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Prediction of cancer survivors’ mortality risk in Korea: a 25-year nationwide prospective cohort study
Yeun Soo Yang, Heejin Kimm, Keum Ji Jung, Seulji Moon, Sunmi Lee, Sun Ha Jee
Epidemiol Health. 2022;44:e2022075.   Published online September 13, 2022
DOI: https://doi.org/10.4178/epih.e2022075
  • 4,505 View
  • 141 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate the factors affecting cancer survival and develop a mortality prediction model for Korean cancer survivors. Our study identified lifestyle and mortality risk factors and attempted to determine whether health-promoting lifestyles affect mortality.
METHODS
Among the 1,637,287 participants in the Korean Cancer Prevention Study (KCPS) cohort, 200,834 cancer survivors who were alive after cancer diagnosis were analyzed. Discrimination and calibration for predicting the 10-year mortality risk were evaluated. A prediction model was derived using the Cox model coefficients, mean risk factor values, and mean mortality from the cancer survivors in the KCPS cohort.
RESULTS
During the 21.6-year follow-up, the all-cause mortality rates of cancer survivors were 57.2% and 39.4% in men and women, respectively. Men, older age, current smoking, and a history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer were associated with reduced risk. The prediction model discrimination in the validation dataset for both KCPS all-cause mortality and KCPS cancer mortality was shown by C-statistics of 0.69 and 0.68, respectively. Based on the constructed prediction models, when we modified exercise status and smoking status, as modifiable factors, the cancer survivors’ risk of mortality decreased linearly.
CONCLUSIONS
A mortality prediction model for cancer survivors was developed that may be helpful in supporting a healthy life. Lifestyle modifications in cancer survivors may affect their risk of mortality in the future.
Summary
Korean summary
현재 암 생존자의 사망 위험을 평가하는 데 유용한 한국형 암 생존자 사망률 예측 모델은 없습니다. 본 연구에서는 고령, 남성, 현재 흡연, 당뇨병 병력을 포함한 생활양식 요인이 사망의 고위험 요인인 반면, 운동 습관 및 암의 가족력은 사망 위험을 감소시키는 것으로 나타났습니다. 현재 흡연과 운동 습관은 사망 위험에 영향을 미치는 수정 가능한 두 가지 요소로써, 이러한 생활습관 요인으로 구성된 예측모형은 생활습관 교정을 통해 우리나라 암 생존자의 사망률을 낮출 수 있음을 시사합니다.
Key Message
Currently, there is no Korean mortality prediction model for cancer survivors that would be useful in evaluating their risk of mortality. The present study showed that lifestyle factors, including older age, male sex, current smoking, and history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer reduced the risk of mortality. Current smoking and exercise habits are the two modifiable factors that affected the risk of mortality. The prediction model comprising these lifestyle factors implies that the risk of mortality of cancer survivors in Korea can be reduced through lifestyle modification.

Citations

Citations to this article as recorded by  
  • COVID-19 Mortality and Severity in Cancer Patients and Cancer Survivors
    Jae-Min Park, Hye Yeon Koo, Jae-ryun Lee, Hyejin Lee, Jin Yong Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort
    Yong-June Kim, Seung Park, Won Tae Kim, Yoon-Jong Bae, Yonghwan Kim, Hee-Taik Kang
    Medicine.2023; 102(47): e36184.     CrossRef
Substance abuse behaviors among university freshmen in Iran: a latent class analysis
Kourosh Kabir, Ali Bahari, Mohammad Hajizadeh, Hamid Allahverdipour, Mohammad Javad Tarrahi, Ali Fakhari, Hossein Ansari, Asghar Mohammadpoorasl
Epidemiol Health. 2018;40:e2018030.   Published online July 2, 2018
DOI: https://doi.org/10.4178/epih.e2018030
  • 11,887 View
  • 208 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.
METHODS
Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup.
RESULTS
The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.
CONCLUSIONS
Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.
Summary

Citations

Citations to this article as recorded by  
  • Current and life-time alcohol consumption in Iranian students: a systematic review and meta-analysis
    Neda Soleimanvandiazar, Salah Eddin Karimi, Mahboobeh Kamali, Marziyeh Moradi, Leila Janani, Saeed Ghanbari, Azadeh Mottaghi, Mojtaba Piri, Leila Ghalichi, Marzieh Nojomi
    Journal of Substance Use.2023; 28(6): 809.     CrossRef
  • Neighborhoods and adolescent polysubstance use in Jamaica
    Amrita Gill, Erica Felker-Kantor, Colette Cunningham-Myrie, Lisa-Gaye Greene, Parris Lyew-Ayee, Uki Atkinson, Wendel Abel, Simon G. Anderson, Katherine P. Theall
    PeerJ.2023; 11: e14297.     CrossRef
  • Designing and Psychometrically Evaluating Students’ Common Types of Misconceptions about Substance Abuse Inventory: A Methodological Study
    Hamid Sharif-Nia, Tahereh Heidari, Mehran Zarghami, Azar Ramezani Toyeh, Parvin Ghasemi Mianaee, Vahid Ganji, Hamideh Azimi Lolaty
    Journal of Nursing and Midwifery Sciences.2023;[Epub]     CrossRef
  • Latent Classes of Substance Use in Young Adults – A Systematic Review
    Martha Charlotta de Jonge, Andrea Johanna Bukman, Lonneke van Leeuwen, Simone Arianne Onrust, Marloes Kleinjan
    Substance Use & Misuse.2022; 57(5): 769.     CrossRef
  • Prevalence of hookah smoking among Iranian pupils and university students: An updated systematic review and meta‐analysis
    Hamid Zaheri, Yosra Raziani, Nesa Khademi, Yousef Moradi, Hossein Shahriari, Reza Ghanei‐Gheshlagh
    The Clinical Respiratory Journal.2022; 16(6): 425.     CrossRef
  • Lifestyle behaviors among undergraduate nursing students: A latent class analysis
    Tassia T. S. Macedo, Fernanda C. Mussi, Debra Sheets, Ana C. P. Campos, Ana L. Patrão, Caren L. M. Freitas, Melissa A. S. Paim
    Research in Nursing & Health.2020; 43(5): 520.     CrossRef

Epidemiol Health : Epidemiology and Health