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Preventable cancer cases and deaths attributable to tobacco smoking in Korea from 2015 to 2030
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Soseul Sung, Jihye An, Jeehi Jung, Hyeon Sook Lee, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Daehee Kang, Keun-Young Yoo, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Hai-Rim Shin, Kwang-Pil Ko, Sue K. Park
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Epidemiol Health. 2025;47:e2025008. Published online February 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025008
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Abstract
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Abstract
OBJECTIVES Tobacco smoking is a major public health concern worldwide. This study aimed to assess its impact on cancer incidence and mortality by estimating the population attributable fraction (PAF) in the Korean population for 2015 and 2020 and by projecting future trends until 2030.
METHODS The Korean relative risk (RR) was calculated via a meta–analysis of RRs for individual cancers attributed to tobacco smoking, based on primary data analysis from the Korean Cohort Consortium. The PAF was estimated using the Levin formula with past and current prevalence rates and the number of cancer cases and deaths, assuming a 15-year latency period.
RESULTS The proportions of cancer cases and deaths in Korea attributable to tobacco smoking were similar to those calculated using Asian and global RRs for both male and female. In 2015 and 2020, tobacco smoking contributed to 14.32% and 13.17% of cancer cases and 21.70% and 20.69% of cancer deaths in adults, respectively. Among Koreans, smoking was responsible for 25.83% of new cancer cases in male in 2015, 23.49% in male in 2020, 1.46% in female in 2015, and 1.68% in female in 2020. In both years, smoking impacted mortality more strongly than incidence in Korean male and female (incidence in male: 25.83% and 23.49%; mortality in male: 32.09% and 30.41%; incidence in female: 1.46% and 1.68%; and mortality in female: 4.70% and 4.96%, respectively).
CONCLUSIONS Tobacco smoking causes cancers and deaths in Korea, however, it is preventable. Effective control policies that consider trends and vulnerabilities among female are required.
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Summary
Korean summary
한국에서 흡연으로 인한 암 부담은 2015년 발생 14.32%, 사망 21.70%였고 2020년에는 발생 13.17%, 사망 20.69%로 나타남. 두 해 모두 남성에서 부담이 훨씬 컸음(남성: 발생 2015년 25.83%, 2020년 23.49%; 사망 2015년 32.09%, 2020년 30.41% / 여성: 발생 2015년 1.46%, 2020년 1.68%; 사망 2015년 4.70%, 2020년 4.96%). 흡연은 예방 가능한 주요 원인이므로, 여성의 취약성과 추세를 고려한 보다 강력한 금연·규제 정책 강화가 필요함.
Key Message
In Korea, tobacco smoking accounted for 14.32% of incident cancers and 21.70% of cancer deaths in 2015, and 13.17% of incidence and 20.69% of mortality in 2020. The burden was much greater in men than in women in both years (men: incidence 25.83% in 2015 and 23.49% in 2020; mortality 32.09% in 2015 and 30.41% in 2020; women: incidence 1.46% in 2015 and 1.68% in 2020; mortality 4.70% in 2015 and 4.96% in 2020). Smoking remains a preventable driver of substantial cancer incidence and mortality, calling for stronger control policies that also address emerging vulnerabilities among women.
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Preventable cancer cases and deaths attributable to alcohol consumption in Korea from 2015 to 2030
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Soseul Sung, Jihye An, Jeehi Jung, Hyeon Sook Lee, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Kwang-Pil Ko, Sue K. Park
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Epidemiol Health. 2025;47:e2025009. Published online February 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025009
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Abstract
OBJECTIVES Alcohol consumption is causally linked to several cancers, and major health organizations classify it as a carcinogen. This study assessed the impact of alcohol consumption on cancer incidence and mortality in Korea in 2015 and 2020, projected trends up to 2030, and compared results based on different criteria.
METHODS The relative risk of cancer associated with alcohol consumption in Korea was determined through a meta-analysis of alcohol-related relative risks for specific cancers, using primary data from the Korean Cohort Study within the Korean Cohort Consortium. The population-attributable fraction (PAF) was calculated using Levin’s formula, incorporating drinking prevalence and the number of cancer cases and deaths, with a 15-year latency period assumed.
