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Regional disparities in major cancer incidence in South Korea, 1999–2018
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Eun Hye Park, Mee Joo Kang, Kyu-Won Jung, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Hyun-Joo Kong, Chang Kyun Choi, Jeong-Soo Im, Hong Gwan Seo
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Epidemiol Health. 2023;e2023089. Published online October 12, 2023
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DOI: https://doi.org/10.4178/epih.e2023089
[Accepted]
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 Abstract
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Abstract
OBJECTIVES
This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in South 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 sex 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 sex 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% 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.
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Summary
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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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