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Special Articles
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2022
Eun Hye Park, Kyu-Won Jung, Nam Ju Park, Mee Joo Kang, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Kui-Son Choi, Han-Kwang Yang, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2025;57(2):312-330.   Published online March 11, 2025
DOI: https://doi.org/10.4143/crt.2025.264
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2022, with international comparisons.
Materials and Methods
Cancer incidence, survival, and prevalence rates were calculated using the Korea National Cancer Incidence Database (1999-2022), with survival follow-up until December 31, 2023. Mortality data obtained from Statistics Korea, while international comparisons were based on GLOBOCAN data.
Results
In 2022, 282,047 newly diagnosed cancer cases (age-standardized rate [ASR], 287.0 per 100,000) and 83,378 deaths from cancer (ASR, 65.7 per 100,000) were reported. The proportion of localized-stage cancers increased from 45.6% in 2005 to 50.9% in 2022. Stomach, colorectal, and breast cancer showed increased localized-stage diagnoses by 18.1, 18.5, and 9.9 percentage points, respectively. Compared to 2001-2005, the 5-year relative survival (2018-2022) increased by 20.4 percentage points for stomach cancer, 7.6 for colorectal cancer, and 5.6 for breast cancer. Korea had the lowest cancer mortality among countries with similar incidence rates and the lowest mortality-to-incidence (M/I) ratios for these cancers. The 5-year relative survival (2018-2022) was 72.9%, contributing to over 2.59 million prevalent cases in 2022.
Conclusion
Since the launch of the National Cancer Screening Program in 2002, early detection has improved, increasing the diagnosis of localized-stage cancers and survival rates. Korea recorded the lowest M/I ratio among major comparison countries, demonstrating the effectiveness of its National Cancer Control Program.
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Prediction of Cancer Incidence and Mortality in Korea, 2025
Kyu-Won Jung, Mee Joo Kang, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Kui Son Choi, Han-Kwang Yang
Cancer Res Treat. 2025;57(2):331-338.   Published online March 11, 2025
DOI: https://doi.org/10.4143/crt.2025.263
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to project cancer incidence and mortality for 2025 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2022 were obtained from the Korea National Cancer Incidence Database, while cancer mortality data from 1993 to 2023 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2025. A joinpoint regression model was applied to identify significant changes in trends, using only the most recent trend data for predictions.
Results
A total of 304,754 new cancer cases and 84,019 cancer deaths are expected in Korea in 2025. The most commonly diagnosed cancer is projected to be thyroid cancer, followed by the colorectal, lung, breast, prostate and stomach cancers. These six cancers are expected to account for 63.8% of the total cancer burden. Lung cancer is expected to be the leading cause of cancer-related deaths, followed by liver, colorectal, pancreatic, stomach, and gallbladder cancers, together comprising 66.6% of total cancer deaths.
Conclusion
The increasing incidence of female breast cancer and the rise in prostate and pancreatic cancers are expected to continue. As aging accelerates, cancer commonly found in older adults are projected to rise significantly.
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Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2021
Eun Hye Park, Kyu-Won Jung, Nam Ju Park, Mee Joo Kang, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2024;56(2):357-371.   Published online March 13, 2024
DOI: https://doi.org/10.4143/crt.2024.253
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2021.
Materials and Methods
Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2021, with survival follow-up until December 31, 2022. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea.
Results
The number of new cancer diagnoses in 2021 increased by 27,002 cases (10.8%) compared to 2020. In 2021, newly diagnosed cancer cases and deaths from cancer were reported as 277,523 (age-standardized rate [ASR], 289.3 per 100,000) and 82,688 (ASR, 67.6 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% from 2012 to 2015, thereafter, followed by non-significant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.8% from 2002 to 2013; 3.2% from 2013 to 2021). The 5-year relative survival between 2017 and 2021 was 72.1%, which contributed to prevalent cases reaching over 2.4 million in 2021.
