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Original Article
Occurrence rate and estimated economic burden of pulp and periapical disease treatment among Korean older adults: a national population-based retrospective study
Hyeonjeong Go, Masae Kuboniwa, Youn-Hee Choi
Epidemiol Health. 2025;47:e2025035.   Published online July 3, 2025
DOI: https://doi.org/10.4178/epih.e2025035
  • 4,463 View
  • 59 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Maintaining healthy dentition is essential for the overall health of older adults. Treatment of pulp and periapical disease (PPD) is crucial for preserving teeth. This study assessed the occurrence rate and economic burden of PPD treatment in an older Korean population.
METHODS
Data were obtained for adults aged ≥65 years from the Korean National Health Insurance Services from 2014 to 2018. The occurrence rate was defined as the proportion of individuals who received ≥1 PPD treatment. The economic burden was estimated using both direct and indirect expenditures, calculated from a societal perspective. Regression analysis was performed to evaluate yearly trends in occurrence rate and economic burden.
RESULTS
Direct costs, which included insured and non-insured medical expenses, ranged from US$13.79 million to US$10.47 million. Indirect costs, comprising transportation and time costs, ranged from US$0.89 million to US$0.80 million. Total costs declined from US$14.68 million to US$11.36 million. The occurrence rate of PPD treatment decreased significantly from 1.24% to 0.91% (p<0.05). The economic burden also demonstrated a statistically significant downward trend, with total PPD costs decreasing from 0.00099% to 0.00066% of Korea’s GDP, and from 0.63% to 0.30% of the annual total dental care benefit costs between 2014 and 2018 (p<0.05).
CONCLUSIONS
The occurrence rate and estimated economic burden of PPD treatment significantly decreased among older Korean adults from 2014 to 2018. Conservative approaches to tooth preservation contribute to more effective oral health policies and help reduce the economic burden of oral disease treatments in an aging society.
Summary
Korean summary
· 한국 노년층에서 치수 및 치근단 질환 치료의 발생률과 경제적 부담은 연구 기간 동안 통계적으로 유의미하게 감소했습니다. · 이러한 연구 결과는 보존적 치과 치료가 고령화 사회에서 구강 질환으로 인한 경제적 부담을 줄이는 효과적인 구강 보건 정책이 될 수 있음을 시사합니다.
Key Message
· The occurrence rate and economic burden of pulp and periapical disease (PPD) treatment among older Korean adults have shown a statistically significant decrease over the study period. · These findings suggest that conservative dental treatment can serve as an effective oral health policy for reducing the economic burden of oral diseases in an aging society.
Epidemiologic Investigation
Spatiotemporal trends in severe complicated influenza among the local population in Taiwan region, 2003-2023
Kangjun Wu, Yujian Lu
Epidemiol Health. 2025;47:e2025016.   Published online April 2, 2025
DOI: https://doi.org/10.4178/epih.e2025016
  • 6,586 View
  • 76 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Severe influenza has raised considerable concern worldwide, and its incidence appears to have shifted in the context of globalization. This study aimed to examine the temporal, spatial, and demographic distributions of local severe influenza cases in Taiwan region from January 2003 to June 2023.
METHODS
We aggregated severe complicated influenza cases by month, area (city/county), age, and sex. The age-standardized incidence rate (ASIR) was calculated to compare differences across regions and populations. Yearly incidence rate ratios comparing males to females were also computed to assess sex differences.
RESULTS
A total of 16,459 cases were included from 2003 to 2023. Crude incidence rates per 100,000 population were 0.07-0.14 for 2003-2008, 3.64-9.81 for 2009-2019, and 0.00-1.87 for 2020-2023. Higher incidence rates were observed in Hualien and Taitung Counties, with average ASIRs exceeding 10.00 per 100,000 population, compared to other cities. Except for 2005 and 2007, the incidence among males exceeded that among females, with ASIR ratios ranging from 1.10 to 2.20. The highest incidence was observed among populations aged 0-4 and those aged ≥55.
CONCLUSIONS
The incidence of severe complicated influenza exhibited clear regional and demographic variations in Taiwan region. The observed rebound in incidence calls for increased vigilance to protect vulnerable populations from severe illness.
Summary
Key Message
In Taiwan Region, the incidence rate of severe complicated influenza was significantly higher between 2009 and 2019 compared to the periods both preceding and following this decade, with a notable resurgence trend emerging in 2023. Severe complicated influenza cases exhibited distinct spatial clustering patterns, particularly concentrated in Taichung and Hualien. Males faced elevated morbidity risks, while both young children and the elderly showed heightened vulnerability—though the elderly population drove the majority of cases.
Original Articles
Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi
Epidemiol Health. 2024;46:e2024074.   Published online September 11, 2024
DOI: https://doi.org/10.4178/epih.e2024074
  • 10,018 View
  • 115 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of women breast cancer from 2006 to 2015, using national data that covered all Korean women.
METHODS
We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.
RESULTS
When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based RD in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% confidence interval [CI], -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.
CONCLUSIONS
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
Summary
Korean summary
2006년부터 2015년 한국의 유방암 불평등 추세를 분석하면, 소득수준이 낮은 여성의 발생률은 상대적으로 낮음에도 불구하고 사망률은 높은 양상을 보였다. 유방암 검진과 치료에 있어 보다 형평성을 고려한 정책이 요구된다.
Key Message
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.

Citations

Citations to this article as recorded by  
  • Impact of fragmented care on cancer outcomes among korean women with breast and cervical cancer: a focus on regional and economic disparities
    Sun Jung Kim, Noorhee Son, Woo-Ri Lee, Dong-Woo Choi, Seojin Park, Kyu-Tae Han
    International Journal for Equity in Health.2025;[Epub]     CrossRef
Gender-specific associations among neck circumference, the rs9939609 FTO gene polymorphism, and the 14-year risk of metabolic syndrome in the Korean adult population
Inkyung Baik
Epidemiol Health. 2024;46:e2024072.   Published online August 23, 2024
DOI: https://doi.org/10.4178/epih.e2024072
  • 7,998 View
  • 83 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Limited data exist on the relation between neck circumference (NC) and the risk of developing metabolic syndrome (MS). This study investigated gender-specific associations between NC and the 14-year risk of MS and explored the impact of the FTO rs9939609 polymorphism on these associations.
METHODS
This population-based prospective cohort study involved 2,666 participants (1,301 men and 1,365 women), who were free of MS at baseline (2005-2006). Incident MS cases, defined by the presence of 3 or more criteria regarding blood pressure and blood levels of glucose, triglycerides, and high-density lipoprotein cholesterol, were identified through biennial examinations until 2020. NC measurements taken at baseline and between 2013 and 2014 were analyzed using Cox proportional hazard regression to determine gender-specific associations with MS risk.
RESULTS
Controlling for potential confounders such as waist circumference (WC), significant associations were observed in both genders. Individuals in the highest NC quartile exhibited more than a 2-fold higher MS risk than those in the lowest quartile; with hazard ratios of 2.37 (95% confidence interval [CI], 1.74 to 3.22) for men and 2.65 (95% CI, 1.89 to 3.72) for women (p for trend <0.001). No significant interaction was found between the <i>FTO</i> polymorphism and NC. In diagnostic test analyses, NC and WC demonstrated comparable area under the curve values in both genders.
CONCLUSIONS
The findings suggest that NC is as effective as WC for predicting the incidence of MS.
Summary
Korean summary
허리둘레는 고혈압, 고혈당, 고지혈증의 위험과 밀접한 관련성을 나타내므로, 대사증후군의 구성 요소로 사용되어 왔다. 하지만 허리둘레 측정 시 피험자의 복장, 자세, 공복 및 식후 상태, 호흡 상태에 따라 측정 오차가 발생한다고 알려졌다. 본 연구는 한국 성인을 대상으로 14년간 진행된 전향적 코호트 연구 자료를 분석하여 목둘레가 허리둘레를 대신해서 대사증후군 위험을 예측할 수 있다는 결과를 확인하였다.
Key Message
Waist circumference has served as an anthropometric component of metabolic syndrome based on data regarding close associations with high blood pressure, hyperglycemia, and dyslipidemia. However, measurement errors of waist circumference due to the subject’s clothing, posture, fasting or postprandial state, and respiratory phase have been pointed out. This 14-year prospective cohort study including Korean adults has revealed that neck circumference can serve as a comparative indicator to waist circumference for predicting metabolic syndrome risk.
Special Articles
Incidence and case fatality of stroke in Korea, 2011-2020
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
Epidemiol Health. 2024;46:e2024003.   Published online December 26, 2023
DOI: https://doi.org/10.4178/epih.e2024003
  • 23,212 View
  • 291 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Stroke remains the second leading cause of death in Korea. This study was designed to estimate the crude, age-adjusted and age-specific incidence rates, as well as the case fatality rate of stroke, in Korea from 2011 to 2020.
METHODS
We utilized data from the National Health Insurance Services from January 1, 2002 to December 31, 2020, to calculate incidence rates and 30-day and 1-year case fatality rates of stroke. Additionally, we determined sex and age-specific incidence rates and computed age-standardized incidence rates by direct standardization to the 2005 population.
RESULTS
The crude incidence rate of stroke hovered around 200 (per 100,000 person-years) from 2011 to 2015, then surged to 218.4 in 2019, before marginally declining to 208.0 in 2020. Conversely, the age-standardized incidence rate consistently decreased by 25% between 2011 and 2020. When stratified by sex, the crude incidence rate increased between 2011 and 2019 for both sexes, followed by a decrease in 2020. Age-standardized incidence rates displayed a downward trend throughout the study period for both sexes. Across all age groups, the 30-day and 1-year case fatality rates of stroke consistently decreased from 2011 to 2019, only to increase in 2020.
CONCLUSIONS
Despite a decrease in the age-standardized incidence rate, the total number of stroke events in Korea continues to rise due to the rapidly aging population. Moreover, 2020 witnessed a decrease in incidence but an increase in case fatality rates.
Summary
Key Message
This nationwide study using Korean National Health Insurance System data reveals a decade-long downward trend in overall stroke incidence rates. While the crude incidence rate showed a temporary increase from 2016 to 2019 before a slight decline in 2020, the age-standardized incidence rate consistently decreased over the study period. The study emphasizes the significance of continuous monitoring and preventive strategies to address stroke as a public health concern in Korea

Citations

Citations to this article as recorded by  
  • Perceptions of Integrated Medical Service Among Stroke Patients in South Korea: Self-Reported Web-Based Survey Study
    Han-Gyul Lee, Woo-Sang Jung, Ho Geol Woo, Seungwon Kwon, Sung Hyuk Heo
    Journal of Multidisciplinary Healthcare.2026; Volume 19: 1.     CrossRef
  • Effect of regular exercise on stroke prevention: an instrumental variables approach
    Wonseok Jeong
    BMC Public Health.2025;[Epub]     CrossRef
  • A Study on the Healthcare Workforce and Care for Acute Stroke: Results From the Survey of Hospitals Included in the National Acute Stroke Quality Assessment Program
    Jong Young Lee, Jun Kyeong Ko, Hak Cheol Ko, Hae-Won Koo, Hyon-Jo Kwon, Dae-Won Kim, Kangmin Kim, Myeong Jin Kim, Hoon Kim, Keun Young Park, Kuhyun Yang, Jae Sang Oh, Won Ki Yoon, Dong Hoon Lee, Ho Jun Yi, Heui Seung Lee, Jong-Kook Rhim, Dong-Kyu Jang, Yo
    Journal of Korean Medical Science.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
  • Association between triglyceride glucose-waist-adjusted waist index and incident stroke in Chinese adults: a prospective cohort study
    Yaqin Ye, Zhenyi He, Jingguo Wu, Junlin Wu, Yanbing Liang
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • G20 stroke burden 1990–2035: trends, projections and precision health insights
    Rongrong Chen, Xiangwen Li, Ruonan Zhao, Xufei Zhao, Lin Ma, Qi Miao, Rongqiang Zhang
    Neurological Sciences.2025; 46(11): 5863.     CrossRef
  • The Importance of Cost-Effectiveness in New Drug Approval: Stroke Burden and Tenecteplase Efficacy
    Hyuk Sung Kwon, Byung-Jo Kim
    Journal of Clinical Neurology.2025; 21(5): 363.     CrossRef
  • Clinical Practice Guideline for Stroke Rehabilitation in Korea—Part 2: Rehabilitation for Motor and Sensory Function (2024)
    Hyun Haeng Lee, Yong Wook Kim, Hyoung Seop Kim, Seung Nam Yang, Sun Im, Woo-Kyoung Yoo, Joon-Ho Shin, Min-Kyun Oh, Won-Seok Kim, Da-Sol Kim, Won Kee Chang, Seyoung Shin, Sekwang Lee, Doo Young Kim, Sung-Hwa Ko, Yeo Jun Yun, Yookyung Lee, Miyoung Choi, Suk
    Brain & Neurorehabilitation.2025;[Epub]     CrossRef
  • Explainable SHAP-XGBoost models for identifying important social factors associated with the atherosclerotic cardiovascular disease risk score using the LASSO feature selection technique
    Jungtae Choi, Jooeun Jeon, Hyoeun An, Hyeon Chang Kim
    Epidemiology and Health.2025; 47: e2025052.     CrossRef
Incidence and case fatality of acute myocardial infarction in Korea, 2011-2020
Yeeun Seo, Jenny Moon, Hyeok-Hee Lee, Hyeon Chang Kim, Fumie Kaneko, Sojung Shin, Eunji Kim, Jang-Whan Bae, Byeong-Keuk Kim, Seung Jun Lee, Min Kim, Hokyou Lee
Epidemiol Health. 2024;46:e2024002.   Published online December 26, 2023
DOI: https://doi.org/10.4178/epih.e2024002
  • 21,274 View
  • 212 Download
  • 5 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Cardiovascular diseases are a leading cause of mortality worldwide, and acute myocardial infarction (AMI) is particularly fatal condition. We evaluated the incidence and case fatality rates of AMI in Korea from 2011 to 2020.
METHODS
We utilized data from the National Health Insurance Services to calculate crude, age-standardized, and age-specific incidence rates, along with 30-day and 1-year case fatality rates, of AMI from 2011 to 2020. Age-standardized incidence rates were determined using direct standardization to the 2005 population.
RESULTS
The crude incidence rate of AMI per 100,000 person-years consistently increased from 44.7 in 2011 to 68.3 in 2019, before decreasing slightly to 66.2 in 2020. The age-standardized incidence rate of AMI displayed a 19% rise from 2011 to 2019, followed by a slight decline in 2020. The increasing trend for AMI incidence was more pronounced in males than in females. Both 30-day and 1-year case fatality rates remained stable among younger individuals but showed a decrease among older individuals. There was a minor surge in case fatality in 2020, particularly among recurrent AMI cases.
CONCLUSIONS
Over the past decade, the AMI incidence rate in Korea has consistently increased, with a slight downturn in 2020. The case fatality rate has remained relatively stable except for a minor increase in 2020. This study provides data for continuous surveillance, the implementation of targeted interventions, and the advancement of research aimed at AMI in Korea.
Summary
Key Message
This study observed the incidence rate of acute myocardial infarction using data from Korean National Health Insurance Service. From 2011 to 2019, the incidence rate increased, but there was a slight decrease in 2020. Additionally, the fatality rate remained relatively stable throughout the study period, except for an increase in 2020. The study emphasizes the importance of continuous monitoring and preventive strategies for effective management of acute myocardial infarction.