RESULTS In Korea, the PAF for alcohol consumption, based on ever/never drinking criteria, was higher than that calculated using other criteria, except for the PAF based on past and current/never drinking criteria. Alcohol consumption contributed to 3.58% of all cancer cases and 3.28% of cancer deaths in 2015. It accounted for 4.58% of new cancer cases in male and 2.08% in female, with a higher contribution to incidence than mortality (4.00 and 2.25% of cancer deaths in male and female, respectively). Projections indicate that alcohol-related cancer PAF will decrease by 17.2% in male but increase by 70.2% in female by 2030.
CONCLUSIONS This study highlights the impact of alcohol consumption on cancer in Korea, emphasizing the need for sex-specific regulations to address sex differences.
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Summary
Korean summary
2015년 알콜 섭취는 한국에서 전체 암 발생의 3.58%, 암 사망의 3.28%를 차지했으며, 남성(4.58%)이 여성(2.08%)보다 더 큰 영향을 받았음. 2030년까지 남성의 알콜 관련 암 발생률은 감소할 것으로 예상되지만, 여성에서는 급증할 것으로 보임. 이러한 결과는 특히 여성에서 증가하는 추세를 반영하여 성별 맞춤형 공공 보건 정책의 필요성을 시사함.
Key Message
In 2015, alcohol consumption was responsible for 3.58% of all cancer cases and 3.28% of cancer deaths in Korea, with a more significant impact on males (4.58% of new cases) than females (2.08%). Projections indicate a decrease in alcohol-related cancer cases among males but a sharp increase in females by 2030. These findings highlight the need for sex-specific public health measures to address the growing impact of alcohol on cancer, particularly the increasing trend in female cases.
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Preventable cancer cases and deaths attributable to deficit of physical activity in Korea from 2015 to 2030
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Soseul Sung, Sungji Moon, Jihye An, Jeehi Jung, Hyeon Sook Lee, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Inah Kim, Jung Eun Lee, Sun Ha Jee, Aesun Shin, Ji-Yeob Choi, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Jeong-Soo Im, Hong Gwan Seo, Sohee Park, Kwang-Pil Ko, Sue K. Park
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Epidemiol Health. 2025;47:e2025010. Published online January 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025010
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OBJECTIVES This study aimed to determine the population-attributable fractions (PAFs) of cancers using various calculation methods and to estimate the PAFs of cancer incidence and mortality resulting from deficit in physical activity (DPA) from 2015 to 2030, based on data on prevalence rates.
METHODS The PAF of cancer was estimated using a cohort study-based meta-analysis of relative risk (RR), national prevalence rates of DPA from 2000 to 2015, and national cancer statistics from 2015 to 2030, with a latency of 15 years.
RESULTS In 2015, DPA contributed to 909 cancer cases and 548 deaths, accounting for 0.42% and 0.68% of new cancer cases and deaths, respectively. By 2030, the PAF values are expected to increase to 1.31% of incidence and 1.80% of mortality, with a continual increase from 2015 to 2030. When the low metabolic equivalent of task (MET) criteria were selected, the PAF values decreased for both incidence and mortality. The PAF calculated with <900 MET-min/wk for the sex-specific MET criterion was higher than that calculated with <900 MET-min/wk for both incidence and mortality.
CONCLUSIONS The risk of cancer associated with DPA is expected to rise in both male and female. Future research and strategies should emphasize the promotion of physical activity for cancer prevention, considering its significant implications for public health.
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Summary
Korean summary
2015년 신체활동 부족(deficit in physical activity, DPA)에 의한 인구집단기여분율(population-attributable fraction, PAF)은 암 발생 0.42%(909건), 암 사망 0.68%(548건)였으며 2030년에는 각각 1.31%, 1.80%로 증가할 것으로 예측됨. 남녀 모두에서 DPA로 인한 암 부담이 증가하고 있으므로, 암 예방을 위한 신체활동 증진 전략을 강화할 필요가 있음.
Key Message
In 2015, deficit in physical activity (DPA) accounted for 0.42% of incident cancers (909 cases) and 0.68% of cancer deaths (548 deaths), with population-attributable fraction (PAF) values projected to rise to 1.31% for incidence and 1.80% for mortality by 2030. The cancer burden attributable to DPA is increasing in both sexes, underscoring the need to strengthen population-level physical-activity promotion for prevention.