Conclusion
In 2021, the number of newly diagnosed cancer patients increased as healthcare utilization recovered from the coronavirus disease 2019–related declines of 2020. Revised cancer registration guidelines expanded the registration scope, particularly for stomach and colorectal cancer. Survival rates have improved over the years, leading to a growing population of cancer survivors, necessitating a comprehensive cancer control strategy. The long-term impact of the pandemic on cancer statistics requires future investigation.

Citations

Citations to this article as recorded by  
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    Sihan Song, Hyeong-Gon Moon, Dong-Young Noh, So-Youn Jung, Eun Sook Lee, Zisun Kim, Hyun Jo Youn, Jihyoung Cho, Young Bum Yoo, Se Kyung Lee, Jeong Eon Lee, Seok Jin Nam, Yoo Seok Kim, Jun Won Min, Shinyoung Jun, Hyojee Joung, Jung Eun Lee
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    Oncology Nursing Forum.2025; 52(2): 151.     CrossRef
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    Huong Hoang Luong, Phuc Phan Hong, Dat Vo Minh, Thinh Nguyen Le Quang, Anh Dinh The, Nguyen Thai-Nghe, Hai Thanh Nguyen
    Visual Computing for Industry, Biomedicine, and Art.2025;[Epub]     CrossRef
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    Soo Hyun Kim
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    Frontiers in Oncology.2025;[Epub]     CrossRef
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    Nouhad El-Haddad, Yang Li, Geoff P. Delaney, Heewon Kang, Shalini Vinod, Margo Barr, Takahiro Tabuchi, Michael Kidd, Freddy Sitas
    Cancer Epidemiology.2025; 96: 102775.     CrossRef
  • A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
    Hyunho Han, Ik Jae Lee, Woong Sub Koom, Chan Woo Wee, Woong Kyu Han
    Journal of Urologic Oncology.2025; 23(1): 20.     CrossRef
  • Laparoscopic and robotic surgery for colorectal cancer in Korea: a nationwide health insurance database analysis from 2019 to 2023
    Eun Ji Park, Hyun Gu Lee, Youn Young Park, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee
    Journal of Minimally Invasive Surgery.2025; 28(1): 25.     CrossRef
  • Current status of endoscopy training for surgeons in Korea: a narrative review
    Dae Kyung Sohn
    Journal of Minimally Invasive Surgery.2025; 28(1): 1.     CrossRef
  • Cancer risk according to lifestyle risk score trajectories: a population-based cohort study
    Thi Minh Thu Khong, Thi Tra Bui, Hee-Yeon Kang, Eunjung Park, Moran Ki, Yoon-Jung Choi, Byungmi Kim, Jin-Kyoung Oh
    BJC Reports.2025;[Epub]     CrossRef
  • Mortality Risk According to Changes in Alcohol Consumption Post‐Diagnosis Among Liver Cancer Patients
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    Liver International.2025;[Epub]     CrossRef
  • Plasma metabolite based clustering of breast cancer survivors and identification of dietary and health related characteristics: an application of unsupervised machine learning
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    Nutrition Research and Practice.2025; 19(2): 273.     CrossRef
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    Trinh Xuan Thi Nguyen, Sumeet Lal, Sulemana Abdul-Salam
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    Annals of Surgical Oncology.2025;[Epub]     CrossRef
  • Iron Consumption and Colorectal Cancer in Korean Adults: A Prospective Cohort Study
    Sukhong Min, Katherine De la Torre, Hyobin Lee, Woo-Kyoung Shin, Daehee Kang
    Nutrients.2025; 17(8): 1309.     CrossRef
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    Suee Lee
    The Korean Journal of Medicine.2025; 100(2): 81.     CrossRef