Citations

Citations to this article as recorded by  
  • American society for preventive cardiology 2024 cardiovascular disease prevention: Highlights and key sessions
    Akhil A. Chandra, Carlos Espiche, Maisha Maliha, Salim S Virani, Roger S Blumenthal, Fatima Rodriguez, Nathan D Wong, Martha Gulati, Leandro Slipczuk, Michael D Shapiro
    American Journal of Preventive Cardiology.2025; 21: 100919.     CrossRef
  • Estimating Hospitalization Incidence for Ischaemic Heart Disease Using National Health Insurance Claims Data
    Su-Jin Lee, Jong-Yeon Kim
    Journal of Health Informatics and Statistics.2025; 50(1): 57.     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
  • Late-onset bleeding due to displaced lesser trochanter after a short gamma nail: a case report
    Pavol Mikula, Katarína Schuberth, Melanie Rubenbauer-Beyerlein, Rupert Schupfner, Matthias Unseld, Hans Jürgen Heppner
    Case Reports in Emergency Surgery and Trauma.2025;[Epub]     CrossRef
  • The predictive role of dyspnea in left main and/or three-vessel coronary artery involvement in patients with myocardial infarction: an analytical cross-sectional study
    Ibrahim Behnam, Mahdi Basiri Moghaddam, Zahra Dalir, Mehrsa Basiri Moghaddam
    BMC Cardiovascular Disorders.2025;[Epub]     CrossRef
  • Comparison of the Prognostic Performance of Various Machine Learning Models in Patients with Acute Myocardial Infarction: Results from the COREA-AMI Registry
    Ji-Hoon Jung, Kyusup Lee, Kiyuk Chang, Youngkeun Ahn, Sung-Ho Her, Sangin Lee
    Medicina.2025; 61(10): 1783.     CrossRef
  • Epidemiology of acute myocardial infarction in the Russian Federation and abroad from 2017 to 2024
    Marina M. Petrova, Alena R. Anokhina, Sergey A. Ustyugov, Darya S. Kaskaeva, Aleksandr A. Evsyukov, Natalia A. Schneider
    CardioSomatics.2025; 16(3): 263.     CrossRef
  • Recurrent myocardial infarction as an unsolved problem of evidence-based medicine
    S. Yu. Martsevich
    Cardiovascular Therapy and Prevention.2024; 23(6): 4019.     CrossRef
Systematic Review
Dietary intake and cancer incidence in Korean adults: a systematic review and meta-analysis of observational studies
Ji Hyun Kim, Shinyoung Jun, Jeongseon Kim
Epidemiol Health. 2023;45:e2023102.   Published online November 30, 2023
DOI: https://doi.org/10.4178/epih.e2023102
  • 22,276 View
  • 266 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Cancer is a major health burden in Korea, and dietary factors have been suggested as putative risk factors for cancer development at various sites. This study systematically reviewed the published literature investigating the associations between dietary factors and cancer incidence among Korean adults, following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines. We focused on the 5 most studied cancer sites (stomach, colorectum, breast, thyroid, and cervix) as outcomes and dietary exposures with evidence levels greater than limited-suggestive according to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) panel’s judgment for any of the cancer sites. This resulted in the inclusion of 72 studies. Pooled estimates of the impact of dietary factors on cancer risk suggested protective associations of fruits and vegetables with risks for gastric cancer (GC), colorectal cancer (CRC), and breast cancer (BC) and dietary vitamin C with the risk of GC, as well as a harmful association between fermented soy products and the risk of GC. Despite the limited number of studies, we observed consistent protective associations of dietary fiber with GC and dietary fiber, coffee, and calcium with CRC. These findings are largely consistent with the WCRF/AICR expert report. However, pooled estimates for the associations of other salt-preserved foods with GC, meat with CRC, and dietary carotenoids and dairy products with BC did not reach statistical significance. Further studies with prospective designs, larger sample sizes, and diverse types of dietary factors and cancer sites are necessary.
Summary
Korean summary
한국 성인을 대상으로 주요 암종 발생과 관련된 식이 요인을 탐색한 72개 역학연구들을 체계적으로 리뷰하고 메타 분석한 결과, 과일 및 채소는 위암, 대장암, 유방암에 대한 보호 효과가 있으며, 식이 비타민 C는 위암 예방에 도움이 된다는 결과가 확인되었다. 반면, 염장 식품 중 발효 대두 제품은 위암 발생 위험을 증가시킬 수 있다. 향후 식이 섭취와 밀접하게 관련되었으나 기존 국내 연구가 부족한 암종과 다양한 식이 요인의 영향을 탐색하는 대규모 전향적 코호트 연구가 요구된다.
Key Message
We conducted a systematic review and meta-analysis on the associations between dietary factors and cancer incidence among Korean adults. Pooled estimates suggested protective associations of fruits and vegetables with risks for gastric cancer (GC), colorectal cancer (CRC), and breast cancer (BC) and dietary vitamin C with the risk of GC, as well as a harmful association between fermented soy products and GC risk. Further research is warranted, emphasizing longitudinal designs, larger sample sizes, and a comprehensive exploration of dietary factors, with a specific focus on anatomical sites with a substantial burden of disease but understudied in the context of diet.

Citations

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  • Genetic evidence of circulating metabolites linking to gastric cancers: a two-sample Mendelian randomization study
    Yu Haiwen, Liu Yongjian, Xie Penglong, Feng Wanting, Xu Dongchu
    Annals of Medicine & Surgery.2025; 87(2): 571.     CrossRef
  • Lacto-Fermented Fruits and Vegetables: Bioactive Components and Effects on Human Health
    Lei Wei, Wannes Van Beeck, Melanie Hanlon, Erin DiCaprio, Maria L. Marco
    Annual Review of Food Science and Technology .2025; 16(1): 289.     CrossRef
  • Association Between the Korean Healthy Eating Index (KHEI) and Healthcare Costs Among Adults: The Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2021
    Soyoung Kim, Minseon Park
    Nutrients.2025; 17(13): 2237.     CrossRef
  • A higher intake of white-edible-colored fruits and vegetables is associated with lower gastrointestinal cancer risk among Korean adults in a prospective cohort study
    Yujin Cho, Jeonghee Lee, Madhawa Gunathilake, Youngyo Kim, Shinyoung Jun, Jeongseon Kim
    Nutrition Research.2025; 142: 1.     CrossRef
  • Ethanol extracts of Rhynchosia nulubilis induce G2/M phase arrest by inducing deoxyribonucleic acid damage in human oral squamous cell carcinoma cells
    Young Sun Hwang
    Dental Journal.2025; 58(3): 273.     CrossRef
  • Food Preservatives and the Rising Tide of Early-Onset Colorectal Cancer: Mechanisms, Controversies, and Emerging Innovations
    Alice N. Mafe, Dietrich Büsselberg
    Foods.2025; 14(17): 3079.     CrossRef
  • Research progress on the effects of coffee on malignant tumors of the digestive system
    Shujuan Dai, Liang Shan, Chuanyin Wang, Xiangyun Meng, Jianjun Liu, Xiongwen Lv
    Pharmacological Research - Natural Products.2025; 9: 100425.     CrossRef
  • Regulatory Effects of Coffee/Chlorogenic Acid and Tea/Epigallocatechin-3-O-Gallate on microRNA in Association with Their Anticancer Activity
    Mamoru Isemura, Sumio Hayakawa, Tomokazu Ohishi, Noriyuki Miyoshi, Ryuuta Fukutomi, Yoriyuki Nakamura
    Current Issues in Molecular Biology.2025; 47(11): 898.     CrossRef
Original Articles
Regional disparities in major cancer incidence in Korea, 1999-2018
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, The Community of Population-Based Regional Cancer Registries
Epidemiol Health. 2023;45:e2023089.   Published online October 12, 2023
DOI: https://doi.org/10.4178/epih.e2023089
  • 16,400 View
  • 226 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
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.
Summary
Korean summary
이 연구는 한국 시군구 단위에서 지난 20년(1999-2018)간 주요 8개 암 발생률의 지역 간 격차를 조사하고, 최근 5년(2014-2018)의 암 발생 군집 가능성을 평가했습니다. 지역 간 격차는 여성에서 갑상선암, 남성에서는 폐암이 가장 큰 격차를 보였습니다. 군집 가능성은 여성의 경우 유방암, 남성의 경우 간암에서 가장 높았습니다. 전국 단위에서는 볼 수 없었던 지역 간 격차 및 군집 발생 가능성이 시군구 단위에서 발견되었고, 이러한 결과는 지역에 맞는 암 정책을 기획하고 실행하는 데 중요한 방향을 제시할 수 있을 것입니다.
Key Message
This study investigated regional disparities in the incidence of eight major cancers in Korea at the municipal level during 1999-2018 and assessed the possibility of cancer clusters during 2014-2018. Thyroid cancer in women and lung cancer in men showed the most significant regional disparities. Breast cancer in women and liver cancer in men displayed the highest possibility of clustering. Regional disparities and cancer clusters were identified locally, which were not detected nationally. These findings could provide valuable guidance for developing and implementing cancer policies that are tailored to local needs.

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  • Inequalities in breast cancer incidence and mortality in women with and without disabilities in South Korea: A population-based cohort study
    Hee-Yeon Kang, Eunjung Park, Thi Tra Bui, Byungmi Kim, Jin-Kyoung Oh
    Preventive Medicine Reports.2025; 59: 103242.     CrossRef
  • Medical travel patterns for hepatocellular carcinoma treatment in South Korea: National Health Insurance data from 2013 to 2021
    Sungmin Kim, Naeun Kim, Hyung-Sik Lee, Mina Kim, Hoseob Kim, Youngmin Choi
    World Journal of Gastrointestinal Oncology.2025;[Epub]     CrossRef
  • Hormone Replacement Therapy and Risks of Various Cancers in Postmenopausal Women with De Novo or a History of Endometriosis
    Hee Joong Lee, Banghyun Lee, Hangseok Choi, Minkyung Lee, Kyungjin Lee, Tae Kyoung Lee, Sung Ook Hwang, Yong Beom Kim
    Cancers.2024; 16(4): 809.     CrossRef
  • What is the relationship between the local population change and cancer incidence in patients with dyslipidemia: Evidence of the impact of local extinction in Korea
    Wonjeong Jeong, Dong‐Woo Choi, Woorim Kim, Kyu‐Tae Han
    Cancer Medicine.2024;[Epub]     CrossRef
Cancer incidence among male construction workers in Korea: a standardized incidence ratio analysis, 2009-2015
Soonsu Shin, Woo-Ri Lee, Jin-Ha Yoon, Wanhyung Lee
Epidemiol Health. 2023;45:e2023060.   Published online June 19, 2023
DOI: https://doi.org/10.4178/epih.e2023060
  • 12,949 View
  • 191 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Construction workers face an elevated risk for several types of cancer. Nevertheless, there is a lack of large-scale epidemiological studies examining the risk of all cancers in construction workers. This study aimed to investigate the risk of various cancers in male construction workers using the Korean National Health Insurance Service (NHIS) database.
METHODS
We used data from the NHIS database from 2009 to 2015. Construction workers were identified using the Korean Standard Industrial Classification code. We calculated the age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for cancer occurrence in male construction workers compared to all male workers.
RESULTS
Compared to all male workers, the SIRs for esophageal cancer (SIR, 1.24; 95% CI, 1.07 to 1.42) and malignant neoplasms of the liver and intrahepatic bile ducts (SIR, 1.18; 95% CI, 1.13 to 1.24) were significantly higher in male construction workers. The SIRs for malignant neoplasms of the urinary tract (SIR, 1.19; 95% CI, 1.05 to 1.35) and non-Hodgkin lymphoma (SIR, 1.21; 95% CI, 1.02 to 1.43) were significantly elevated in building construction workers. The SIR for malignant neoplasms of the trachea, bronchus, and lung (SIR, 1.16; 95% CI, 1.03 to 1.29) was significantly higher in heavy and civil engineering workers.
CONCLUSIONS
Male construction workers have an increased risk for esophageal cancer, liver cancer, lung cancer, and non-Hodgkin’s cancer. Our results indicate that tailored strategies for cancer prevention should be developed for construction workers.
Summary
Korean summary
건설 노동자는 작업환경에서 수많은 유해 인자에 노출되지만, 건설 노동자에서 암의 연령 표준화 발생비를 조사한 역학 연구는 부족하다. 이번 연구에서 식도암과 간담도암의 연령 표준화 발생비는 전체 남성 근로자에 비해 남성 건설 근로자에게서 증가하였다. 이러한 결과는 건설 근로자에서 암 위험이 증가했음을 나타내며, 이 직업군에서 암 예방을 위한 추가 연구와 정책이 필요함을 의미한다.
Key Message
Despite the exposure of construction workers to numerous hazardous substances at workplace, epidemiological studies investigating the risk of all cancers in this occupational group are lacking. In this study, the age-standardized incidence ratio of esophageal cancer and hepatobiliary cancers increased in male construction workers compared to all male workers. Our results underscore the increased several cancer risks faced by male construction workers, necessitating the development of tailored strategies for cancer prevention in this occupational group.
National trends and projection of chronic kidney disease incidence according to etiology from 1990 to 2030 in Iran: a Bayesian age-period-cohort modeling study
Fatemeh Shahbazi, Amin Doosti-Irani, Alireza Soltanian, Jalal Poorolajal
Epidemiol Health. 2023;45:e2023027.   Published online February 17, 2023
DOI: https://doi.org/10.4178/epih.e2023027
  • 21,093 View
  • 248 Download
  • 8 Web of Science
  • 12 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Chronic kidney disease (CKD) is a major public health problem worldwide. Predicting CKD incidence rates and case numbers at the national and global levels is vital for planning CKD prevention programs.
METHODS
Data on CKD incidence rates and case numbers in Iran from 1990 to 2019 were extracted from the Global Burden of Disease online database. The average annual percentage change was computed to determine the temporal trends in CKD age-standardized incidence rates from 1990 to 2019. A Bayesian age-period-cohort model was used to predict the CKD incidence rate and case numbers through 2030.
RESULTS
Nationally, CKD cases increased from 97,300 in 1990 to 315,500 in 2019. The age-specific CKD incidence rate increased from 168.52 per 100,000 to 382.98 per 100,000 during the same period. Between 2020 and 2030, the number of CKD cases is projected to rise to 423,300. The age-specific CKD incidence rate is projected to increase to 469.04 in 2030 (95% credible interval, 399.20 to 538.87). In all age groups and etiological categories, the CKD incidence rate is forecasted to increase by 2030.
CONCLUSIONS
CKD case numbers and incidence rates are anticipated to increase in Iran through 2030. The high level of CKD incidence in people with diabetes mellitus, hypertension, and glomerulonephritis, as well as in older people, suggests a deficiency of attention to these populations in current prevention plans and highlights their importance in future programs for the national control of CKD.
Summary
Key Message
Based on our findings, it is predicted that the number of chronic kidney patients in Iran will reach 423,300 people by 2030. Additionally, the age-specific incidence rate of chronic kidney disease (CKD) is projected to increase to 469.04 in the same year. The CKD incidence rate is forecasted to increase by 2030 in all age groups and etiological categories, including type 1 diabetes mellitus, type 2 diabetes mellitus, hypertension, glomerulonephritis, and other causes.

