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Aesun Shin 8 Articles
The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care
Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin
Epidemiol Health. 2022;44:e2022044.   Published online May 1, 2022
DOI: https://doi.org/10.4178/epih.e2022044
  • 3,806 View
  • 286 Download
  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.
METHODS
A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.
RESULTS
A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.
CONCLUSIONS
During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.
Summary
Korean summary
코로나19 이전인 2019년에 비해 코로나19 유행 첫 해인 2020년에 암환자의 1개 상급종합병원 응급실 방문이 유의하게 감소하였고, 특히 코로나19 의심 증상이 있거나, 중증도가 높거나, 비수도권 지역에 거주하는 환자에서 응급실 방문의 감소가 뚜렷하였다. 코로나19 이전과 코로나19 유행 시 외래 방문 암환자의 수, 신환 수는 큰 차이가 없었고, 입원한 암환자의 수 역시 유의한 차이가 없었다. 코로나19 대유행 시 암환자의 응급실 방문 감소는 병원 밖에서 적시에 응급실에 방문하지 못하는 부수적 피해의 가능성을 시사하여, 이에 대한 관심이 필요하다.
Key Message
The study identified a significant decrease in the emergency department visits of the cancer patients at a tertiary hospital in Korea during the COVID-19 pandemic. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between pre-COVID-19 and during-COVID-19 periods.

Citations

Citations to this article as recorded by  
  • COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
    Shin-Woo Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
The impact of COVID-19 on screening for colorectal, gastric, breast, and cervical cancer in Korea
Hyeree Park, Seung Hee Seo, Jong Heon Park, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
Epidemiol Health. 2022;44:e2022053.   Published online June 21, 2022
DOI: https://doi.org/10.4178/epih.e2022053
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  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening.
METHODS
Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals.
RESULTS
The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer).
CONCLUSIONS
After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.
Summary
Korean summary
본 연구는 코로나 대유행 기간 전과 후 대장암, 위암, 유방암, 자궁경부암 검진 수검률 차이를 비교하고자 하였다. 첫 코로나 확진자가 발생한 2020년을 코로나 대유행 기간, 전년도 기간인 2019년을 코로나 대유행 전 기간으로 설정하며 국민건강보험공단에서 집계된 전수자료를 이용하여 암 검진 대상자 수와 수검자 수를 비교 분석하였다. 4개 암종 모두에서 2019년도와 비교하여 2020년도에 전국적으로 수검률이 감소하는 경향이 있었으며, 1차 대유행이 있었던 3월과 3차 대유행 시기인 12월에 2019년도 동기간과 비교하여 수검률이 크게 감소하였고, 80대 이상 노인 인구에서 감소폭이 다른 연령대와 비교하여 크게 나타났다.
Key Message
We found decline of the colorectal, gastric, breast and cervical cancer screening participation rates in 2020 following the two major COVID-19 waves, compared with those of 2019, and the highest decline was observed in the elderly population aged 80 years and older.