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    Hyojun Park, Jung-In Kim, Chang Heon Choi, Jong Min Park, Seonghee Kang, Hyeongmin Jin, Eui Kyu Chie, Jaeman Son
    Biomedical Physics & Engineering Express.2025; 11(3): 035009.     CrossRef
  • Hepatocellular carcinoma in Korea: an analysis of the 2016-2018 Korean Nationwide Cancer Registry
    Jihyun An, Young Chang, Gwang Hyeon Choi, Won Sohn, Jeong Eun Song, Hyunjae Shin, Jae Hyun Yoon, Jun Sik Yoon, Hye Young Jang, Eun Ju Cho, Ji Won Han, Suk Kyun Hong, Ju-Yeon Cho, Kyu-Won Jung, Eun Hye Park, Eunyang Kim, Bo Hyun Kim
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  • Use of Pulmonary Rehabilitation for Lung Cancer Patients in Korea: Analysis of the National Health Insurance Service Database
    Sang Hun Kim, Cho Hui Hong, Jong-Hwa Jeong, Jinmi Kim, Jeong Su Cho, Jin A Yoon, Jung Seop Eom, Byeong Ju Lee, Myung Hun Jang, Myung-Jun Shin, Yong Beom Shin
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  • Prediction of Cancer Incidence and Mortality in Korea, 2025
    Kyu-Won Jung, Mee Joo Kang, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Kui Son Choi, Han-Kwang Yang
    Cancer Research and Treatment.2025; 57(2): 331.     CrossRef
  • Colorectal Cancer Survivors' Inner Strength, Multiple Identities, and Quality of Life by Gender and Ostomy Presence: A Cross-Sectional Study
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  • Chuna Manual Therapy or Electroacupuncture with Pregabalin for Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Pilot Study
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    Sun Yi Park, Ji-Ho Park, Jung Wook Yang, Eun-Jung Jung, Young-Tae Ju, Chi-Young Jeong, Ju-Yeon Kim, Taejin Park, Tae-Han Kim, Miyeong Park, Young-Joon Lee, Sang-Ho Jeong
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    Oncology.2024; 102(11): 969.     CrossRef
  • Performance of the National Cancer Screening Program for Gastric Cancer in Korea
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  • Sites of Metastasis and Survival in Metastatic Renal Cell Carcinoma: Results From the Korean Renal Cancer Study Group Database
    Chan Ho Lee, Minyong Kang, Cheol Kwak, Young Hwii Ko, Jung Kwon Kim, Jae Young Park, Seokhwan Bang, Seong Il Seo, Jungyo Suh, Wan Song, Cheryn Song, Hyung Ho Lee, Jinsoo Chung, Chang Wook Jeong, Jung Ki Jo, Seock Hwan Choi, Joongwon Choi, Changil Choi, Se
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  • Evolving trends in treatment patterns for hepatocellular carcinoma in Korea from 2008 to 2022: a nationwide population-based study
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    Jeong Il Yu
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    Journal of Personalized Medicine.2024; 14(10): 1058.     CrossRef
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    Ran Won, Heesook Son, Jeehee Han, Youn-Jung Son
    Geriatric Nursing.2024; 60: 636.     CrossRef
  • Breast Cancer Statistics in Korea, 2021
    Chihwan David Cha, Chan Sub Park, Hee-Chul Shin, Jaihong Han, Jung Eun Choi, Joo Heung Kim, Kyu-Won Jung, Sae Byul Lee, Sang Eun Nam, Tae In Yoon, Young-Joon Kang, Zisun Kim, So-Youn Jung, Hyun-Ah Kim
    Journal of Breast Cancer.2024; 27(6): 351.     CrossRef
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    Jong Eun Park, Woo Min Jeong, Ye Jin Choi, So Young Kim, Kyoung Eun Yeob, Jong Hyock Park
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Endometrial cancer detected unusually after an ankle fracture secondary to severe anemia in an obese woman with heavy menstrual bleeding: A case report
    Hyung Yoon, Tae Go, Kyung Kim, Yong Song, Dong Suh, Ki Kim
    Molecular and Clinical Oncology.2024;[Epub]     CrossRef
  • Updates in the 2024 Korean Thyroid Association Clinical Practice Guidelines for Differentiated Thyroid Cancer: from Diagnosis to Initial Treatment