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  • Association of cardiovascular risk factors with diabetic kidney disease severity in the Iranian population
    Rad Ghannadzadeh Kermani Pour, Maryam Karimi Ghahfarokhi, Ali Golestani, Shahrzad Mohseni, Sepehr Khosravi, Alireza Azarboo, Mohammadreza Mohajeri-Tehrani, Mahnaz Pejman Sani, Ozra Tabatabaei-Malazy
    Scientific Reports.2026;[Epub]     CrossRef
  • Nationwide trends and incidence of blindness in patients with diabetic retinopathy identified using an age-period-cohort analysis
    Ju-Yeun Lee, Kunho Bae, Sangjun Lee, Sue K. Park
    Eye.2025; 39(1): 118.     CrossRef
  • Global, regional, and national burden of chronic kidney disease and its underlying etiologies from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021
    Ling Deng, Shujin Guo, Yuping Liu, Yaojia Zhou, Youren Liu, Xiaoxia Zheng, Xijie Yu, Ping Shuai
    BMC Public Health.2025;[Epub]     CrossRef
  • Application progress of bio-manufacturing technology in kidney organoids
    Runqi Mao, Junming Zhang, Haoxiang Qin, Yuanyuan Liu, Yuxin Xing, Wen Zeng
    Biofabrication.2025; 17(2): 022007.     CrossRef
  • Burdens of idiopathic developmental intellectual disability attributable to lead exposure from 1990 to 2021 and projection to 2035 in China: findings from the 2021 global burden of disease study
    Chaoqun Song, Feidan Deng, Lichun Qiao, Minghao Lin, Hui Zhang, Miaoqian Li, Changwei Zhao
    Frontiers in Public Health.2025;[Epub]     CrossRef
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    Mohadese Bahmani, Mostafa Bijani, Zhila Fereidouni, Azizallah Dehghan, Amene Modreki
    BMC Nephrology.2025;[Epub]     CrossRef
  • Trajectory Patterns of Metabolic Syndrome Severity Score and Risk of Chronic Kidney Diseases
    Ladan Mehran, Atefeh Amouzegar, Safdar Masoumi, Maryam Adib, Fereidoun Azizi, Atieh Amouzegar
    Kidney Diseases.2025; 11(1): 530.     CrossRef
  • Enhancement of Chronic Kidney Disease Health Literacy in Young Generation: Community Service in Islamic Boarding School
    Astri Dewayani, Rimbun Rimbun, Langgeng Agung Waskito, Dewi Ratna Sari, Viskasari Pintoko Kalanjati, Lucky Prasetiowati, Tania Ardiani Saleh, Fernanda Toriq Ainur, Abdillah Juang Airlangga, Fathiy Zakaria Aslama, Aafi Baharuddin Attamimi, Dinda Rachma
    Wikrama Parahita : Jurnal Pengabdian Masyarakat.2025; 9(2): 181.     CrossRef
  • Supporting Caregivers of Hemodialysis Patients: Applying the 5-A Self-management Model to Alleviate Caregiver Burden
    Zahra Zarmohammadi, Marzieh Khatooni, Mehdi Ranjbaran, Seyedeh Zahra Hosseinigolafshani
    Journal of Nursing and Midwifery Sciences.2024;[Epub]     CrossRef
  • Improving Drug- and Disease-related Knowledge of Patients with Chronic Kidney Disease: Randomized Controlled Trial from a Sri Lankan Outpatient Clinic
    Dilmi Wickramasinghe, Catherine Lynch, Judith Coombes, Shaluka Jayamanne, Shamila De Silva
    Asian Journal of Pharmaceutical Research and Health Care.2024; 16(2): 208.     CrossRef
  • Global forecasting of chronic kidney disease mortality rates and numbers with the generalized additive model
    Fatemeh Shahbazi, Amin Doosti-Irani, Alireza Soltanian, Jalal Poorolajal
    BMC Nephrology.2024;[Epub]     CrossRef
  • Exploring the Lived Experiences of Family Caregivers Who Provided End-of-Life Care to Hemodialysis Patients: A Phenomenological Study in Iran
    Sakineh Moghaddam Zeabadi, Ali Razaghpoor, Seyedehzahra Hosseinigolafshani
    Jundishapur Journal of Chronic Disease Care.2024;[Epub]     CrossRef
The associations of tobacco use, sexually transmitted infections, HPV vaccination, and screening with the global incidence of cervical cancer: an ecological time series modeling study
Luyan Zheng, Yushi Lin, Jie Wu, Min Zheng
Epidemiol Health. 2023;45:e2023005.   Published online December 13, 2022
DOI: https://doi.org/10.4178/epih.e2023005
  • 15,366 View
  • 155 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to quantify the temporal associations between cervical cancer incidence and cervical cancer-related factors and to predict the number of new cervical cancer cases averted under counterfactual scenarios compared to the status quo scenario.
METHODS
We described temporal trends in cervical cancer and associated factors globally from 1990 to 2019. We then used generalized linear mixed models to explore the impact of tobacco use, sexually transmitted infections (STIs), human papillomavirus (HPV) vaccination, and cervical screening on cervical cancer incidence. A counterfactual analysis was performed to simulate the most effective scenario for reducing cervical cancer incidence.
RESULTS
The worldwide incidence of cervical cancer showed a downward trend over the past 3 decades (estimated annual percentage change, -0.72%), although the incidence remained high (>30 cases per 100,000 persons) in sub-Saharan Africa, Latin America, and the Caribbean. Higher smoking and STI prevalence showed significant direct associations with the incidence of cervical cancer, whereas HPV vaccination and screening coverage showed significant inverse associations. If the strategic goals for accelerating the elimination of cervical cancer and tobacco control programs had been achieved in 2019, the largest decrease in the number of new cervical cancer cases would have been observed, with 54,169 fewer new cases of cervical cancer in 2019.
CONCLUSIONS
Our counterfactual analysis found that a comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence.
Summary
Key Message
A comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence in our counterfactual analysis.

Citations

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  • Determinants of cervical cancer incidence and mortality: A study on WHO countries
    Ferdane Betul Bolukbasi, Bayram Sahin
    Health Care for Women International.2025; : 1.     CrossRef
  • Analysis of urinary tobacco-specific nitrosamine 4- (methylnitrosamino)1-(3-pyridyl)-1- butanol (NNAL) and HPV infection in American women: National health and nutrition examination survey
    Daiwen Liang, Qi Zhang, Wenyu Li, Youkun Lin, Ashis K. Basu
    PLOS ONE.2024; 19(5): e0304499.     CrossRef
Nationwide trends in the incidence of tuberculosis among people with disabilities in Korea: a nationwide serial cross-sectional study
Jinsoo Min, So Young Kim, Jong Eun Park, Yeon Yong Kim, Jong Hyock Park
Epidemiol Health. 2022;44:e2022098.   Published online October 28, 2022
DOI: https://doi.org/10.4178/epih.e2022098
  • 14,673 View
  • 155 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Studies on the association between disabilities and tuberculosis (TB) are scarce. We aimed to assess the risk of active TB disease among people with disabilities.
METHODS
We conducted a nationwide serial cross-sectional study using national registry linkage databases from 2008 to 2017. The crude and age-standardized and sex-standardized incidence rates of TB were analyzed for each year according to the presence, type, and severity of disabilities. The crude incidence rate and odds of developing TB disease were examined with a multivariable logistic regression model using data from 2017.
RESULTS
The overall incidence of active TB decreased between 2008 and 2017. The age- and sex-standardized incidence rates of TB disease among people with disabilities were significantly higher than among those without disabilities throughout all observed years (p<0.001). As of 2017, the population with disabilities had a higher crude incidence rate of active TB disease than that without disabilities (119.9/100,000 vs. 48.5/100,000 person-years, p<0.001), regardless of sex, income level, and place of residence. Compared to those without disabilities, those with disabilities had higher odds of active TB (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.15 to 1.24). Individuals with mental disabilities (aOR, 1.51; 95% CI, 1.24 to1.84) had the highest odds of active TB incidence, followed by those with developmental disabilities (aOR, 1.30; 95% CI, 1.09 to 1.55).
CONCLUSIONS
People with disabilities are at a greater risk of developing TB disease. Active screening and care for TB cases would be beneficial for people with disabilities.
Summary
Korean summary
장애가 있는 사람은 이차적 건강 문제가 발생할 가능성이 더 높고 그들의 건강결정요인은 결핵 발생 위험 요인과 겹친다. 장애인은 비장애인에 비해 연령과 성별에 관계없이 활동성 결핵 발병률이 현저히 높았으며, 장애 유형 중 정신장애와 발달장애가 결핵에 더 취약한 것으로 나타났다. 장애인과 같이 결핵 감염 위험이 있는 취약계층을 파악하고 이들에게 결핵진단 및 항결핵치료의 어려움을 극복할 수 있도록 다학제적 지원을 제공하는 것이 중요하겠다.
Key Message
People with disabilities are more likely to develop secondary health conditions and their social determinants of health overlap with the risk factors for developing TB disease. We found that compared to people without disabilities, a markedly higher incidence of active TB disease among people with disabilities regardless of age and sex, and mental and developmental disabilities among types of disability were more prone to TB disease. It is critical to identify the vulnerable populations, such as people with disabilities, at risk of developing TB infection and provide them with multidisciplinary support to overcome any barriers during TB diagnosis and anti-TB treatment.

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  • Long-Term Mortality After Tuberculosis Among People With Disabilities in Korea
    Jinsoo Min, So Young Kim, Jong Eun Park, Yeon Yong Kim, Hee Soo Yang, Bo Hui Park, Seong Woo Jeon, Yu Jin Kim, Bumhee Yang, Kyoung Eun Yeob, Jong Hyock Park
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • People with disabilities are at risk of osteoporotic fractures: a population-based study in South Korea
    Ji Hyoun Kim, So Young Kim, Jong Eun Park, Yo Han Im, Hyunjeong Cho, Yeon Yong Kim, Jong-Hyock Park
    Journal of Public Health.2025; 47(4): 858.     CrossRef
  • HIV knowledge and access to testing for people with and without disabilities in low‐ and middle‐income countries: evidence from 37 Multiple Indicator Cluster Surveys
    Sara Rotenberg, Shanquan Chen, Jill Hanass‐Hancock, Calum Davey, Lena Morgon Banks, Hannah Kuper
    Journal of the International AIDS Society.2024;[Epub]     CrossRef
  • The Korea National Disability Registration System
    Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin
    Epidemiology and Health.2023; 45: e2023053.     CrossRef
  • Nationwide Trends in Osteoporosis in Koreans With Disabilities From 2008 to 2017
    Ji Hyoun Kim, So Young Kim, Jong Eun Park, Hyo Jong Kim, Hyun Jeong Jeon, Yeon Yong Kim, Jong‐Hyock Park
    JBMR Plus.2023;[Epub]     CrossRef
  • Growing disparity in the prevalence of chronic obstructive pulmonary disease between people with and without disabilities: a Korean nationwide serial cross-sectional study
    Jinsoo Min, Jong Eun Park, So Young Kim, Yeon Yong Kim, Jong Hyock Park
    Scientific Reports.2023;[Epub]     CrossRef
Incidence of edentulism among older adults using the Korean National Health Insurance Service database, 2013-2018
Hyeonjeong Go, Eun-Kyong Kim, Hoi-In Jung, Song Vogue Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi
Epidemiol Health. 2022;44:e2022091.   Published online October 17, 2022
DOI: https://doi.org/10.4178/epih.e2022091
  • 18,735 View
  • 280 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Population aging is rapidly accelerating worldwide. Oral diseases related to aging are also on the rise. This study examined trends in the incidence of edentulism among the older Korean population using data from the Korean National Health Insurance Service (KNHIS).
METHODS
Data on older adults, aged ≥75 years of age, were obtained from the KNHIS for the period 2013-2018. Edentulism was defined as a treatment history of complete dentures in the KNHIS database. The exclusion criteria consisted of both disease codes and treatment codes related to conservative dental treatment, including periodontal and extraction treatment afterward. Crude incidence rates (CIRs) and age-standardized incidence rates (AIRs) with 95% confidence intervals were calculated and reported per 100,000 person-years by the direct method. Trends were tested by Cochrane Armitage models.
RESULTS
Statistically significant increasing trends in both CIRs and AIRs were found among the older Korean population registered in the KNHIS (CIRs, 707.92 to 895.92; AIRs, 705.11 to 889.68; p<0.01). The incidence tended to increase in both genders (p<0.01). Both CIRs and AIRs in specific regions also showed slight but significant annual increases except for Jeju Island (p<0.01 or <0.05). The incidence showed increasing trends (p<0.01) in all income quintiles apart from the highest quintile. The edentulism incidence was highest in the lowest income group (the first quintile).
CONCLUSIONS
Our data showed that the incidence of edentulism among the elderly showed an increasing trend from 2013 to 2018. This result provides a basis for future epidemiological studies on the incidence of edentulism in the older Korean population.
Summary