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  • Impact of the COVID-19 Pandemic on Gastric Cancer Screening in South Korea: Results From the Korean National Cancer Screening Survey (2017–2021)
    Kyeongmin Lee, Mina Suh, Jae Kwan Jun, Kui Son Choi
    Journal of Gastric Cancer.2022; 22(4): 297.     CrossRef
  • Impact of frailty on survival and readmission in patients with gastric cancer undergoing gastrectomy: A meta-analysis
    Xiaoyan Wang, Yimeng Sun, Pei Wang, Yu Jie, Guodong Liu, Dandan Gong, Yu Fan
    Frontiers in Oncology.2022;[Epub]     CrossRef
Association of the inflammatory balance of diet and lifestyle with colorectal cancer among Korean adults: a case-control study
Shinyoung Jun, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim
Epidemiol Health. 2022;44:e2022084.   Published online September 30, 2022
DOI: https://doi.org/10.4178/epih.e2022084
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Dietary and lifestyle exposures may affect the risk of colorectal cancer (CRC) by promoting chronic inflammation. Therefore, we assessed the separate and joint associations of dietary and lifestyle inflammation scores (DIS and LIS, respectively) with CRC.
METHODS
Data from 919 pathologically confirmed CRC cases and 1,846 age- and sex-matched controls recruited at the National Cancer Center Korea were analyzed. We calculated the DIS and LIS, which characterize the collective contributions of 19 dietary and 4 lifestyle factors, respectively, to systemic inflammation by applying weights based on high-sensitivity C-reactive protein. A higher score represented a higher balance of pro- to anti-inflammatory exposures. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for CRC risk compared across the DIS and LIS tertile categories, with the lowest tertile as the reference group.
RESULTS
The highest DIS tertile had significantly increased odds of having CRC (OR, 2.65; 95% CI, 2.10 to 3.36), and the odds increased with increasing DIS. The highest LIS tertile group had 1.28-fold higher odds of having CRC (95% CI, 1.03 to 1.58). In the cross-classification analysis, the odds of having CRC increased as the DIS and LIS jointly increased until the DIS reached the highest tertile, where the risk was very high (3-fold or more) regardless of the LIS.
CONCLUSIONS
In conclusion, a higher balance of pro-inflammatory relative to anti-inflammatory dietary and lifestyle factors, especially dietary factors, was associated with higher CRC risk among Korean adults.
Summary
Korean summary
본 연구는 국립암센터에서 수집한 대장암 환자-대조군 데이터를 활용하여, 새롭게 개발된 식이 염증 지수(Dietary Inflammation Score, DIS) 및 생활습관 염증 지수(Lifestyle Inflammation Score, LIS)와 대장암 발생 위험 간의 연관성을 탐색하였다. 분석 결과, 식이 염증 지수 혹은 생활습관 염증 지수가 높은 집단에서 대장암 위험이 더 높아, 식이와 생활습관이 체내 염증 수준을 높여 대장암 발생 위험을 높일 가능성이 제기되었다
Key Message
Dietary inflammation score (DIS) and lifestyle inflammation score (LIS) quantify the collective effect of dietary and lifestyle factors, respectively, on systemic inflammation. In this case-control study, we assessed the associations of DIS and LIS with colorectal cancer risk among Korean adults. Our results suggest that a higher balance of pro-to anti-inflammatory dietary and lifestyle factors may be associated with higher risk for colorectal cancer. The findings from our study support that reducing inflammation through dietary or lifestyle changes could potentially reduce the risk for colorectal cancer.
Association between gallstones and the risk of biliary tract cancer: a systematic review and meta-analysis
Dan Huang, Hyundeok Joo, Nan Song, Sooyoung Cho, Woosung Kim, Aesun Shin
Epidemiol Health. 2021;43:e2021011.   Published online February 3, 2021
DOI: https://doi.org/10.4178/epih.e2021011
  • 8,802 View
  • 343 Download
  • 7 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Biliary tract cancers (BTCs) are rare but highly fatal. Although the etiology of BTC is poorly understood, gallstones are proposed to be a major risk factor. We conducted a systematic review and meta-analysis to examine the associations between gallstone characteristics and BTC risk.
METHODS
We searched the MEDLINE, Embase, and Cochrane Central databases and systematically reviewed cohort and case-control studies published before April 9, 2018. All the included studies reported appropriate risk estimates and confidence intervals (CIs) for associations between the presence, size, number, or duration of gallstones and the risk of BTC, including gallbladder cancer (GBC), extrahepatic bile duct cancer (EBDC), and ampulla of Vater cancer (AOVC). Summary odds ratios (ORs) and their 95% CIs were calculated using a random-effects model in the meta-analysis. Subgroup analyses were conducted to inspect sources of potential heterogeneity, and the Egger test was performed to assess publication bias.
RESULTS
Seven cohort studies and 23 case-control studies in Asian, European, and American populations were included. The presence of gallstones was associated with an increased risk of BTC (OR, 4.38; 95% CI, 3.23 to 5.93; I2=91.2%), GBC (OR, 7.26; 95% CI, 4.33 to 12.18), EBDC (OR, 3.17; 95% CI, 2.24 to 4.50), and AOVC (OR, 3.28; 95% CI, 1.33 to 8.11). Gallstone size (>1 vs. <1 cm; OR, 1.88; 95% CI, 1.10 to 3.22) was significantly associated with the risk of GBC.
CONCLUSIONS
Gallstone characteristics, such as presence, size, and number, are associated with an increased risk of BTC. However, significantly high heterogeneity in the meta-analyses is a limitation of this study.
Summary
Korean summary
The prevalence of APCT-detected sacroiliitis in CD patients was higher than that in controls, but the condition was asymptomatic. The clinical significance of asymptomatic sacroiliitis in Korean CD patients remains unclear.
Key Message
본 연구에서는 체계적 문헌고찰과 메타분석법을 활용하여 여러 선행연구에서 담도계암 전반과 담석의 다양한 특성사이에 연관성이 있는지 탐구하였다. 총 30개의 문헌을 분석한 결과 담석의 존재 여부가 담도계암과 각 하위 암의 위험을 모두 높이는 것으로 나타났고, 담석의 크기가 클수록 담낭암의 위험이 높은 것으로 드러났다. 본 연구는 담석과 담도계암 전반의 연관성에 대해 체계적으로 정리한 최초의 문헌으로서 담석과 담도계암의 관계에 대한 이해의 폭을 넓히고, 추후 해당 주제로 추가 연구를 수행하는 데에 있어 기준점이 될 수 있으리라 기대한다.

