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Original article Regional disparities in major cancer incidence in South Korea, 1999–2018
Eun Hye Park1,5orcid , Mee Joo Kang1,2orcid , Kyu-Won Jung1,2orcid , Eun Hye Park1,2orcid , E Hwa Yun1,2orcid , Hye-Jin Kim1,2orcid , Hyun-Joo Kong1,2orcid , Chang Kyun Choi1,2orcid , Jeong-Soo Im4orcid , Hong Gwan Seo1,3orcid
Epidemiol Health 2023;e2023089
DOI: https://doi.org/10.4178/epih.e2023089 [Accepted]
Published online: October 12, 2023
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1Korea Central Cancer Registry, National Cancer Center, Goyang, Korea, Goyang-si, Korea
2Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea, Goyang-si, Korea
3National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea, Goyang-si, Korea
4National Cancer Control Institute, National Cancer Center, Goyang, Korea, Goyang-si, Korea
5Graduate School of Public Health, Seoul National University, Seoul, Korea, Seoul, Korea
Corresponding author:  Kyu-Won Jung,
Email: ara@ncc.re.kr
Received: 2 June 2023   • Revised: 12 September 2023   • Accepted: 13 September 2023
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Abstract

OBJECTIVES
This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in South Korea during 1999–2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014–2018.
METHODS
The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by sex and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran's I with a spatial weight matrix based on adjacency or distance.
RESULTS
Regional disparities varied depending on cancer type and sex during the 20-year study period. For men, the regional disparities of stomach, colon and rectum, lung, and liver cancer declined, and those of thyroid and prostate cancer recently decreased, despite an overall increasing incidence. For women, regional disparities in stomach, colon and rectum, lung, liver, and cervical cancer declined, that of thyroid cancer recently decreased, despite an overall increasing incidence, and that of breast cancer steadily increased. In 2014–2018, breast cancer (I, 0.61; 95% CI, 0.53 to 0.70) showed a high probability of cancer clusters in women, and liver cancer (I, 0.48; 95% CI, 0.40 to 0.56) showed a high probability of cancer clusters in men.
CONCLUSIONS
Disparities in cancer incidence that were not seen at the national level were discovered at the municipal level. These results could provide important directions for planning and implementing local cancer policies.

Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.