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  • Awareness, Attitudes, Needs, and Demands Toward Tooth Replacement Options Among Patients at an Emirati University‐Setting Clinic
    Amaweya Alsammarraie, K. Sulafa El-Samarrai, Kelvin I. Afrashtehfar, Musab Saeed, Esraa Jaber, Berksam Amr Fatouh, Shahenda A. L. Sayed, Sara Khoshniyat, Wala Alkurdi, Mawada Abdelmagied, Boonlert Kukiattrakoon
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    Thair Mahroq, Ahmet Arslan, İbrahim Mutlu, Zakaria Al Joulaji
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    Dong Eun Im, Hye-Young Kang
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  • Clinical Performance and Longevity of Implant-Assisted Removable Partial Dentures Compared to Other Removable Prosthesis Types: A Systematic Review
    Robert-Cosmin Dinu, Cristian-Laurentiu Comanescu, Sergiu Drafta, Alexandru-Eugen Petre
    Dentistry Journal.2025; 13(9): 389.     CrossRef
  • Trend in the Incidence of Severe Partial Edentulism among Adults Using the Korean National Health Insurance Service Claim Data, 2014–2018
    Hyeonjeong Go, Hoi-In Jung, Song Vogue Ahn, Jeonghoon Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi
    Yonsei Medical Journal.2024; 65(4): 234.     CrossRef
  • Decomposition Analysis of the Prevalence of Denture Use Between Rural and Urban Older Individuals With Edentulism in China: Cross-Sectional Study
    Lei Yuan, Yuan Yuan, Haotian Ren, Feng Zhang, Zhe Zhao, Qinqin Jiang, Zhenbang Wei, Jin-hai Sun
    Interactive Journal of Medical Research.2024; 13: e48778.     CrossRef
  • Estimated economic costs of dental implants among older South Korean adults, 2015–2018
    Hyeonjeong Go, Jeonghoon Ahn, Song Vogue Ahn, Hosung Shin, Atsuo Amano, Youn‐Hee Choi
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Seroprevalence of SARS-CoV-2 antibodies during the third wave of COVID-19 in the Seoul metropolitan area of Korea
Kyuhyun Yoon, Jayeun Kim, Kyong Ran Peck, Hyun Soo Kim, Hyukmin Lee, Yoo-Sung Hwang, Soon Young Lee, Sung-il Cho, Hun Jae Lee, Yeong-gyeong Kim, Byoungguk Kim, June-Woo Lee, Ah-Ra Kim, Hyeon Nam Do, Dong-Hyun Kim
Epidemiol Health. 2022;44:e2022085.   Published online September 30, 2022
DOI: https://doi.org/10.4178/epih.e2022085
  • 15,362 View
  • 195 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
After the third wave of coronavirus disease 2019 (COVID-19), by mid-February 2021, approximately 0.16% of the Korean population was confirmed positive, which appeared to be among the lowest rates worldwide at that time. However, asymptomatic transmission is challenging for COVID-19 surveillance. Therefore, a community-based serosurvey of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted to understand the effectiveness of Korea’s strong containment strategy.
METHODS
We collected 5,002 residual sera samples from January 30 to March 3, 2021, from 265 medical facilities in Seoul, 346 in Gyeonggi Province, and 57 in Incheon. Sixty samples from tertiary institutions were excluded. We defined the sub-regions according to the addresses of the medical facilities where the specimens were collected. Elecsys Anti-SARS-CoV-2 was used for screening, and positivity was confirmed using the SARS-CoV-2 sVNT Kit. Prevalence was estimated using sampling weights and the Wilson score interval for a binomial proportion with a 95% confidence interval.
RESULTS
Among the 4,942 specimens, 32 and 25 tested positive for COVID-19 in the screening and confirmatory tests, respectively. The overall crude prevalence of SARS-CoV-2 antibodies was 0.51%. The population-adjusted overall prevalence was 0.55% in women and 0.38% in men. The region-specific estimation was 0.67% and 0.30% in Gyeonggi Province and Seoul, respectively. No positive cases were detected in Incheon.
CONCLUSIONS
The proportion of undetected cases in Korea remained low as of early 2021. Therefore, an infection control strategy with exhaustive tracing and widespread pre-emptive testing appears to be effective in containing community spread of COVID-19.
Summary
Korean summary
코로나19바이러스 감염병(COVID-19)의 한국 내 3차 대유행기인 2020년 말 이후, 2021년 1월 우리나라 인구의 약 0.16%가 누적 확진되었으며, 이는 세계에서 매우 낮은 비율을 보이는 국가 중 하나였습니다. 그러나 COVID-19의 무증상 전파는 감염 확산방지와 감시체계에 문제점들을 초래할 수 있어 지역사회 기반 혈청 조사를 통해 그 현황을 파악했습니다. 2021년 1월 30일부터 3월 3일까지 서울, 경기, 인천 등 수도권 소재 1, 2차 의료기관에서 수집된 혈액검체의 잔여혈청표본 4942개에 대해 Roche사의 Elecsys Anti-SARS-CoV-2를 이용한 1차 항체검사와, GenScript의 SARS-CoV-2 sVNT Kit를 이용하여 2차 중화항체유무를 확인하였다. 4942명의 검체 중 1차 검사와 2차 중화항체검사에서 각각 32명과 25명이 항체 양성이었다. SARS-CoV-2 항체의 전체 수도권 조유병률은 0.51%였습니다. 인구의 연령보정 전체 유병률은 0.47%였으며, 성별로는 여성에서 0.55%, 남성에서 0.38%였습니다. 지역별 추정치는 경기도와 서울이 각각 0.67%와 0.30%였고, 인천에서는 양성사례가 발견되지 않았습니다. 한국의 미발견 사례 비율은 누적 확진율의 3배에 달하지만, 여전히 1% 미만으로 ​​낮습니다. 철저한 추적과 광범위한 선제적 검사를 통한 감염 관리 전략이 지역사회에서 바이러스 확산을 억제하는 데 효과적이었던 것으로 보입니다.
Key Message
Around February 2021, the SARS-CoV-2 antibody test was conducted on the residual serum of adults (≥19 years) collected from primary and secondary medical institutions in the metropolitan area in South Korea. The estimated overall prevalence was 0.60% in the electrochemiluminescence immunoassay (ECLIA) detecting IgG against the nucleocapsid protein and 0.47% for the neutralization antibody. The positivity of the confirmed test using surrogate neutralizing antibodies was only 78% of the ECLIA’s results. For prevention and control measures against the spread of SARS-CoV-2 infections and new variants emerge, serosurvey targeting community-dwelling people is needed to understand the changing status in the community.

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Review
Epidemiology of myocardial infarction in Korea: hospitalization incidence, prevalence, and mortality
Rock Bum Kim, Jang-Rak Kim, Jin Yong Hwang
Epidemiol Health. 2022;44:e2022057.   Published online July 12, 2022
DOI: https://doi.org/10.4178/epih.e2022057
  • 29,772 View
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  • 25 Web of Science
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AbstractAbstract AbstractSummary PDF
Abstract
Few studies have comprehensively presented epidemiological indicators of myocardial infarction in Korea. However, multiple published articles and open-source secondary data on the epidemiology of myocardial infarction are now available. This review summarized the hospitalization incidence, prevalence, and mortality rate of myocardial infarction in Korea using articles and open-source data from the Health Insurance Service and the Department of Statistics, surveys of sample populations, registries of patients, and other sources. The epidemiological indicators of myocardial infarction were compared between Korea and other high-income countries. The incidence of hospitalization due to myocardial infarction in Korea was 43.2 cases per 100,000 population in 2016 and has consistently increased since 2011. It was 2.4 times higher among men than among women. The estimated prevalence among adults over 30 years of age ranged from 0.34% to 0.70% in 2020; it was higher among men and increased with age. The mortality in 2020, which was 19.3 per 100,000 population in 2020, remained relatively stable in recent years. Mortality was higher among men than among women. Based on representative inpatient registry data, the proportion of ST-elevated myocardial infarction decreased until recently, and the median time from symptom onset to hospital arrival was approximately 2 hours and 30 minutes. The hospitalization incidence, prevalence, and mortality rate of myocardial infarction were lower in Korea than in other countries, although there was an increasing trend. Comprehensive national-level support and surveillance systems are needed to routinely collect accurate epidemiological indicators.
Summary
Korean summary
○우리나라의 심근경색증 발생률은 2016년 기준 인구 10만명 당 43.2명으로 추정되며 2011년 이후 증가하고 있음. ○ 30세 이상 인구에서 심근경색증 유병률은 0.34% (건강보험청구데이터) 또는 1.0% (국민건강영양조사)로 추정됨. ○ 전체인구에서 심근경색증으로 인한 사망률은 2019년 인구 10만명 당 18.8명으로 최근 큰 변화가 없거나 약간 감소하는 추세임.
Key Message
This review article showed the hospitalized incidence, prevalence, mortality, and features on patient registry of myocardial infarction in Korea from published articles and opened data sources.

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COVID-19: Original Article
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
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  • 13 Web of Science
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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 (R<sup>2</sup>). 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 R<sup>2</sup> 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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Brief Communication
Cancer incidence in the Tobruk area, eastern Libya: first results from Tobruk Medical Centre
Faisal Ismail, Ahmed G. Elsayed, Islam El-Garawani, Eman Abdelsameea
Epidemiol Health. 2021;43:e2021050.   Published online August 3, 2021
DOI: https://doi.org/10.4178/epih.e2021050
  • 20,711 View
  • 366 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Cancer is a major cause of morbidity and mortality worldwide, and it is an increasing problem in developing countries. Estimation of the incidence of cancer is important, especially in regions with limited epidemiological data on cancer. Therefore, the aim of this study was to provide an updated report on the incidence of cancers in the Tobruk region in eastern Libya.
METHODS
Data on cancer patients from the records of the Department of Histopathology of Tobruk Medical Centre from January 2013 to June 2020 were included.
RESULTS
In total, 402 cases were recorded. Men patients accounted for 30.3% (n=122) of cases, and women patients represented 69.6% (n=280). The overall mean age at the time of the first diagnosis was 49.0±17.1 years. The most common malignancies were breast and uterine cancer in women (18.4%, n=74; 15.9%, n=64, respectively), colorectal cancer (11.6%, n=47; 26 in women and 21 in men), bladder cancer (8.2%, n=33; 8 in women and 25 in men), and thyroid cancer (8.0%, n=32; 23 in women and 9 in men).
CONCLUSIONS
Breast and uterine cancers were the most common cancers in women, and bladder and colorectal cancer were the most common cancers in men, followed by colorectal cancer in both genders. These data will help health authorities launch preventive plans for cancer in the region. Further studies to identify aetiological factors and cancer-related risk factors need to be conducted in the region.
Summary
Key Message
Cancer incidence in the Tobruk area, eastern Libya: first results from Tobruk Medical Centre; cancer is a major cause of morbidity and mortality worldwide and so in Libya; this is an updated report on the incidence of cancers in the Tobruk region in eastern Libya.

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Systematic Review
Prevalence of high-risk HPV genotypes in sub-Saharan Africa according to HIV status: a 20-year systematic review
Jude Ogechukwu Okoye, Chukwudi Amaechi Ofodile, Oluwaseun Kelechi Adeleke, Okechi Obioma
Epidemiol Health. 2021;43:e2021039.   Published online May 25, 2021
DOI: https://doi.org/10.4178/epih.e2021039
  • 30,067 View
  • 464 Download
  • 44 Web of Science
  • 47 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This review assessed the rate of high-risk human papillomavirus (HPV) infection among women living in sub-Saharan Africa. It also determined the prevalence of high-risk HPV (hrHPV) among human immunodeficiency virus (HIV) seropositive (HIV+) and seronegative (HIV-) women in sub-Saharan Africa, pre-2010 and post-2010.
METHODS
In this systematic review, Google Scholar, PubMed Central, and Embase were searched to identify cohort and case-control studies that investigated the relationship between HIV and HPV infection. The database searches yielded 17 studies published between 1999 and 2018.
RESULTS
In the general population, the prevalence of any HPV/multiple HPV infections was higher among HIV+ (53.6/22.6%) than among HIV- women (26.5/7.3%) with odds ratios of 3.22 and 3.71, respectively (95% confidence interval, 3.00 to 3.42 and 2.39 to 5.75, p< 0.001). The prevalent HPV genotypes among HIV+ and HIV- women diagnosed with invasive cervical cancer (ICC) were HPV-16/18 and HPV-45. The prevalence of HPV-16, HPV-18, and HPV-45 was lower in 1999-2010 (3.8, 1.7, and 0.8%, respectively) than in 2011-2018 (19.1, 6.0, and 3.6%, respectively). Among women diagnosed with ICC, HIV+ women had a higher prevalence of HPV-56, HPV-31, and HPV-51 (7.3, 5.3, and 3.3%, respectively) than HIV- women (1.3, 2.2, and 0.4%, p< 0.001, p= 0.050, and p= 0.013, respectively).
CONCLUSIONS
The prevalence of HPV infection, multiple HPV infections, and non-vaccine HPV types were higher among HIV+ women than among HIV- women in sub-Saharan Africa. Although HIV infection influences the distribution of HPV types, this study suggests that cervical cancer incidence in sub-Saharan Africa is primarily driven by the prevalence of vaccine hrHPVs, especially HPV-16 and HPV-18.
Summary
Key Message
Despite increasing awareness of Human papillomavirus (HPV) among women and availability of HPV vaccines, mounting evidence shows that the age-standardized incidence rate of cervical cancer is increasing in sub-Saharan Africa. This review revealed the influences of some viruses on the trends of the disease between 1999-2010 and 2011-2018.