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  • Cholecystectomy reduces the risk of cholangiocarcinoma in patients with complicated gallstones, but has negligible effect on hepatocellular carcinoma
    Hyeong Sik Ahn, Hyun Jung Kim, Tae Uk Kang, Seon Mee Park
    Journal of Gastroenterology and Hepatology.2022; 37(4): 669.     CrossRef
  • Primary spindle cell sarcoma of gallbladder
    Xin Long, Yan Chen, Wei-Xun Chen, Yu Wu, Jia Song, Jin Chen, Lei Zhang
    Medicine.2022; 101(2): e28549.     CrossRef
  • Circulating miRNA and cell-free DNA as a potential diagnostic tool in early detection of biliary tract cancer: a meta-analysis
    Aakansha Singh, Anjana Dwivedi
    Biomarkers.2022; 27(5): 399.     CrossRef
  • Immunogenetic clustering of 30 cancers
    Lisa M. James, Apostolos P. Georgopoulos
    Scientific Reports.2022;[Epub]     CrossRef
  • Risk factors for the occurrence of ampullary tumors: A case‐control study
    Piera Zaccari, Livia Archibugi, Giulio Belfiori, Enrico Nista, Giuseppe dell'Anna, Stefano Crippa, Tommaso Schepis, Matteo Tacelli, Francesca Aleotti, Maria Chiara Petrone, Alberto Mariani, Guido Costamagna, Antonio Gasbarrini, Alberto Larghi, Massimo Fal
    United European Gastroenterology Journal.2022; 10(7): 730.     CrossRef
  • Evolving Paradigms in the Systemic Treatment of Advanced Gallbladder Cancer: Updates in Year 2022
    Zishuo Ian Hu, Kian-Huat Lim
    Cancers.2022; 14(5): 1249.     CrossRef
  • Feedback Signaling between Cholangiopathies, Ductular Reaction, and Non-Alcoholic Fatty Liver Disease
    Tianhao Zhou, Debjyoti Kundu, Jonathan Robles-Linares, Vik Meadows, Keisaku Sato, Leonardo Baiocchi, Burcin Ekser, Shannon Glaser, Gianfranco Alpini, Heather Francis, Lindsey Kennedy
    Cells.2021; 10(8): 2072.     CrossRef
The age-standardized incidence, mortality, and case fatality rates of COVID-19 in 79 countries: a cross-sectional comparison and their correlations with associated factors
Dongui Hong, Sohyae Lee, Yoon-Jung Choi, Sungji Moon, Yoonyoung Jang, Yoon-Min Cho, Hyojung Lee, Sukhong Min, Hyeree Park, Seokyung Hahn, Ji-Yeob Choi, Aesun Shin, Daehee Kang
Epidemiol Health. 2021;43:e2021061.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021061
  • 13,816 View
  • 304 Download
  • 6 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population.
METHODS
The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R2). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated.
RESULTS
The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R2 between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly.
CONCLUSIONS
Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.
Summary
Korean summary
국가별 발생률, 사망률, 치명률을 WHO 표준 인구로 연령표준화하였고, 의료자원과 관계된 지표와의 상관관계를 파악하였다. 2021년 4월 6일 기준, 연령표준화 발생률, 사망률, 치명률이 가장 높은 나라는 각각 체코 (10만명당 14,253명), 멕시코 (10만명당 182명), 멕시코 (6.7%)이며, 60세 이상 노인은 사망률과 치명률이 더 높은 것으로 나타났다. 1인당GDP, 인구당 의사 수, 인구당 병상 수는 발생률과 양의 상관관계가, 치명률과는 음의 상관관계가 있었고 노인에게서는 상관관계가 약하게 나타났다. 코로나바이러스감염증-19로 인한 피해를 최소화하기 위해서 의료자원의 투입과 더불어 노인의 감염예방이 중요할 것이다.
Key Message
The incidence, mortality, and case fatality rates of 79 countries were age-standardized using the WHO standard population. The correlations between the rates and the healthcare resource-related factors were investigated. As of April 6, 2021, the countries with the highest age-standardized incidence, mortality, and case fatality rates were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively; the mortality and case fatality rates were higher among the elderly. GDP per capita, number of hospital beds per population, and number of doctors per population were associated positively with incidence rate, and negatively with case fatality rates: the correlations were weaker among the elderly. To minimize the burden caused by COVID-19, preventing the elderly from infection is important as well as supply of medical resources.