    Eun Kyung Lee
    International Journal of Thyroidology.2024; 17(2): 259.     CrossRef
  • A Case Study of Korean Medicine in Treating Worsened Esophagitis Symptoms Following Anticancer Therapy in a Patient with Esophageal Cancer
    Eun-seo Kim, Soo-min Jo, Si-young Song, Geun-jeong Kim, Young-su Lee
    The Journal of Internal Korean Medicine.2024; 45(5): 895.     CrossRef
  • The Emerging Treatment of BCG (Bacillus Calmette-Guérin)-Unresponsive Non–Muscle-Invasive Bladder Cancer
    Jong Ho Park, Jong Jin Oh
    Journal of Urologic Oncology.2024; 22(3): 246.     CrossRef
  • Adherence to the Cancer Prevention Recommendations from World Cancer Research Fund/American Institute for Cancer Research After Cancer Diagnosis on Mortality in South Korea
    Donghyun Won, Jeeyoo Lee, Sooyoung Cho, Ji Yoon Baek, Daehee Kang, Aesun Shin
    Nutrients.2024; 16(23): 4049.     CrossRef
  • Trends in Thyroid Cancer Mortality Rates in Korea: Insights from National Health Database
    Won Gu Kim
    Endocrinology and Metabolism.2024; 39(6): 853.     CrossRef
  • Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis
    Soo Young Lee, Eon Chul Han
    Digestive Surgery.2024; : 1.     CrossRef
  • Nationwide Incidence Trends of Pediatric Parotid Malignancy in Korea and a Retrospective Analysis of Single-Institution Surgical Experience of Parotidectomy
    Hyun Seong Kim, Seo Young Kim, Eun-Jae Chung, Seong Keun Kwon, Soon-Hyun Ahn, Yuh-Seog Jung, Jungirl Seok
    Korean Society of Head and Neck Oncology.2024; 40(2): 7.     CrossRef
  • Total gastrectomy patients had a lower diet volume and greater diet frequency than distal gastrectomy patients after 6 months
    Ye-Ji Kim, Sang-Ho Jeong, Eun-Jung Jung, Taejin Park, Jin-Kwon Lee, Tae-Han Kim, Young-Hye Kim, Jae-Seok Min, Miyeong Park, Young-Joon Lee
    Medicine.2024; 103(51): e40878.     CrossRef
  • Quality of life outcomes in terminal cancer patients attending regional cancer centers in South Korea: protocol for a prospective cohort study
    Jung hye Kwon, Jung Hun Kang, Jung-Sik Huh, Su-Jin Koh, Kyu-Hyoung Lim, Byungho Choi, Rock Bum Kim, Young Jin Choi, Eun-Kee Song, Hyun Woo Lee, Ye-Seul Kim, Se-Il Go, Hwan Jung Yun, Sun Jin Sym, Hyewon Ryu, Myung-won Lee
    BMC Cancer.2024;[Epub]     CrossRef
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
  • Post-colonoscopy Colorectal Cancer: Causes and Prevention
    Jong Yoon Lee
    Journal of Digestive Cancer Research.2024; 12(3): 160.     CrossRef
  • 10,242 View
  • 552 Download
  • 40 Web of Science
  • 54 Crossref
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Prediction of Cancer Incidence and Mortality in Korea, 2024
Kyu-Won Jung, Mee Joo Kang, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo
Cancer Res Treat. 2024;56(2):372-379.   Published online March 11, 2024
DOI: https://doi.org/10.4143/crt.2024.252
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to report the projected cancer incidence and mortality for the year 2024 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2021 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2022 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and multiplying the projected age-specific rates by the anticipated age-specific population for 2024. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend for prediction.
Results
In total, 292,221 new cancer cases and 83,770 cancer deaths are expected to occur in Korea in 2024. The most common cancer site is expected to be the thyroid, followed by the colon and rectum, lung, breast, and stomach. These five cancers are expected to represent 55.7% of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and stomach cancers.