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Original Articles
Epidemiological distribution of primary central nervous system tumors in the Western Province of Saudi Arabia: a local registry from neuroscience-affiliated centers
Maher Kurdi, Nadeem Shafique Butt, Saleh Baeesa, Badrah Alghamdi, Yazid Maghrabi, Anas Bardeesi, Rothaina Saeedi, Ahmed I. Lary
Epidemiol Health. 2021;43:e2021037.   Published online May 23, 2021
DOI: https://doi.org/10.4178/epih.e2021037
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Central nervous system (CNS) tumors are a major and growing global healthcare challenge. Western Saudi Arabia has an inconsistent data registry; therefore, the epidemiology of CNS tumors is unclear across the country. This study is aimed to assemble the epidemiological matrix of CNS tumors in the Western Province of Saudi Arabia.
METHODS
A retrospective analysis was performed using clinical data obtained from 3 neuroscience centers in Western Saudi Arabia in the period 2014-2019. The sample size included 663 adult and pediatric cases from the local and expatriate populations diagnosed with CNS tumors. The distributions of age, sex, clinical presentation, tumor location, type of surgery, histological subtype, genetic characteristics, and recurrence rate were explored.
RESULTS
The analysis included 500 adult cases and 163 pediatric cases up to 18 years of age with a male-to-female ratio of 1.16. The mean age at diagnosis was 38.0±22.6 years. The supratentorium was the most common location (n=515, 77.7%). Most patients presented with headache (n=298, 44.9%), followed by a focal neurological deficit (19.9%). The most common primary CNS tumor was glioblastoma (n=234, 35.3%), followed by meningioma (n=100, 15.1%). The recurrence rate after surgery was estimated to be 40.9% among all CNS tumors.
CONCLUSIONS
This is the first tumor registry of Western Province of Saudi Arabia that describes the distribution of primary CNS tumors and highlights their epidemiological matrix. Several incidence trends in terms of histological type, age group, sex, location, and recurrence were determined, and some genetic characteristics were recognized.
Summary
Key Message
Incidence, prevalence and the recurrence of CNS tumors vary according to histological type, age at diagnosis, sex, and available treatments. Further research should be performed to identify potential risk factors for CNS tumors in Saudi Arabia. Genome technology provides an opportunity to relate incidence rates with risk factors.

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Incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017)
Kim Ngoc Tran, Yoon Park, Byung-Woo Kim, Jin-Kyoung Oh, Moran Ki
Epidemiol Health. 2020;42:e2020075.   Published online December 16, 2020
DOI: https://doi.org/10.4178/epih.e2020075
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Cervical cancer is a major disease burden in Vietnam. This study aimed to estimate the incidence and mortality rates of cervical cancer in Vietnam (1999-2017) in comparison to those in Korea, where a population-based cancer registry and national cervical cancer screening program have been implemented.
METHODS
The estimated incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017) were collected from Global Burden of Disease 2017 study. Estimated age-standardized rates (ASRs) in both countries were calculated utilizing the 1999-2017 population of each country and the World Health Organization standard population. The reported ASRs in Korea were also computed using data on incidence and mortality (1999-2017) and the Korean population from the Korea Statistical Information Service.
RESULTS
In Vietnam, the estimated incidence and mortality of cervical cancer decreased annually by 0.84% and 1.01%. In Korea, the trend of reported incidence showed a dramatic drop (1999-2007 annual percent change [APC], -4.53%) before stably declining (2007-2017 APC, -2.71%). Reported mortality also significantly decreased (2003-2008 APC, -6.63%), and then maintained a stable decline (2008-2017 APC, -3.78%). The incidence and mortality rates were higher in Vietnam than in Korea. The declining trend of incidence and mortality in Vietnam was slower than the corresponding trends in Korea.
CONCLUSIONS
A national screening program should be implemented for Vietnamese women aged over 30 to maintain, or even hasten, the decline in cervical cancer incidence and mortality. A population-based cancer registry may help monitor the effectiveness of a cervical cancer screening program.
Summary
Korean summary
국가 암 등록 체계와 국가 암 검진 프로그램이 아직 마련되지 않은 베트남에서 자궁경부암에 대한 질병부담을 줄일 수 있는 방향성을 제시하고자, 한국의 암 관리 현황과 질병부담을 비교한 연구입니다. 국가 암 등록자료를 구축하고 자궁경부암에 대한 국가 암 검진 프로그램을 도입한 한국과 베트남의 자궁경부암 발생률과 사망률 추이를 비교함으로 베트남에서도 체계적인 암 관리와 예방의 필요성을 강조하고자 한 연구입니다.

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Temporal trend and spatial distribution of acute lymphoblastic leukemia in Iranian children during 2006-2014: a mixed ecological study
Sajjad Rahimi Pordanjani, Amir Kavousi, Babak Mirbagheri, Abbas Shahsavani, Koorosh Etemad
Epidemiol Health. 2020;42:e2020057.   Published online July 29, 2020
DOI: https://doi.org/10.4178/epih.e2020057
  • 22,425 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
The present study investigated the spatiotemporal epidemiological status of acute lymphoblastic leukemia (ALL), the most common childhood cancer, in Iran.
METHODS
Using an exploratory mixed design, this ecological study examined 3,769 under-15 children with ALL recorded in the National Cancer Registry of Iran during 2006-2014. Data were analyzed using the Mann-Whitney U test, the Getis-Ord general G (GOGG) index, optimized hot spot analysis, and Pearson correlation coefficients (PCC) at a significance level of 0.05.
RESULTS
The average annual incidence of the disease was 2.25 per 100,000 under-15 children, and the cumulative incidence rate (CIR) was 21.31 per 100,000 under-15 children. Patients’ mean age was 5.90 years (standard deviation, 3.68), and the peak incidence was observed among 2-year to 5-year-olds. No significant difference was found in mean age between boys and girls (p=0.261). The incidence of ALL was more common during spring and summer than in other seasons. The GOGG index was 0.039 and significant (p<0.001). Hot spots were identified in south, central, and eastern Iran and cold spots in the north and west of Iran. The PCC between the CIR and latitude was negative (r=-0.507; p=0.003) but that between the CIR and longitude was positive (r=0.347; p=0.055).
CONCLUSIONS
The incidence of ALL in Iranian children was lower than that observed in developed countries, but showed an increasing trend. It can be argued that the incidence of ALL is due to synergistic interactions between environmental, infectious, geographical, and genetic risk factors.
Summary

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    Sajjad Rahimi Pordanjani, Ghobad Moradi, Behrad Pourmohammadi, Elaheh Mazaheri, Farshid Farivar, Somayeh Derakhshan
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Socio-demographic and lifestyle factors associated with multimorbidity in New Zealand
Nayyereh Aminisani, Christine Stephens, Joanne Allen, Fiona Alpass, Seyed Morteza Shamshirgaran
Epidemiol Health. 2020;42:e2020001.   Published online December 27, 2019
DOI: https://doi.org/10.4178/epih.e2020001
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The incidence of multimorbidity (MM) and its correlates among older adults remain poorly understood. This study aimed to examine the socio-demographic and lifestyle factors associated with MM in New Zealand.
METHODS
People aged 55-70 years were invited to participate in a population-based cohort study, the Health Work and Retirement Study, in 2006. Those who accepted the invitation and completed the baseline questionnaire were followed up on a biennial basis. Data on socio-demographic factors, health and lifestyle behaviours, and diagnoses of chronic diseases were obtained from baseline and 6 waves of follow-up. Generalised estimating equations (GEE) adjusted for both time-constant and time-varying factors were used to model factors associated with the onset of MM.
RESULTS
A total of 1,673 participants (with 0 or 1 chronic condition) contributed to an overall 8,616 person-years of observation. There were 590 new cases of MM over 10 years of follow-up, corresponding to an overall incidence of 68.5 per 1,000 person-years. The results of the age- and sex-adjusted GEE analysis showed that age, ethnicity, living alone, obesity, hypertension, and having 1 chronic condition at baseline were significant predictors of MM onset. Higher education, income, physical activity, and regular alcohol consumption were protective factors. In a fully adjusted model, marital status (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.01 to 1.37; p=0.039), hypertension (OR, 1.23; 95% CI, 1.02 to 1.48; p=0.032) and having 1 chronic condition at baseline (OR, 2.92; 95% CI, 2.33 to 3.67; p<0.001) remained significant.
CONCLUSIONS
The higher incidence of MM among Māori people, socioeconomically disadvantaged groups, those with low physical activity, and obese individuals highlights the importance of targeted prevention strategies.
Summary

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Incidence and predictors of tuberculosis among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia: a retrospective follow-up study
Masino Tessu Beshir, Aklil Hailu Beyene, Kenean Getaneh Tlaye, Tefera Mulugeta Demelew
Epidemiol Health. 2019;41:e2019028.   Published online June 22, 2019
DOI: https://doi.org/10.4178/epih.e2019028
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AbstractAbstract PDF
Abstract
OBJECTIVES
Tuberculosis (TB) is common in children with human immunodeficiency virus (HIV), but its effect on the survival of HIV-infected children is not well understood. Therefore, the aim of this study was to assess the incidence and predictors of active TB among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia.
METHODS
A retrospective study was conducted over 5 years using a checklist to gather data from 428 randomly selected pediatric patient charts. The checklist was adapted from the standardized antiretroviral therapy (ART) follow-up form currently used by the institution’s ART clinic. Data were analyzed by bivariate and multivariable analysis using Cox regression proportional hazards models, as appropriate. Survival was calculated and compared using the Kaplan-Meier and log-rank tests.
RESULTS
Of the 466 charts reviewed, 428 patient records were included in the analysis. A total of 67 new TB cases were observed during the follow-up period. Hence, the incidence rate in this cohort was found to be 6.03 per 100 child-years of observation. A baseline hemoglobin level <10 g/dL (adjusted hazard ratio [aHR], 7.04; 95% confidence interval [CI], 1.03 to 48.15), moderate wasting (aHR, 2.86; 95% CI, 1.02 to 7.99), and not receiving isoniazid preventive therapy (aHR, 8.23; 95% CI, 2.11 to 32.06) were among the independent predictors of TB occurrence.
CONCLUSIONS
The incidence of TB was high, particularly in pre-ART patients receiving chronic care for HIV. Close followup of HIV-positive children is crucial to protect them against the development of TB. Initiating isoniazid preventive therapy, averting malnutrition, and managing anemia are also of significant importance.
Summary

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Review
Congenital toxoplasmosis among Iranian neonates: a systematic review and meta-analysis
Shahabeddin Sarvi, Tooran Nayeri Chegeni, Mehdi Sharif, Mahbobeh Montazeri, Seyed Abdollah Hosseini, Afsaneh Amouei, Zahra Hosseininejad, Davood Anvari, Reza Saberi, Shaban Gohardehi, Ahmad Daryani
Epidemiol Health. 2019;41:e2019021.   Published online May 17, 2019
DOI: https://doi.org/10.4178/epih.e2019021
  • 26,989 View
  • 261 Download
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AbstractAbstract PDFSupplementary Material
Abstract
Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.
Summary

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Data Profile
National Epidemiologic Survey of Thyroid cancer (NEST) in Korea
Chang-Mo Oh, Hyun-Joo Kong, Eunyang Kim, Hyejin Kim, Kyu-Won Jung, Sohee Park, Young-Joo Won
Epidemiol Health. 2018;40:e2018052.   Published online October 26, 2018
DOI: https://doi.org/10.4178/epih.e2018052
  • 25,876 View
  • 283 Download
  • 29 Web of Science
  • 31 Crossref
AbstractAbstract PDF
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).
Summary

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Editorial
Tuberculosis control in the Republic of Korea
Kyung Sook Cho
Epidemiol Health. 2018;40:e2018036.   Published online August 2, 2018
DOI: https://doi.org/10.4178/epih.e2018036
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The incidence and mortality rates of tuberculosis (TB) in the Republic of Korea are 77 and 5.2 per 100,000 people, respectively (2016), which are the highest among the member countries of the Organization for Economic Cooperation and Development. Recently, the incidence of TB among teens and individuals in their 20s in the Republic of Korea decreased significantly. The decrease is largely attributed to the TB screening and contact investigation efforts targeting schools over the past few years. However, the incidence of TB among elderly individuals remains high, and it is even increasing compared to that in the past 10 years. Older individuals account for 42% of all TB cases and 82% of TB-related deaths. The success rate of TB treatment in the Republic of Korea has gradually increased due to various programs, such as control of non-compliance, insurance coverage for TB diagnosis and treatment, and TB public–private mix models. This study suggests that policy makers should focus their efforts on policies that prioritize a significant reduction in the incidence of TB based on the 2nd National Strategic Plan for Tuberculosis Control (2018–2022).
Summary
Korean summary
2016년 한국의 결핵 발생률은 인구 10만명당 77명이고, 결핵 사망률은 인구 10만명당 5.2명으로 경제협력개발기구(OECD) 회원국 중 가장 높은 수준이다. 본 연구는 지난 수 십 년간 한국의 결핵 발생률, 유병률 및 사망률의 변화 추이와 그간 한국 정부가 시행해 온 다양한 결핵 관리 정책들을 분석하고 향후 개선방안을 제시하고자 하였다.

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Original Articles
Epidemiologic characteristics of scrub typhus on Jeju Island
Sung Uk Lee
Epidemiol Health. 2017;39:e2017039.   Published online August 18, 2017
DOI: https://doi.org/10.4178/epih.e2017039
  • 22,788 View
  • 214 Download
  • 3 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Scrub typhus is the most common febrile disease in Korea during the autumn. Jeju Island is the largest island in South Korea and has a distinctive oceanic climate. This study aimed to identify epidemiologic characteristics of scrub typhus on Jeju Island.
METHODS
From January 2011 to December 2016, 446 patients were diagnosed with scrub typhus on Jeju Island. The patients’ personal data and the environmental factors that might be related to scrub typhus were investigated and retrospectively analyzed.
RESULTS
The median age of the patients was 58-years-old (range, 8 to 91) and 43% of them worked in the agricultural, forestry or livestock industry. Regardless of their job, 87% of the patients had a history of either working outdoors or of other activities before developing scrub typhus. The south and southeast regions of Jeju Island, especially Namwon-eup, showed the highest incidence of scrub typhus. Workers in mandarin orange orchards seemed to be the highest risk group for scrub typhus infection.
CONCLUSIONS
Scrub typhus on Jeju Island showed unique characteristics. To efficiently prevent scrub typhus, each year individual regional approaches should be developed based on the epidemiologic characteristics of the disease.
Summary
Korean summary
쯔쯔가무시증은 진드기에 의해 감염되는 대표적인 가을철 발열성 질환이다. 제주 지역에서 발생하는 쯔쯔가무시증의 역학적 특성을 분석한 결과 제주도의 남, 남동쪽이 다발생 지역으로 나타났다. 또한 이 지역의 감귤 농업이 쯔쯔가무시증이 발생할 수 있는 주요 위험요인인 것으로 추정된다.