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  • Rapid establishment of a dedicated COVID-19 hospital in Mexico city during a public health crisis
    Roberto Tapia-Conyer, Rafael Ricardo Valdez-Vázquez, Julieta Lomelín-Gascón, Rodrigo Saucedo-Martínez, Luis Alberto Martinez-Juarez, Héctor Gallardo-Rincón
    Hospital Practice.2022; 50(3): 183.     CrossRef
  • Comparative epidemiology of five waves of COVID-19 in Mexico, March 2020–August 2022
    Iván de Jesús Ascencio-Montiel, Oscar David Ovalle-Luna, Ramón Alberto Rascón-Pacheco, Victor Hugo Borja-Aburto, Gerardo Chowell
    BMC Infectious Diseases.2022;[Epub]     CrossRef
  • Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019
    Jiaye Yu, Zhuo Wang, Qinyi Bao, Shuxin Lei, Yayu You, Zhehui Yin, Xiaojie Xie
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Is it possible to prepare for a pandemic?
    Robert Tucker Omberg, Alex Tabarrok
    Oxford Review of Economic Policy.2022; 38(4): 851.     CrossRef
  • Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
    Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
    Osong Public Health and Research Perspectives.2022; 13(6): 424.     CrossRef
  • The First Wave of COVID-19 in Forensic Psychiatry: A Rapid Review Series
    Y. Bodryzlova, A. J. Lemieux, A. Crocker
    Victims & Offenders.2022; : 1.     CrossRef
The classification capability of the Asia Pacific Colorectal Screening score in Korea: an analysis of the Cancer Screenee Cohort
Xuan Quy Luu, Kyeongmin Lee, Jeongseon Kim, Dae Kyung Sohn, Aesun Shin, Kui Son Choi
Epidemiol Health. 2021;43:e2021069.   Published online September 16, 2021
DOI: https://doi.org/10.4178/epih.e2021069
  • 4,482 View
  • 197 Download
  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to validate a simple risk assessment tool for estimating the advanced colorectal neoplasia (ACN) risk at colonoscopy screenings and potential factors relevant for implementing this tool in the Korean population.
METHODS
Our study analyzed data from the Cancer Screenee Cohort Study conducted by the National Cancer Center in Korea. The risk level was assessed using the Asia Pacific Colorectal Screening (APCS) score developed by the Asia-Pacific Working Group on Colorectal Cancer. Logistic regression models were used to examine the associations between colorectal-related outcomes and the risk level by APCS score. The discriminatory performance of the APCS score for various colorectal-related outcomes was assessed using C-statistics.
RESULTS
In 12,520 individuals, 317 ACN cases and 4,528 adenoma cases were found. The APCS tool successfully classified the study population into different risk groups, and significant differences in the ACN rate and other outcomes were observed. The APCS score demonstrated acceptable discrimination capability with area under the curve values ranging from 0.62 to 0.65 for various outcomes. The results of the multivariate logistic regression model revealed that the high-risk group had a 3.1-fold higher risk of ACN (95% confidence interval, 2.08 to 4.67) than the average-risk group. Body mass index (BMI) was identified as a significant predictor of ACN in both multivariate and subgroup analyses.
CONCLUSIONS
Our study highlighted significant differences in colorectal-related screening outcomes by colorectal risk level measured using the APCS score, and BMI could be used to improve the discriminatory capability of the APCS score.
Summary
Korean summary
검진의 위해성을 줄이면서 동시에 이득을 최대화할 수 있는 최적의 검진 프로그램은 암 발생 위험도를 고려하는 것이다. 이 연구는 Asia-Pacific Working Group on Colorectal Cancer에서 제안한 “Asia Pacific Colorectal Screening Score (APCS)”가 한국인에서 대장암 발생 위험도를 선별적으로 잘 구분해 낼 수 있음을 보여주었다. 나아가 대장암의 위험도 점수를 산출하는데 체질량지수가 중요한 예측 변수라는 것을 확인하였고, 한국인에서 대장암 발생 위험도의 변별력을 향상시키기 위해 기존의 APCS에 체질량지수를 추가할 것을 제안하였다.
Key Message
This study highlighted that the Asia Pacific Colorectal Screening Score by the Asia-Pacific Working Group on Colorectal Cancer could successfully classify Korean screenees into different risk groups with acceptable discriminatory capability. Furthermore, our study results also suggest that BMI is a significant predictor of colorectal-related health outcomes, which could be potentially added to the original APCS score for improving its discriminatory power.