Conclusion
The age-standardized incidence rates for female breast and prostate cancers are estimated to continue to increase. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

Citations

Citations to this article as recorded by  
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    Hyunho Han, Ik Jae Lee, Woong Sub Koom, Chan Woo Wee, Woong Kyu Han
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    Seo Hee Choi, Seung-Hoon Beom, Young Deuk Choi, Won Sik Ham, Hyunho Han, Woong Kyu Han, Won Sik Jang, Seung Hwan Lee, Jaeho Cho
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    Ga Hyun Lee, Yeon Hee Kim, Sang Myung Woo, Woo Jin Lee, Sung-Sik Han, Sang-Jae Park, Sherry Price, Penias Tembo, James R. Hébert, Mi Kyung Kim
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  • 8 Web of Science
  • 11 Crossref
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Original Articles
General
Health Inequities in Cancer Incidence According to Economic Status and Regions Are Still Existed Even under Universal Health Coverage System in Korea: A Nationwide Population Based Study Using the National Health Insurance Database
Youngs Chang, Soo-Hee Hwang, Sang-A Cho, Hyejin Lee, Eunbyul Cho, Jin Yong Lee
Cancer Res Treat. 2024;56(2):380-403.   Published online December 6, 2023
DOI: https://doi.org/10.4143/crt.2023.650
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study is to determine the level of health equity in relation to cancer incidence.
Materials and Methods
We used the National Health Insurance claims data of the National Health Insurance Service between 2005 and 2022 and annual health insurance and medical aid beneficiaries between 2011 and 2021 to investigate the disparities of cancer incidence. We calculated age-sex standardized cancer incidence rates by cancer and year according to the type of insurance and the trend over time using the annual percentage change. We also compared the hospital type of the first diagnosis by cancer type and year and cancer incidence rates by cancer type and region in 2021 according to the type of insurance.
Results
The total cancer incidence increased from 255,971 in 2011 to 325,772 cases in 2021. The absolute difference of total cancer incidence rate between the NHI beneficiaries and the medical aid (MA) recipients increased from 510.1 cases per 100,000 population to 536.9 cases per 100,000 population. The odds ratio of total cancer incidence for the MA recipients increased from 1.79 (95% confidence interval [CI], 1.77 to 1.82) to 1.90 (95% CI, 1.88 to 1.93). Disparities in access to hospitals and regional cancer incidence were profound.
Conclusion
This study examined health inequities in relation to cancer incidence over the last decade. Cancer incidence was higher in the MA recipients, and the gap was widening. We also found that regional differences in cancer incidence still exist and are getting worse. Investigating these disparities between the NHI beneficiaries and the MA recipients is crucial for implementing of public health policies to reduce health inequities.

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  • National Expenditures on Anticancer and Immunomodulating Agents During 2013–2022 in Korea
    Jieun Yun, Youngs Chang, Minsol Jo, Yerin Heo, Dong-Sook Kim
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • A 5-Year Mortality Prediction Model for Prostate Cancer Patients Based on the Korean Nationwide Health Insurance Claims Database
    Joungyoun Kim, Yong-Hoon Kim, Yong-June Kim, Hee-Taik Kang
    Journal of Personalized Medicine.2024; 14(10): 1058.     CrossRef
  • 3,530 View
  • 179 Download
  • 1 Web of Science
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Genitourinary cancer
Physical Activity and Bladder Cancer Risk: Findings of the Japan Collaborative Cohort Study
Hang An, Keyang Liu, Kokoro Shirai, Ryo Kawasaki, Akiko Tamakoshi, Hiroyasu Iso
Cancer Res Treat. 2024;56(2):616-623.   Published online October 6, 2023
DOI: https://doi.org/10.4143/crt.2023.962
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The association of physical activity with the risk of bladder cancer remains inconsistent among Asian populations. We aimed to examine the association in a large Japanese cohort.
Materials and Methods
In a population-based prospective cohort study, a total of 50,374 Japanese adults aged 40-79 years without a history of cancer or cardiovascular disease who had information on physical activity from self-administrated questionnaires were used for analysis. We performed Cox proportional hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident bladder cancer after adjusting for several potential confounders.