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    Jeehyun Kim, Penelope Vounatsou, Byung Chul Chun
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    Sung Uk Lee
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  • Awareness and Work-Related Factors Associated with Scrub Typhus: A Case-Control Study from South Korea
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Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study
Fatemeh Khosravi Shadmani, Erfan Ayubi, Salman Khazaei, Mohadeseh Sani, Shiva Mansouri Hanis, Somayeh Khazaei, Mokhtar Soheylizad, Kamyar Mansori
Epidemiol Health. 2017;39:e2017020.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017020
  • 28,852 View
  • 303 Download
  • 33 Web of Science
  • 26 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran.
METHODS
This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province.
RESULTS
We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC.
CONCLUSIONS
Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.
Summary

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Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries
Eunji Choi, Sangeun Lee, Bui Cam Nhung, Mina Suh, Boyoung Park, Jae Kwan Jun, Kui Son Choi
Epidemiol Health. 2017;39:e2017006.   Published online February 5, 2017
DOI: https://doi.org/10.4178/epih.e2017006
  • 32,420 View
  • 477 Download
  • 110 Web of Science
  • 105 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country.
METHODS
The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable.
RESULTS
The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening.
CONCLUSIONS
The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.
Summary

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Trends in gastrointestinal cancer incidence in Iran, 2001-2010: a joinpoint analysis
Mehdi Darabi, Mohsen Asadi Lari, Seyed Abbas Motevalian, Ali Motlagh, Shahram Arsang-Jang, Maryam Karimi Jaberi
Epidemiol Health. 2016;38:e2016056.   Published online December 5, 2016
DOI: https://doi.org/10.4178/epih.e2016056
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AbstractAbstract PDF
Abstract
OBJECTIVES
The main purpose of this study was to evaluate changes in the time trends of stomach, colorectal, and esophageal cancer during the past decade in Iran.
METHODS
Cancer incidence data for the years 2001 to 2010 were obtained from the cancer registration of the Ministry of Health. All incidence rates were directly age-standardized to the world standard population. In order to identified significant changes in time trends, we performed a joinpoint analysis. The annual percent change (APC) for each segment of the trends was then calculated.
RESULTS
The incidence of stomach cancer increased from 4.18 and 2.41 per 100,000 population in men and women, respectively, in 2001 to 17.06 (APC, 16.7%) and 8.85 (APC, 16.2%) per 100,000 population in 2010 for men and women, respectively. The corresponding values for colorectal cancer were 2.12 and 2.00 per 100,000 population for men and women, respectively, in 2001 and 11.28 (APC, 20.0%) and 10.33 (APC, 20.0%) per 100,000 in 2010. For esophageal cancer, the corresponding increase was from 3.25 and 2.10 per 100,000 population in 2001 to 5.57 (APC, 12.0%) and 5.62 (APC, 11.2%) per 100,000 population among men and women, respectively. The incidence increased most rapidly for stomach cancer in men and women aged 80 years and older (APC, 23.7% for men; APC, 18.6% for women), for colorectal cancer in men aged 60 to 69 years (APC, 24.2%) and in women aged 50 to 59 years (APC, 25.1%), and for esophageal cancer in men and women aged 80 years and older (APC, 17.5% for men; APC,15.3% for women) over the period of the study.
CONCLUSIONS
The incidence of gastrointestinal cancer significantly increased during the past decade. Therefore, monitoring the trends of cancer incidence can assist efforts for cancer prevention and control.
Summary

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Age-period-cohort analysis of hepatitis A incidence rates in Korea from 2002 to 2012
Joo Yeon Seo, Sungyong Choi, BoYoul Choi, Moran Ki
Epidemiol Health. 2016;38:e2016040.   Published online September 30, 2016
DOI: https://doi.org/10.4178/epih.e2016040
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to evaluate the epidemiology of hepatitis A in Korea from 2002 to 2012 using age-period-cohort analyses.
METHODS
We used claims data from the Korean National Health Insurance Corporation for the entire population. Census data from 2010 were used as the standard population. The incidence of hepatitis A was assumed to have a Poisson distribution, and the models and effects were evaluated using the intrinsic estimator method, the likelihood ratio, and the Akaike information criterion.
RESULTS
The incidence of hepatitis A gradually increased until 2007 (from 17.55 to 35.72 per 100,000 population) and peaked in 2009 (177.47 per 100,000 population). The highest incidence was observed among 27-29-year-old individuals when we omitted data from 2005 to 2007. From 2005 to 2007, the peak incidence was observed among 24-26-year-old individuals, followed by 27-29-year-olds. The best model fits were observed when the age-period-cohort variables were all considered at the same time for males, females, and the whole population.
CONCLUSIONS
The incidence of hepatitis A exhibited significant age-period-cohort effects; its incidence peaked in 2009 and was especially high among Koreans 20-39 years of age. These epidemiological patterns may help predict when high incidence rates of hepatitis A may occur in developing countries during their socioeconomic development.
Summary
Korean summary
A형 간염 발생률은 서서히 증가하는 추세였으나 2009년 가파르게 증가하여 최고조에 이르렀으며, (177 명 100,000 명당) 1978–1986 년 생 (발생 당시25–35세) 사이에서 가장 높았다. 남성, 여성, 전체 인구를 통틀어 가장 적합한 모형은 연령, 기간, 코호트 변수를 모두 고려한 모형이었다. 한국의 A형 간염 발생은 고위험 양상에서 중등도 위험양상으로 변해가고 있으며, 이는 역학적 변화를 겪는 여러 나라의 향후 양상을 예측하는데 도움이 될 것이다.

Citations

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  • Hepatitis A vaccination
    Li Zhang
    Human Vaccines & Immunotherapeutics.2020; 16(7): 1565.     CrossRef
  • Causes and countermeasures for repeated outbreaks of hepatitis A among adults in Korea
    Moran Ki, Hyunjin Son, Bo Youl Choi
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Prefectural difference in spontaneous intracerebral hemorrhage incidence in Japan analyzed with publically accessible diagnosis procedure combination data: possibilities and limitations
Toru Fukuhara, Yusuke Hori
Epidemiol Health. 2016;38:e2016028.   Published online July 2, 2016
DOI: https://doi.org/10.4178/epih.e2016028
  • 23,133 View
  • 190 Download
  • 3 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
Annually reported, publically accessible Diagnosis Procedure Combination (DPC) data from the Japanese government is a part of the total DPC database of the Japanese medical reimbursement system for hospitalization. Although medical issues can be evaluated with these data promptly, the applicability of these data in epidemiological analyses has not been assessed.
METHODS
We performed analyses using only statistical indices reported on the a government website. As a preliminary step, the prefectural consistency of spontaneous intracerebral hemorrhage (sICH) was examined with prefectural mortality over 20 years. Then the prefectural incidence of sICH for four years was calculated, utilizing publically accessible DPC data. To determine its reliability, the consistency was examined, and correlations were analyzed with three prefectural factors expected to have an effect: the elderly rate, mortality due to sICH, and the non-DPC bed rate. In addition, a comparison model between prefectures with this method was developed by analyzing other prefecture-specific factors.
RESULTS
Prefectural mortality due to sICH and prefectural sICH incidence in the DPC database were both consistent over the years. Prefectural sICH incidence had a constant positive correlation with the elderly rate, a partial correlation with mortality due to sICH, but no correlation with the non-DPC bed rate, which is one of the major biases when utilizing the DPC database. In the comparison model, the factors of low income and alcohol consumption showed increased sICH incidence.
CONCLUSIONS
Although careful attention to its limitations is required, publically accessible DPC data will provide insights into epidemiological issues.
Summary

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  • Trends in surgical procedures for spontaneous intracerebral hemorrhage in Japan
    Shigeyuki Tahara, Yujiro Hattori, Shotaro Aso, Kazuaki Uda, Ryosuke Kumazawa, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Akio Morita
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The incidence of congenital hypothyroidism and its determinants from 2012 to 2014 in Shadegan, Iran: a case-control study
Ehsan Keshavarzian, Ali Asghar Valipoor, Mohammad Reza Maracy
Epidemiol Health. 2016;38:e2016021.   Published online May 26, 2016
DOI: https://doi.org/10.4178/epih.e2016021
  • 26,291 View
  • 289 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Congenital hypothyroidism (CH) is one of the major causes of preventable mental retardation in infants. The aim of this study was to determine the incidence of CH in Shadegan, Khuzestan Province, Iran from 2012 to 2014 and to identify the risk factors associated with CH.
METHODS
A total of 203 cases were confirmed from 2012 to 2014 in Shadegan, with 66, 86, and 51 patients reported in 2012, 2013, and 2014, respectively. A total of 3,900, 3,991, and 4,050 live births occurred in 2012, 2013, and 2014, respectively. The controls (n=657) were selected using a random number table, and a case-control study was carried out to determine the risk factors for neonatal CH, including demographic, environmental, and medical factors.
RESULTS
The incidence of CH was 17.0 per 1,000 live births in 2012, 21.5 per 1,000 live births in 2013, and 12.6 per 1,000 live births in 2014. This study showed that the likelihood of CH in children born to parents with a history of consanguineous marriage was 2.41 times greater than in children born to parents with no such history (odds ratio, 2.41; 95% confidence interval [CI], 1.65 to 3.53). This study also found that CH was 3.4 times more likely (95% CI, 2.29 to 5.20) in infants born in urban settings than in infants born in rural areas.
CONCLUSIONS
The incidence of CH in Shadegan from 2012 to 2014 was approximately 17 times greater than the expected incidence in Iran. CH was associated with a history of consanguineous marriage and urbanization.
Summary

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    Saeed Khorramnia, Babak Shekarchi, Mojgan Mohajeri Iravani, Mohammad Teymurizadeh, Romina Golpayegani, Ali Sarkoohi, Hamid Pakzad Moghadam, Akbar Haji Ghasemalian, Ebadallah Shiri Malekabad, Zia Navidi
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    Manar Al-Lawama, Rasha Odeh, Abeer AlAssaf, Jumana Albaramki, Nour Ghanem, Dina Abu Assab, Aseel Al-Dmour, Esraa Arabiat, Arwa Kiswani, Salam Al-Kayed, Hadeel Alzoubi, Saleh Al Jbour
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    Hajar Vatankhah, Hassan Ahmadinia, Mina Asadikaram, Batool Rezaei, Mohsen Rezaeian, Zahra Jamali
    Journal of Occupational Health and Epidemiology.2024; 13(4): 247.     CrossRef
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    Fariba Abbasi, Leila Janani, Malihe Talebi, Hosein Azizi, Lotfali Hagiri, Shahnaz Rimaz
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    Bahare Gholami Chaboki, Manijeh Tabrizi, Maryam Heydarpour Meymeh, Hojjat Alaei, Alireza Akbarzadeh Baghban
    International Journal of Preventive Medicine.2021;[Epub]     CrossRef
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    Nur Rochmah, Muhammad Faizi, Carrina Dewanti, Ahmad Suryawan
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    Soraya Doustmohamadian, Sahar Mehrizi, Mohammad Naser Rahbar, Majid Mirmohammadkhani
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    Hale Tuhan
    Turkish Journal of Pediatric Disease.2019; 13(6): 451.     CrossRef
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    Narges Khanjani, Ahmad Ahmadzadeh, Bahram Bakhtiari, Farzan Madadizadeh
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Brief Communication
Incidence and mortality rates of colorectal cancer in Malaysia
Muhammad Radzi Abu Hassan, Ibtisam Ismail, Mohd Azri Mohd Suan, Faizah Ahmad, Wan Khamizar Wan Khazim, Zabedah Othman, Rosaida Mat Said, Wei Leong Tan, Siti Rahmah @ Noor Syahireen Mohammed, Shahrul Aiman Soelar, Nik Raihan Nik Mustapha
Epidemiol Health. 2016;38:e2016007.   Published online March 9, 2016
DOI: https://doi.org/10.4178/epih.e2016007
  • 41,528 View
  • 599 Download
  • 37 Web of Science
  • 35 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity.
METHODS
The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution.
RESULTS
The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05).
CONCLUSIONS
CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.
Summary

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Health Statisticses
Changing trends in colorectal cancer in the Republic of Korea: contrast with Japan
Minjoo Yoon, Nicholas Kim, Byungho Nam, Jungnam Joo, Moran Ki
Epidemiol Health. 2015;37:e2015038.   Published online August 17, 2015
DOI: https://doi.org/10.4178/epih/e2015038
  • 34,073 View
  • 330 Download
  • 21 Web of Science
  • 18 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
Colorectal cancer has a high worldwide incidence. Japan, a country that is geographically and culturally similar to the Republic of Korea (here after Korea), has recently reported a decreasing trend in the incidence of colorectal cancer. However, Korea had the highest incidence of colorectal cancer among Asian countries in 2012. Our aim was to observe the changing trends in incidence and mortality of colorectal cancer in Korea and to compare them to those in Japan. Incidence data were collected from the Korean Central Cancer Registry and mortality data were collected from Korean Statistical Information Service. Incidence and mortality data on colorectal cancer in Japan were acquired from the National Cancer Center in Japan. Age-standardized incidence and mortality rates were determined based on Segi’s world population. Screening data from both countries were collected from the national cancer center in each country. In Korea, the age-standardized incidence rate of colorectal cancer in both sexes was 20.9 to 38.0 per 100,000 from 1999 to 2012 and the rate in males increased more dramatically than in females. In addition, the increase between 2002 and 2012 was first observed in the age group over 40. In Japan, the incidence of colorectal cancer has been more constant over recent years than in Korea. The age-standardized mortality rate of colorectal cancer in both sexes in Korea was 8.5 to 9.3 per 100,000 from 2000 to 2013, and the trend in mortality was constant during this period. In Japan, the mortality rate decreased slightly during the same period. Crude screening rates were increased overall in both Korea and Japan during the period studied. Since the incidence of colorectal cancer has increased in Korea, the control of this cancer is an important public health issue. As Japan has achieved a reduction in colorectal cancer, adjustment of Korea’s current systems for screening and treatment of colorectal cancer according to those of Japan may contribute to improved colorectal cancer control in Korea.
Summary
Korean summary
우리나라와 지리적, 문화적으로 가까운 일본은 대장암 발생 및 사망이 감소하고 있는 반면, 한국의 대장암 발생은 증가하는 추세이다. 본 연구는 한국의 대장암 발생 및 사망의 경향을 관찰하고, 이를 일본의 경우와 비교하고자 한다