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  • A scoping review of risk-stratified bowel screening: current evidence, future directions
    J. M. Cairns, S. Greenley, O. Bamidele, D. Weller
    Cancer Causes & Control.2022; 33(5): 653.     CrossRef
Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort
Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung
Epidemiol Health. 2021;43:e2021093.   Published online November 2, 2021
DOI: https://doi.org/10.4178/epih.e2021093
  • 4,084 View
  • 127 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.
METHODS
Medical use data of colorectal cancer patients were obtained from the Korean National Health Insurance Database from 2004 to 2018. We randomly selected 40% of all colorectal cancer patients (n=148,848). Cognitive impairment was defined as having 1 or more International Classification of Diseases, 10th revision diagnostic codes for dementia or mild cognitive impairment. Patients aged 18 years or younger, patients diagnosed with cognitive impairment before colorectal cancer diagnosis (n=8,225), and patients who did not receive primary resection (n=45,320) were excluded. The effects of individual chemotherapy regimens on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate the overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Landmark analyses with different lag times were conducted as sensitivity analyses.
RESULTS
Chemotherapy did not increase the risk of cognitive impairment in colorectal cancer patients (colon cancer: HR, 0.92; 95% confidence interval [CI], 0.83 to 1.03; rectal cancer: HR, 0.88; 95% CI, 0.75 to 1.04), while radiotherapy was negatively associated with cognitive impairment in rectal cancer patients (HR, 0.01; 95% CI, 0.84 to 0.99). Varying directions of the associations between regimens and cognitive impairment were detected. The adverse effect of certain chemotherapy regimens on cognition was more prominent in older adults.
CONCLUSIONS
Chemotherapy and radiotherapy did not increase the risk of cognitive impairment. Older patients with low cognitive reserve could be affected by the adverse cognitive effects of chemotherapy.
Summary
Korean summary
- 대장암 환자를 대상으로 한 항암화학요법 및 방사선요법은 인지기능저하의 위험을 높이지 않았다 - 일부 항암화학요법의 경우 고령의 대장암 환자에서 인지기능저하의 위험을 증가시킬 수 있다
Key Message
Results from nationwide cohort of Korea showed that chemotherapy and radiotherapy did not increase the risk of cognitive impairment in colorectal cancer patients.

Citations

Citations to this article as recorded by  
  • Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
    Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
    He-Ying Hu, Ya-Ru Zhang, Qiaolifan Aerqin, Ya-Nan Ou, Zuo-Teng Wang, Wei Cheng, Jian-Feng Feng, Lan Tan, Jin-Tai Yu
    Translational Psychiatry.2022;[Epub]     CrossRef
The Association between Helicobacter pylori Infection and Gastric Adenocarcinoma: a Review of the Literature.
So Young Oh, Aesun Shin, Seung Sik Hwang, Keun Young Yoo
Korean J Epidemiol. 2002;24(2):93-106.
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Abstract
PURPOSE
Stomach cancer is a major cancer in the world as well as in Korea. Helicobacter pylori infection was suggested causing atropic gastritis, but there has been a debate on the association with the gastric adenocarcinoma. We reviewed recent literatures and meta-analyses on the association between Helicobacter pylori infection and the development of gastric adenocarcinoma. PESULTS: The animal experiments suggested that Helicobacter pylori is a causative agent of gastric adenocarcinoma. Meta-analyses on the relationship between Helicobacter pylori infection and gastric adenocarcinoma showed increased risk in infected person, but the strength of association was varied with study design, characteristics of study participants and the nature of tumors.
CONCLUSIONS
Recent study results suggested that Helicobacter pylori is a necessary causative agent for development of gastric adenocarcinoma. Assessment of the association between Helicobacter pylori infection and other factors related with gastric cancer risks and the effects of the eradication therapy of Helicobacter pylori infection on the prevention of gastvic cancer need further evaluation.
Summary
Korean summary
Key Message

Epidemiol Health : Epidemiology and Health