Results
During the median 17.5 years of follow-up, 153 incident bladder cancers (116 men and 37 women) were identified. After the multivariable adjustment, HRs (95% CI) of bladder cancer concerning those with recreational sports participation of 1-2 hr/wk, 3-4 hr/wk, and 5 hr/wk and more were 0.67 (0.38-1.20), 0.79 (0.36-1.74), and 0.28 (0.09-0.89), respectively (p for trend=0.017). Compared with mostly sitting at the workplace, occupational physical activity of standing and walking were associated with a lower risk of bladder cancer (HR, 0.53 [95% CI, 0.32 to 0.85]). Hours of daily walking were not associated with the risk. The lower risk of bladder cancer was more evident for recreational sports (HR, 0.33 [95% CI, 0.10 to 1.00]), and for occupational standing and walking activity at work (HR, 0.57 [95% CI, 0.33 to 0.98]) among men.
Conclusion
Recreational sports participation and occupational physical activity were inversely associated with the risk of bladder cancer among Japanese, especially in men.

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  • Physical Activity and Cancer Incidence and Mortality: Current Evidence and Biological Mechanisms
    Joanna Kruk, Basil Hassan Aboul-Enein, Marta Ewelina Gołębiewska, Ewa Duchnik, Urszula Czerniak, Mariola Marchlewicz
    Cancers.2025; 17(9): 1410.     CrossRef
  • 4,613 View
  • 186 Download
  • 1 Crossref
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Breast cancer
Epidemiology of Second Non-breast Primary Cancers among Survivors of Breast Cancer: A Korean Population–Based Study by the SMARTSHIP Group
Haeyoung Kim, Su SSan Kim, Ji Sung Lee, Jae Sun Yoon, Hyun Jo Youn, Hyukjai Shin, Jeong Eon Lee, Se Kyung Lee, Il Yong Chung, So-Youn Jung, Young Jin Choi, Jihyoung Cho, Sang Uk Woo, Korean Breast Cancer Society
Cancer Res Treat. 2023;55(2):580-591.   Published online December 27, 2022
DOI: https://doi.org/10.4143/crt.2022.410
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer.
Materials and Methods
Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis.
Results
The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02).
Conclusion
Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient’s age at IBC diagnosis, income level, and a receipt of systemic treatments.

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  • Risk of second primary cancer in young breast cancer survivors: an important yet overlooked issue
    Xinyi Liang, Yiwei Qin, Pengwei Li, You Mo, Dawei Chen
    Therapeutic Advances in Medical Oncology.2025;[Epub]     CrossRef
  • Molecule subtypes play important roles for second primary malignancies development based on 324,661 breast cancer survivors
    Jin Shi, Jian Liu, Guo Tian, Daojuan Li, Di Liang, Yutong He
    Scientific Reports.2025;[Epub]     CrossRef
  • Association of radiotherapy for stage I–III breast cancer survivors and second primary malignant cancers: a population-based study
    Jin Shi, Jian Liu, Guo Tian, Daojuan Li, Di Liang, Jun Wang, Yutong He
    European Journal of Cancer Prevention.2024; 33(2): 115.     CrossRef
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Marked Reduction in the Risk of Dementia in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study
Jooyoung Oh, Hye Sun Lee, Soyoung Jeon, Jeong-Ho Seok, Tae-Kyung Yoo, Woo-Chan Park, Chang Ik Yoon
Cancer Res Treat. 2023;55(2):551-561.   Published online October 19, 2022
DOI: https://doi.org/10.4143/crt.2022.272
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
An inverse relationship between cancer and neurodegenerative disease, which presents the possibility of a reduced risk of dementia in cancer patients, has been suggested previously. However, a nationwide longitudinal population-based study of specific types of cancer with due consideration of treatment effects has not been conducted.
Materials and Methods
This nationwide population-based cohort study used data obtained in a 12-year period (January 2007- December 2018) in the Korean National Health Insurance claims database. All female breast cancer patients (age ≥ 50 years) diagnosed between 2009 and 2010 were included after excluding those with physician visits for any cancer during a 2-year period (2007-2008). Patients with senile cataract constituted the control group. The main study outcome was the risk of developing dementia.