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  • Statistical methods for measuring trends in colorectal cancer incidence in registries: A systematic review
    Norah Alsadhan, Alaa Almaiman, Mar Pujades-Rodriguez, Cathy Brennan, Farag Shuweihdi, Sultana A. Alhurishi, Robert M. West
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    Ji Eun Yoon, Soo Young Lee, Han Duk Kwak, Seung Seop Yeom, Chang Hyun Kim, Jae Kyun Joo, Hyeong Rok Kim, Young Jin Kim
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Changing trends in the incidence (1999-2011) and mortality (1983-2013) of cervical cancer in the Republic of Korea
Yoon Park, Champadeng Vongdala, Jeongseon Kim, Moran Ki
Epidemiol Health. 2015;37:e2015024.   Published online May 29, 2015
DOI: https://doi.org/10.4178/epih/e2015024
  • 35,534 View
  • 250 Download
  • 20 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
Cervical cancer is a well-known preventable cancer worldwide. Many countries including Korea have pursued the positive endpoint of a reduction in mortality from cervical cancer. Our aim is to examine changing trends in cervical cancer incidence and mortality after the implementation of a national preventive effort in Korea. Cervical cancer incidence data from 1999 to 2011 and mortality data from 1983 to 2013 were collected from the Korean Statistical Information Service. Yearly age-standardized rates (ASR) per 100,000 were compared using two standards: the 2005 Korean population and the world standard population, based on Segi’s world standard for incidence and the World Health Organization for mortality. In Korea, the age-standardized incidence of cervical cancer per 100,000 persons declined from 17.2 in 2000 to 11.8 in 2011. However, the group aged 25 to 29 showed a higher rate in 2011 (ASR, 6.5) than in 2000 (ASR, 3.6). The age-standardized mortality rate per 100,000 persons dropped from 2.81 in 2000 to 1.95 in 2013. In the worldwide comparison, the incidence rates remained close to the average incidence estimate of more developed regions (ASR, 9.9). The decreasing mortality trend in Korea approached the lower rate observed in Australia (ASR, 1.4) in 2010. Although the incidence rate of cervical cancer is continuously declining in Korea, it is still high relative to other countries. Moreover, incidence and mortality rates in females aged 30 years or under have recently increased. It is necessary to develop effective policy to reduce both incidence and mortality, particularly in younger age groups.
Summary
Korean summary
한국의 자궁경부암 발생률과 사망률은 꾸준히 감소하고 있는 추세이다. 그러나 한국의 발생률은 여러 선진국에 비해 여전히 높은 수준에 머무르고 있다. 또한, 지난 10년 동안 자궁경부암 사망률은 상대적으로 큰 감소를 보이지 않았다. 특히 35세 미만에서는 자궁경부암 발생률이 감소하지 않았고, 사망률은 오히려 높아진 것으로 나타났다. 젊은 연령층의 자궁경부암 예방과 관리가 필요하다.

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    Erdenetuya Bolormaa, Seung-Ah Choe, Mia Son, Myung Ki, Domyung Paek
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Brief Communication
Epidemiological evidences on overdiagnosis of prostate and kidney cancers in Korean
Jong-Myon Bae
Epidemiol Health. 2015;37:e2015015.   Published online March 7, 2015
DOI: https://doi.org/10.4178/epih/e2015015
  • 27,920 View
  • 165 Download
  • 7 Web of Science
  • 10 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The prostate specific antigen test is widely used as the main method of screening prostate cancer in Korea. Additionally, the use of ultrasound sonography may lead to overdiagnosis of kidney cancer as well as thyroid cancer. This study aimed to highlight epidemiological evidences regarding overdiagnosis of prostate and kidney cancers in Korean.
METHODS
The annual trends of national incidence and mortality of prostate and kidney cancers provided by the Korean Statistical Information Service were evaluated.
RESULTS
The rate of increase in the incidence of prostate and kidney cancer was 6 and 5 times higher than that of mortality between 2000 and 2011, respectively. Additionally, the age group showing the highest incidence in prostate cancer shifted from 85 years and older to 75-79 years.
CONCLUSIONS
This evidence suggests that prostate and kidney cancers are overdiagnosed in Korea. Further research in this area, using national cancer registry databases, should be encouraged to prevent overdiagnosis.
Summary
Korean summary
갑상선암의 과진단은 목초음파검사의 시행에 따른 것이란 주장에 따라, 전립선암과 신장암은 각각 전립선특이항원검사와 복부초음파검사의 시행에 따라 과진단이 있을 것으로 예상된다. 과진단의 여부는 검사 시행 이후 발생률이 증가하는 반면, 사망률은 변동이 없는 것으로 판단할 수 있다. 통계청의 해당 암 발생률과 사망률 추이를 살펴볼 때, 국내에서도 전립선암과 신장암에서 과진단이 있음을 확인할 수 있었다.

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Health Statistics
Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011
Yeerae Kim, Jinju Park, Byung-Ho Nam, Moran Ki
Epidemiol Health. 2015;37:e2015006.   Published online February 16, 2015
DOI: https://doi.org/10.4178/epih/e2015006
  • 41,194 View
  • 232 Download
  • 41 Web of Science
  • 33 Crossref
AbstractAbstract PDF
Abstract
Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA) and native Asians (from Korea, Japan, China, and the Philippines) were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries
Summary

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Methods
Overdiagnosis: epidemiologic concepts and estimation
Jong-Myon Bae
Epidemiol Health. 2015;37:e2015004.   Published online February 10, 2015
DOI: https://doi.org/10.4178/epih/e2015004
  • 35,615 View
  • 244 Download
  • 15 Web of Science
  • 17 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Overdiagnosis of thyroid cancer was propounded regarding the rapidly increasing incidence in South Korea. Overdiagnosis is defined as ‘the detection of cancers that would never have been found were it not for the screening test’, and may be an extreme form of lead bias due to indolent cancers, as is inevitable when conducting a cancer screening programme. Because it is solely an epidemiological concept, it can be estimated indirectly by phenomena such as a lack of compensatory drop in post-screening periods, or discrepancies between incidence and mortality. The erstwhile trials for quantifying the overdiagnosis in screening mammography were reviewed in order to secure the data needed to establish its prevalence in South Korea.
Summary
Korean summary
최근 갑상선암의 발생 증가는 과진단에 기인한 것이란 주장이 제기되었다. 과진단은 ‘평생동안 몰랐을 암을 검진으로 알아낸 경우’로 정의하는 바, 예상보다 늦은 진행으로 예후가 더 좋고 치료를 안해도 사망률 변동을 만들지 못하는 암에 대하여 반복되는 암검진에 더 잘 진단되는 기간차이 바이어스가 개입되는 것을 제대로 통제하지 못해서 생긴 것이다. 검진을 더 이상 하지 않았을 경우 발생률이 본래대로 되돌아오지 않는 현상을 보이거나, 사망률과 발생률 간의 변동에서 큰 차이를 보일 때 과진단이 있다고 판단한다. 국내에서 발생하는 과진단의 크기를 측정하기 위한 방법들을 알아보기 위하여, 기존의 유방암 조기검진용 유방촬영술에 대한 과진단 크기를 알아낸 연구방법들을 살펴보았다.

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Methodological issues for determining intervals of subsequent cancer screening
Jong-Myon Bae
Epidemiol Health. 2014;36:e2014010.   Published online July 30, 2014
DOI: https://doi.org/10.4178/epih/e2014010
  • 28,114 View
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  • 6 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The gap between nationwide recommendations of cancer screening and the related evidences obtained from Korean adults should be filled. Estimation of the mean sojourn time (MST) in a specific cancer is important to determine the intervals of subsequent screening. This author arranged the methods for calculating MST into 5 categories based on the parameters used. Under the legal barrier for protection of individual privacy and confidentiality in a Korean academic situation, the methods involving the use of transition rates or prevalence/incidence ratio would be applicable among these methods.
Summary
Korean summary
국가 암조기 검진사업에서 제시하는 검진지침은 우리나라 국민을 대상으로 한 역학연구 결과에 근거하여 개발해야 한다. 특정 암에 대한 조기검진 지침에는 검진방법, 시작 및 종료 연령과 함께 검사 주기를 담아야 한다. 이중 반복검사의 간격은 해당 암의 평균체류기간을 산출하여 결정한다. 저자는 특정 암의 평균체류기간을 구하는 방법을 5가지로 분류하여 제시하였다. 또한 현재 개인정보 보호를 강조하는 여건에서 수행이 가능한 방법을 검토하였다.

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Original Articles
Burden of Disease of Multiple Sclerosis in Korea
Soo-Eun Chung, Hae-Kwan Cheong, Jae-Hyun Park, Ho Jin Kim
Epidemiol Health. 2012;34:e2012008.   Published online November 30, 2012
DOI: https://doi.org/10.4178/epih/e2012008
  • 31,299 View
  • 161 Download
  • 22 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. There are few reports on the burden of disease of MS, worldwide. The authors aim to estimate burden of disease and estimate the epidemiologic indexes of MS in Korea using available epidemiologic data.</p></sec><sec><title>METHODS</title><p>Epidemiologic indexes were computed using DISMOD II software based on prevalence from nationwide survey, incidence estimated from extrapolation, mortality from National Statistics Office, and duration of disease from literature as input indexes. We calculated disability-adjusted life year (DALY) as a measure of premature mortality and disability, equivalent to years of healthy life lost due to a given condition.</p></sec><sec><title>RESULTS</title><p>The incidence of MS in Korea was 0.1 per 100,000, higher in female than in male. The highest incidence was estimated in the age group between 35 and 44 years in male and age group between 25 and 29 years in female. Total burden of disease of MS was 1,394 DALY, comprised of 292 (21%) years of life lost and 1,101 (79%) years lived with disability. The mean age at onset of MS was 33 years old in men and 32 years old in female. Estimated duration of disease was 35 years in men and 40 years in female. Most of the DALY of MS occurred in the adult population between 25 and 54 years of age.</p></sec><sec><title>CONCLUSION</title><p>Although MS is a rare disease in Korea, most of the DALY arises from young people, which results in a major financial burden on the patient, family, health system and society.</p></sec>
Summary

