward the development of building biological machines.

Survival of korean adult cancer patients by stage at diagnosis, 2006-2010: national cancer registry study

Purpose

Although the cancer stage at diagnosis is the most important prognostic factor for patients' survival, there are few population-based estimates of stage-specific survival outcome, especially in Asian countries. Our study aims to estimate stage-specific survival for Korean patients.

Materials and Methods

We analyzed the Korea National Cancer Incidence Database data on 626,506 adult patients aged ≥ 20 years, who were diagnosed between 2006 and 2010 with stomach, colorectal, liver, lung, breast, cervix, prostate, and thyroid cancers. Patients were followed up to December 2011, and the 5-year relative survival rates (RSRs) were calculated for gender and age group by Surveillance, Epidemiology, and End Results (SEER) stage at diagnosis.

Results

The 5-year RSRs for all localized-stage cancers, except for lung and liver, exceeded 90% with that for thyroid cancer being the highest at 100.4%. These values for distant stage liver, lung, and stomach cancers were very dismal at 2.5%, 4.8%, and 5.5%, respectively, while it was 69.1% for thyroid cancer, and was in the range of 18.3-36.4% for colorectal, cervix, breast and prostate cancers. Overall, the 5-year RSRs for all cancer types decreased with aging across all the disease stages with exception of prostate cancer, which suggests biologic difference in these cancer types in a young age group. When compared with US SEER data, Korean patients had better stage-specific survival rates for stomach, colorectal, liver, and cervical cancers.

Conclusion

Korean cancer patients showed relatively favorable stage distribution and 5-year RSRs, which suggests potential contribution of the national cancer screening program.

Prediction of cancer incidence and mortality in Korea, 2013

PURPOSE

To estimate the current cancer burden in Korea, cancer incidence and mortality rates were projected for the year 2013.

MATERIALS AND METHODS

Cancer incidence data from 1999 to 2010 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2011 were obtained from Statistics Korea. Cancer incidence in 2013 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was used, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly.

RESULTS

In total, 247,732 new cancer cases and 74,179 cancer deaths are projected to occur in Korea in 2013. For all sites combined, the crude incidence rates are projected to be 489.8 and 492.2, and the age-standardized incidences to be 350.4 and 318.4 per 100,000 for males and females, respectively.

CONCLUSION

Cancer has become an important public health concern in Korea, and as the Korean population ages, the cancer burden will continue to increase.

Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010

Purpose

This article gives an overview of nationwide cancer statistics, including incidence, mortality, survival and prevalence, and their trends in Korea based on 2010 cancer incidence data.

Materials and Methods

Incidence data from 1993 to 2010 were obtained from the Korea National Cancer Incidence Database, and vital status was followed until 31 December 2011. Mortality data from 1983 to 2010 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, prevalence, and relative survival were calculated.

Results

In total, 202,053 cancer cases and 72,046 cancer deaths occurred during 2010, and 960,654 prevalent cancer cases were identified in Korea as of 1 January 2011. The incidence of all cancers combined showed an annual increase of 3.3% from 1999 to 2010. The incidences of liver and cervical cancers have decreased while those of thyroid, breast, prostate and colorectal cancers have increased. Notably, thyroid cancer, which is the most common cancer in Korea, increased by 24.2% per year rapidly in both sexes. The mortality of all cancers combined showed a decrease by 2.7% annually from 2002 to 2010. Five-year relative survival rates of patients who were diagnosed with cancer from 2006 to 2011 had improved by 22.9% compared with those from 1993 to 1995.

Conclusion

While the overall cancer incidence in Korea has increased rapidly, age-standardized cancer mortality rates have declined since 2002 and survival has improved.

Prediction of cancer incidence and mortality in Korea, 2013

Purpose

To estimate the current cancer burden in Korea, cancer incidence and mortality rates were projected for the year 2013.

Materials and Methods

Cancer incidence data from 1999 to 2010 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2011 were obtained from Statistics Korea. Cancer incidence in 2013 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was used, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly.

Results

In total, 247,732 new cancer cases and 74,179 cancer deaths are projected to occur in Korea in 2013. For all sites combined, the crude incidence rates are projected to be 489.8 and 492.2, and the age-standardized incidences to be 350.4 and 318.4 per 100,000 for males and females, respectively.

Conclusion

Cancer has become an important public health concern in Korea, and as the Korean population ages, the cancer burden will continue to increase.