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Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in Korea
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Minsung Cho, Hyeok-Hee Lee, Jang-Hyun Baek, Kyu Sun Yum, Min Kim, Jang-Whan Bae, Seung-Jun Lee, Byeong-Keuk Kim, Young Ah Kim, JiHyun Yang, Dong Wook Kim, Young Dae Kim, Haeyong Pak, Kyung Won Kim, Sohee Park, Seng Chan You, Hokyou Lee, Hyeon Chang Kim
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Epidemiol Health. 2024;46:e2024001. Published online December 26, 2023
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DOI: https://doi.org/10.4178/epih.e2024001
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14,866
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Abstract
OBJECTIVES The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review.
METHODS We first established a concept and definition of “hospitalization episode,” taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms’ accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm-identified events.
RESULTS We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.
CONCLUSIONS We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.
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Summary
Key Message
In this study, we developed algorithms to identify acute myocardial infarction (AMI) and stroke events from the Korean National Health insurance Service database. To validate them, we conducted retrospective review of medical records across 24 hospitals throughout Korea. The overall positive predictive values for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.
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Sung‐Ho Ahn, Hye Sun Lee, Jun‐Hyuk Lee Journal of Cachexia, Sarcopenia and Muscle.2025;[Epub] CrossRef - Confidence-linked and uncertainty-based staged framework for phenotype validation using large language models
Sumin Lee, Hyeok-Hee Lee, Hokyou Lee, Kyu Sun Yum, Jang-Hyun Baek, Jaewon Khil, Jaeyong Lee, Sojung Shin, Minsung Cho, Na Yeon Ahn, Seng Chan You, Hyeon Chang Kim Journal of the American Medical Informatics Association.2025; 32(8): 1320. CrossRef - Cardiovascular risk across blood pressure categories defined by the 2024 ESC and 2023 ESH hypertension guidelines: insights from a Korean nationwide cohort study
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Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim Epidemiology and Health.2023; 46: e2024003. CrossRef
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Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women’s Health-Related Issues
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Eunji Choi, Ha Na Cho, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee
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Epidemiol Health. 2019;41:e2019005. Published online February 13, 2019
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DOI: https://doi.org/10.4178/epih.e2019005
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23,477
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Abstract
OBJECTIVES While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.
METHODS Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.
RESULTS Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.
CONCLUSIONS Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.
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Summary
Korean summary
한국 성인 여성의 과체중 및 비만유병률은 서구여성에 비해 낮으며 2005년 이후 큰 변화 없이 약40%대로 일정하게 유지되어왔으나, 사회경제적불평등에 대한 연구는 체계적으로 이루어지지 않음.
경사불평등(Slope index of inequality)과 상대불평등(Relative index of inequality) 지표를 사용하여 비만유병률에서 발견되는 사회경제적불평등을 조사한 결과, 교육수준별 불평등이 유의하게 나타남.
19-44세의 젊은 여성층에서는 소득수준이 낮은 집단에, 65-79세의 노년기 여성층에서는 도시화된 지역에 사는 집단에 비만유병률이 치중되어있음.
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Citations
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Dumilah Ayuningtyas, Dian Kusuma, Vilda Amir, Dwi Hapsari Tjandrarini, Pramita Andarwati Nutrients.2022; 14(16): 3332. CrossRef - Socioeconomic Disparities in Cardiovascular Health in South Korea
Chi-Young Lee, Eun-Ok Im Journal of Cardiovascular Nursing.2021; 36(1): 8. CrossRef - Incidence and risk of venous thromboembolism according to primary treatment in women with ovarian cancer: A retrospective cohort study
Jin-Sung Yuk, Banghyun Lee, Kidong Kim, Myoung Hwan Kim, Yong-Soo Seo, Sung Ook Hwang, Sang-Hee Yoon, Yong Beom Kim, Wen-Chi Chou PLOS ONE.2021; 16(4): e0250723. CrossRef - Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys
SuJin Song, Jae Eun Shim Korean Journal of Community Nutrition.2021; 26(6): 495. CrossRef - Regional disparities in the associations of cardiometabolic risk factors and healthy dietary factors in Korean adults
Kyungho Ha, YoonJu Song, Hye-Kyeong Kim Nutrition Research and Practice.2020; 14(5): 519. CrossRef
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National Epidemiologic Survey of Thyroid cancer (NEST) in Korea
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Chang-Mo Oh, Hyun-Joo Kong, Eunyang Kim, Hyejin Kim, Kyu-Won Jung, Sohee Park, Young-Joo Won
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Epidemiol Health. 2018;40:e2018052. Published online October 26, 2018
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DOI: https://doi.org/10.4178/epih.e2018052
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Abstract
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).
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