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    Mark Stuntz
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  • Optic Neuritis in Korean Children: Low Risk of Subsequent Multiple Sclerosis
    Young Mi Kim, Hye Young Kim, Min Jeong Cho, Min Jung Kwak, Kyung Hee Park, Gyu Min Yeon, Yunjin Lee, Sang Ook Nam
    Pediatric Neurology.2015; 53(3): 221.     CrossRef
  • No association between CCL2 gene polymorphisms and risk of inflammatory demyelinating diseases in a Korean population
    S. Namgoong, J. S. Bae, H. S. Cheong, J.‐H. Kim, J. Y. Kim, L. H. Kim, H. J. Kim, H. D. Shin
    Tissue Antigens.2014; 84(2): 223.     CrossRef
Annual average cancer incidence and trend of cancer incidence in Daegu for 5 years, 1997~2001.
Byung Yeol Chun, Jin Hoon Yang, Jung Hup Song, Ji Seun Lim
Korean J Epidemiol. 2007;29(1):59-69.
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Abstract
PURPOSE
This study is conducted to identify the annual average cancer incidence and the trend of cancer incidence in Daegu during the 5-year period from 1997 to 2001.
METHOD
Data on newly diagnosed cancer patients from 1997 to 2001 were collected with a standard registration form. Medical record reviewers visited hospitals if necessary, to detect missing cancer patients.
RESULTS
The annual average overall number of cancer patient was 4,606 (male 2,529 and female 2,077). The crude average annual incidence of cancer in male were 211.8 (ASR 251.4) and 169.8 (ASR 151.3) in female. Five major cancers in male were stomach (ASR 60.3), bronchus and lung (ASR 44.8), liver and intrahepatic bile ducts (ASR 40.7), rectum (ASR 11.2), and colon (ASR 10.8). However, in women, those were stomach (ASR 25.3), breast (ASR 19.8), cervix (ASR 14.9), bronchus and lung (ASR 12.7), liver and intrahepatic bile ducts (ASR 11.1). Increases in incidence were found for colon cancer for both sexes, rectal cancer for males, and lung and breast cancer for females. Decreases were shown for liver cancer for both sexes and stomach and cervical cancer for females.
CONCLUSIONS
Primary prevention of cancer based on results of this study remains important.
Summary
Framingham Equation Model Overestimates Risk of Ischemic Heart Disease in Korean Men and Women.
Kyung A Ahn, Ji Eun Yun, Eo Rin Cho, Chung Mo Nam, Yangsu Jang, Sun Ha Jee
Korean J Epidemiol. 2006;28(2):162-170.
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Abstract
BACKGROUND
The prediction of the absolute risk of ischemic heart disease (IHD) is commonly based on the risk prediction equations, originated from the Framingham Heart Study.
METHOD
Framingham equation model was applied to participants from 2001 Korean National Health and Nutrition Examination Survey (KNHNES) to estimate the 5 year risk of IHD among Koreans ranging from 30 to 74 year-olds. The estimated risks were compared to the incidence and admission rates from two statistical reports among Koreans. Five year admission rate was estimated by the annual report from National Health Insurance Corporation (NHIC).
RESULTS
The average ages (standard deviation) were 34.31(27.23) year-old for KNHNES and 48.26(12.87) year-old for Framingham population used in this study. The risk of IHD predicted by the Framingham equation model substantially exceeded the risks actually reported in Korea. Five-year predicted risks by Framingham equation model were 4.86% for men and 1.93% for women; whereas from incidence data in Korea, five-year risks for acute myocardial infarction (AMI) were for 0.47% for men and 0.18% for women. These AMI incidence was similar to the admission rate (0.34 for men and 0.15 for women) estimated by NHIC. Also, 5-year admission rate of IHD were 1.16 for men and 0.78 for women. The magnitude of risk overestimation by Framingham mode is approximately at least 150 to 320%.
CONCLUSION
Korean guidelines for the management for high risk group of IHD need to develop and correct for overestimation to avoid inflation of costs in primary prevention.
Summary
A Study on the Epidemiologic Characteristics of Scrub Typhus in Gyeongsangbuk-do, 1999-2001.
Young Sun Min, Hyun Sul Lim, Kwan Lee, Cheoll Jung, Hae Kwan Cheong
Korean J Epidemiol. 2005;27(2):70-79.
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Abstract
ONJECTIVE: This study was carried out to investigate the epidemiologic characteristics and magnitudes of scrub typhus (tsutsugamushi disease) in Gyeongsangbuk-do, Korea.
METHODS
Resources of data collected were epidemiologic surveillance report to public health centers on each disease occurrence. The authors reviewed 344 epidemiologic surveillance reports for cases of scrub typhus developed in Gyeongsangbuk-do, Korea from Jan 1, 1999 to Dec 31, 2001.
RESULTS
The scrub typhus cases were 376 during three year period, and the incidence was significantly higher in the county area than in the city area. Incidence of scrub typhus was increasing each year. In 344 epidemiologic surveillance reports, the job of the cases was farmer (67.2%), housewife (4.7%), clerk (3.5%). Two hundred ninety eight cases (86.6%) have experienced outdoor activities before development of the scrub typhus. The outdoor places of exposure were dry field (64.8%), rice field (51.7%), hill (12.8), and grass field (9.7%). The symptoms reported were fever (93.3%), headache (83.7%), chill (69.5%), and rash (54.4%).
CONCLUSIONS
Incidence of scrub typhus was increasing in Gyeongsangbuk-do, Korea, this phenomenon may be related to change of climate, the reporting rate of disease and outing activities. Good surveillance and adequate analysis of epidemiologic data is a essential for the prevention of the disease. With this result, high risk population was identified and effective intervention should be done to prevent the disease.
Summary
Lung cancer incidence, mortality and survival rate in Korean Elderly Pharmacoepidemiologic Cohort(KEPEC) in 1994-1998.
Nam Kyong Choi, Kyung Eun Youn, Dae Seuk Heo, Yooni Kim, Seung Mi Lee, Byung Joo Park
Korean J Epidemiol. 2002;24(2):121-130.
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Abstract
PURPOSE
This study was conducted to estimate incidence, mortality and survival rate of lung cancer in the elderly people in Korea.
METHODS
Study population was Korean Elderly Phamacoepidemiologic Cohort (KEPEC). The lung cancer incidence cases were detected from three different sources, medical utilization database of the Korea Medical Insurance Corporation (KMIC), the database from the National Cancer Registry, and the database from the Regional Cancer Registry. The hospital survey to confirm the final diagnosis of the potential cases was conducted. A specialist on lung cancer reviewed the abstracted data to confirm the final diagnoses. The lung cancer death cases were detected from the mortality database at National Statistical Office. Incidence rate, survival rate and mortality rate of lung cancer and their 95% confidence intervals were estimated with SAS Window ver. 8.1. PESULTS: There were 213 confirmed lung cancer cases in KEPEC between Jan. 1994 and Dec. 1998. Age-standardized incidence rate of lung cancer to the Korean population was estimated to be 316.9 per 100,000 person-years in male and 65.2 per 100,000 person-years in female. Age-standardized mortality rate of lung cancer to the Korean population was estimated to be 342.3 per 100,000 person-years in male and 84.8 per 100,000 person-years in female. One year survival rate was 17% in male and 11% in female. Two year survival rate was 2% in male and 4% in female.
CONCLUSION
Age-standardized incidence rate, age-standardized mortality rate and survival rate of lung cancer in the elderly Korean may be useful for further study and making health policy for managing lung cancer in the elderly.
Summary
Review
Methods for Estimation of Nationwide Cancer Incidence from Population-based Cancer Registries .
Jong Myon Bae, Choong Won Lee, Duk Hee Lee, Yoon Ok Ahn
Korean J Epidemiol. 2002;24(1):1-6.
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Abstract
While there has not been a nationwide cancer incidence data yet, it is necessary to consider a preferable method for estimation of nationwide cancer incidence under the cancer registry system in Korea. Some papers and texts related to estimate a nationwide cancer incidence were searched and reviewed. It could be summarized into 5 major methods: (1) for having only mortality data for all cancers, (2) of using major demographic factors, (3) of using nationwide mortality data, (4) of using nationwide mortality and survival data, and (5) of considering cancer risk factors. Among the methods, second method of using major demographic factors would be preferable in Korean situation
Summary
Original Articles
The Analysis of the Correlation of Diabetes Mellitus Incidence and Prevalence with Body Mass Index among Adults Registered in a Health Promotion Center of a University Hospital.
Sang Hoon Ahn, Jung Soon Kim
Korean J Epidemiol. 2000;22(2):159-170.
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Abstract
BACKGROUND
The prevalence and incidence of diabetes mellitus in Korea are higher than western countries. Despite the fact that obesity is an important risk factor of DM, western obesity criteria by BMI level has been used in Korea, which was based on the data derived from the western people having higher average body mass index(BMI) and lower DM incidence than Koreans. Therefore, this study was performed to find out the BMI level, at which point the risk of developing DM increases and its incidence per year.
METHODS
13,301 men and women who visited the Health Promotion Center at Seoul National University Hospital between March 1, 1995 and February 28, 1999 were studied. Factors attributable to DM including BMI were investigated. BMI was categorized in detail to find out the critical point of BMI with increased DM. The incidence of DM per year was investigated by analysing the cohort consisting of people who have visited the center more than once.
RESULTS
The risk factors of DM revealing significant statistical association were age, systolic blood pressure, total cholesterol, triglyceride and BMI. The age-sex adjusted odds ratio at BMI 24.0 was 1.950(95% CI 1.089~3.492) compared to the reference BMI(<21.0) when applying the current diagnostic criteria of DM(140mg/dl), and it was 1.635(95% CI 1.018~2.627) at BMI 22.0 by the new criteria of DM(126mg/dl). Crude incidence rate of DM was 0.9% by the current criteria and 2.1% by the new criteria.
CONCLUSIONS
Current WHO obesity criteria by BMI that we use in Korea should be readjusted(the criteria of overweight lowered from BMI 25.0 to 24.0, and obesity from 30.0 to 27.0 for Koreans), particularly in the aspect of prevention of DM for Korean people. Crude incidence rate of DM was 0.9%, much higher than that of western people, which calls for national concern on prevention and management of DM.
Summary
An Epidemiologic Investigation of Shigella Sonnei Outbreak at a Primary School in Taegu city.
Byung Yeol Chun, Keon Yeop Kim, Ki Soo Park, Sang Won Lee, Young Joo Hur, Sun Hee Park, Ki Sang Kim, Sang Won Lee, Soon Ja Kim, Young Sook Hong
Korean J Epidemiol. 2000;22(2):101-107.
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Abstract
PURPOSE
S: This study was conducted to determine the source of infection and mode of transmission of the shigellosis outbreak on March 27, 1998 at a primary school in Taegu city.
METHODS
On-site interview using a standard questionnaire and rectal swab were conducted to 1,629 peoples who ate lunch on March 26 and 1,389 peoples who contacted with suspected cases. And bacteriological examination for 91 environmental materials and 25 food items were performed.
RESULTS
Of the 1,629 persons who ate lunch on March 26, seventy three had culture-confirmed S. sonnei infection(first attack rate: 4.5%). And additional fifty four had shigellosis among those 1,389 persons who might be exposed to the suspected cases(second attack rate: 3.9%). A total of 730 persons who complained one of four typical symptoms or more were treated as suspected cases(first attack rate of suspected cases: 44.8%). S. sonnei was never isolated from water, foods, and other environmental materials. The median incubation period was estimated about two days. The common symptom reported were diarrhea(88.7%), fever(73.4%), abdominal pain(54.7%), and vomiting episode(38.4%) in order. The shorter duration of the outbreak and the large proportion of cases involving students who ate lunch on March 26 are consistent with fecal-oral transmission, although the limited epidemiologic data obtainable do not clearly define the route of transmission.
CONCLUSIONS
Thus the outbreak reported here appear to be related to the unsanitary conditions of food facility in this school.
Summary
Incidence Density and Risk Factors of Low Back Pain among the Workers in a Welding Material Manufacturing Factory.
Ju Tae Park, Hyun Sul Lim
Korean J Epidemiol. 1999;21(1):36-52.
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Abstract
This study was performed to understand the incidence density and detect the risk factors of occupational low back pain. A cross-sectional study was conducted with a questionnaire in a welding material manufacturing factory in October, 1993. Therefore, we selected 140 workers who had never complained of low back pain as cohorts. Also, we added 236 newly entered persons who had never complained of low back pain. The total number of cohorts were 376 workers. And then we continued with a questionnaire survey in October, 1996 and with a questionnaire survey and medical examinations by a specialist in October, 1997. Follow-ups were done for 337 workers. The number of newly developed low back pain among workers were 127. The characteristics of low back pain were as follows. The durations of pain were less than or equal to 2 days (42.6%), from 3 days to less than 1 week (8.7%), from 1 week to less than 1 month (11.0%), 1 month or more (6.2%). The frequency was everyday (7.9%), once per week (21.3%), once per month (14.2%), once per 2-3 months (9.4%), once per 5 months (11.0%). The severity of pain was slight (9.4%), mild (33.1%), moderate (13.4%), severe (10.2%) and very severe (1.6%). The onset of most low back pain was insidious (41.7%). The diagnosis of low back pain was muscle strain (37.8%), lumbar sprain (23.6%) and myofacial pain syndrome (3.9%). The number of newly developed low back pain among workers were 127, their incidence density was 15.7 per 100 person-years. In univariate analysis, age, marital status, educational level, smoking habit, category of job, tenures and frequency of stretching exercises showed a statistical significance. The multivariate logistic regression analysis confirmed that category of job and tenures (p<0.05) were independent risk factors for low back pain among workers. The number of newly developed occupational low back pain among production workers were 71, their incidence density was 11.3 per 100 person-years. In univariate analysis, age, marital status, educational level, regular exercise, tenures, posture of waist and lifting of heavy materials showed a statistical significance. The multivariate logistic regression analysis confirmed that posture of waist (p<0.05) and lifting of heavy materials (p<0.1) were independent risk factors for occupational low back pain among production workers.
Summary
Epidemiologic Characteristics of the Pneumoconiosis Patients in Manufacturing Industries.
Won Chul Lee, Hyeon Woo Yim, Kyung Jae Lee, Se Yong Lee, Kwang Ho Meng, Young Gyu Phee, Hyun Wook Kim, Jung Wan Koo, Young Lim, Im Goung Yun
Korean J Epidemiol. 1998;20(1):141-153.
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Abstract
Pneumoconiosis was the first reported occupational disease in Korea and was the most common one until 1990. In the past, most pneumoconiosis patients were found among underground workers in various mines. Recently this occupational disease has increasingly affected workers in manufacturing industries such as ship building, briquette, glass, foundry industries, and so on. In order to investigate the scale of pneumoconiosis in manufacturing industries, we evaluated the detailed medical examination records and insurance deliberation data from 1989 until 1994. Information about work history, medical history, and exposure dust type were collected for each member of the study population. All chest X-rays were interpreted and classified using the International Labor Organization(ILO) scale by three radiologist who have had extensive experience evaluation pneumoconiosis. For the calculation of the incidence rate of manufacturing pneumoconiosis, we analyzed the Specific Health Examination data and estimated the population at risk as a denominator of the incidence rate. We divided manufacturing industry into 9 subclasses by industrial classification and estimated the incidence rate of pneumoconiosis per 100,000 workers at risk respectively. The results were as follows, 1. 485 workers were newly diagnosed with pneumoconiosis during 6 years from 1989 to 1994. 482 workers had radiographs consistent with simple pneumoconiosis and three with progressive massive fibrosis. Among those with radiographs consistent with simple pneumoconiosis, 395 workers(81.4%) had category 1 profusion, 76 workers(15.7%) had category 2 profusion and 11 workers(2.3%) had category 3 profusion. 2. Almost all of them were male(97.9%) and their average age was 48.3 uears. Manufacturing pneumoconiosis patients were more common in their forties and fifties. 3. The average duration of dust exposure required for the occurrence of pneumoconiosis was 13.5 years. In the case of metal products manufacturing which is mostly related to welding, the average duration of dust exposure was 12.0 years. It was slightly shorter than other manufacturing industries. The average duration of dust exposure required for the occurrence of pneumoconiosis seemed to be shorter in welding operators, even though the welders lung has a weak tissue reaction and the condition is reversible. 4. According to the Industrial classification, 299 cases(61.6%) were found in workers of non-metal mineral products manufacturing, and 56 cases(11.5%) in basic metals industry. 5. The average annual incidence rate of pneumoconiosis in manufacturing industries from 1990 to 1994 was 56.6 per 100,000 workers at risk. On sub-classification, the average annual incidence rate of pneumoconiosis in non-metal mineral products manufacturing industry was the highest among them, showing 479 per 100,000 workers at risk. 6. Radiologic prevalence rate of tuberculosis in these cases was 6.6%. 7. X-ray category profusion in newly diagnosed manufacturing pneumoconiosis varied according to sub-classification. The proportion of category 1 profusion in metal products manufacturing is higher than that in non-metal mineral products manufacturing. 8. The type pattern of small round opacities varied according to sub-classification in manufacturing industry. In non-metal mineral products manufacturing, the small round opacity were observed 25.9% cases with p type, 72.1% with q type and 2.0% with r type respectively. But in metal products manufacturing, the small round opacity were observed 51.4% cases with p type and 48.6% with q type respectively. The cause might be that the exposed dust is different according to job. 9. The type pattern of small round opacities varied according to dust type. Metal dusts showed similar radiologic shape to the coal dusts, but welding fume showed more frequent p type(60.3%) and less frequent q type(377%). rock dust showed less frequent p types(18.3%) and more frequent q types(75.3%). Since the incidence rate of non-metal manufacturing workers showed higher rate than other manufacturing industry, Preventive measures and health care education should be carefully carried out in these workers.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
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