Results
From a total of 90,396 and 85,906 patients with breast cancer and cataract, respectively, patients without behavior codes were excluded. Data for 15,407 breast cancer patients and 7,020 controls were analyzed before matching. After matching for comorbidities and age, either group comprised 2,252 patients. The median follow-up time was 104.1±24.0 months after matching. After matching, breast cancer was a predictor of a lower risk of for dementia (hazard ratio, 0.091; 95% confidence interval, 0.075 to 0.111; p < 0.001). In breast cancer patients, receiving chemotherapy and endocrine therapy did not significantly affect the incidence of dementia.
Conclusion
Breast cancer was associated with a remarkably decreased risk of dementia. The findings strongly suggest an inverse relationship between cancer and neurodegeneration, regardless of the adverse effects of cancer treatment on cognitive function.

Citations

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  • Timing of risk factors, prodromal features, and comorbidities of dementia from a large health claims case–control study
    Stefan Teipel, Manas Akmatov, Bernhard Michalowsky, Steffi Riedel-Heller, Jens Bohlken, Jakob Holstiege
    Alzheimer's Research & Therapy.2025;[Epub]     CrossRef
  • Bidirectional association between breast cancer and dementia: a systematic review and meta-analysis of observational studies
    Fuxing Bao, Liang Yu, Xiaolei Zhang, Qier Mu
    PeerJ.2025; 13: e18888.     CrossRef
  • Developing theragnostics for Alzheimer's disease: Insights from cancer treatment
    Hyun-ju Lee, Hee-Jeong Choi, Yoo Joo Jeong, Yoon-Hee Na, Jin Tae Hong, Ji Min Han, Hyang-Sook Hoe, Key-Hwan Lim
    International Journal of Biological Macromolecules.2024; 269: 131925.     CrossRef
  • 5,465 View
  • 174 Download
  • 3 Web of Science
  • 3 Crossref
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Special Articles
Prediction of Cancer Incidence and Mortality in Korea, 2022
Kyu-Won Jung, Young-Joo Won, Mee Joo Kang, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo
Cancer Res Treat. 2022;54(2):345-351.   Published online March 21, 2022
DOI: https://doi.org/10.4143/crt.2022.179
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to report the projected cancer incidence and mortality for the year 2022 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2019 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2020 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2022. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend.
Results
In total, 274,488 new cancer cases and 81,277 cancer deaths are expected to occur in Korea in 2022. The most common cancer site is expected to be the thyroid, followed by the lung, colon and rectum, breast, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and gallbladder cancers.
Conclusion
The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

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Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2019
Mee Joo Kang, Young-Joo Won, Jae Jun Lee, Kyu-Won Jung, Hye-Jin Kim, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2022;54(2):330-344.   Published online March 16, 2022
DOI: https://doi.org/10.4143/crt.2022.128
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2019.
Materials and Methods
Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2019, with survival follow-up until December 31, 2020. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea.
Results
In 2019, newly diagnosed cancer cases and deaths from cancer were reported as 254,718 (ASR, 275.4 per 100,000) and 81,203 (ASR, 72.2 per 100,000), respectively. For the first time, lung cancer (n=29,960) became the most frequent cancer in Korea, excluding thyroid cancer. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. The incidence of thyroid cancer increased again from 2016 (annual percentage change, 6.2%). Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2002 to 2013; 3.3% from 2013 to 2019). The 5-year relative survival between 2015 and 2019 was 70.7%, which contributed to prevalent cases reaching over 2 million in 2019.
Conclusion
Cancer survival rates have improved over the past decades, but the number of newly diagnosed cancers is still increasing, with some cancers showing only marginal improvement in survival outcomes. As the number of cancer survivors increases, a comprehensive cancer control strategy should be implemented in line with the changing aspects of cancer statistics.

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Original Articles
Lung and Thoracic cancer
Long-term Exposure to PM10 Increases Lung Cancer Risks: A Cohort Analysis
Hyun Woo Lee, Sung-Chan Kang, Sun-Young Kim, Young-Jae Cho, Seungsik Hwang
Cancer Res Treat. 2022;54(4):1030-1037.   Published online January 17, 2022
DOI: https://doi.org/10.4143/crt.2021.1030
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Although lung cancer incidences in female never-smokers have increased, few studies focus on explicit investigation. We aimed to investigate the relationship between long-term exposure to ambient particulate matter sized 10 μm or less in diameter (PM10) and the incidence of lung cancer within different genders and smoking status populations.
Materials and Methods
We included Seoul metropolitan residents, aged between 20 and 65 years, who underwent a national health screening examination from 2005-2007 and were followed up until 2015. Individual-level long-term exposure to PM10 was assessed based on subject home addresses. To assess the relationship between PM10 and lung cancer, we estimated hazard ratios (HRs) for increased lung cancer incidence from a 10 µg/m3 increase in PM10.
Results
Among 5,831,039 individuals, 36,225 (0.6%) developed lung cancer within the 7 years observed. In females, the majority (94.4%) of lung cancer development was found in never-smokers. In adjusted analyses, a significant relationship between lung cancer development and PM10 was observed in males, regardless of smoking status (never-smoker: HR, 1.14 [95% confidence interval (CI), 1.13 to 1.15]; ex-smoker: HR, 1.16 [95% CI, 1.14 to 1.17]; current smoker: HR, 1.18 [95% CI, 1.17 to 1.19]). We also found significant associations in female never- or ex-smokers with smaller HRs (never-smoker: HR, 1.06 [95% CI, 1.05 to 1.07]; ex-smoker: HR, 1.13 [95% CI, 1.02 to 1.23]; current smoker: HR, 1.04 [95% CI, 0.99 to 1.10]).
Conclusion
Our findings suggest that long-term exposure to PM10 is associated with lung cancer development. A novel approach to lung cancer screening needs to be considered depending on the exposed PM10 level.

Citations

Citations to this article as recorded by  
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    Zikang Feng, Lina Zheng, Ning Xue
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    Kay Choong See
    Singapore Medical Journal.2024;[Epub]     CrossRef
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    Eliana Vergara-Vásquez, Luis M. Hernández Beleño, Tailin T. Castrillo-Borja, Tomás R. Bolaño-Ortíz, Yiniva Camargo-Caicedo, Andrés M. Vélez-Pereira
    Heliyon.2024; 10(16): e36284.     CrossRef
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Skin cancer
Incidence and Survival Rates of Cutaneous Melanoma in South Korea Using Nationwide Health Insurance Claims Data
TaeHo Kim, Siyeong Yoon, Dong-Eun Shin, Sang Cheol Lee, Jisu Oh, So-Young Lee, Do Kyung Kim, Segi Kim, Bosung Jung, Minsup Kim, Soonchul Lee
Cancer Res Treat. 2022;54(3):937-949.   Published online September 30, 2021
DOI: https://doi.org/10.4143/crt.2021.871
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Melanoma incidence is rising worldwide along with the associated personal and socioeconomic health expenditures. We investigated the incidence and survival-rate patterns of melanoma in South Korea using nationwide data.
Materials and Methods
This retrospective cohort study included patients with melanoma between 2004 and 2017, based on National Health Insurance (NHI) claims data in South Korea. The incidence, prevalence, and survival rate were analyzed along with baseline demographic characteristics. We collected solar irradiation dose (SID) and healthcare ranking score (HRS) according to the administrative district from the Korea Meteorological Administration and Korea Health Promotion Institute. The incidence and survival rates were assessed using Pearson's correlation, the Kaplan-Meier estimation, multiple linear regression, and multiple logistic regression methods.
Results
Twenty-five thousand, five hundred ninety-one patients with melanoma were diagnosed during the study period. The age-standardized incidence of melanoma steadily increased from 2004 to 2017 from 2.6 to 3.0/100,000/yr. The incidence of melanoma increased with significantly higher income (p < 0.05). The prevalence followed a similar pattern as the incidence. According to multivariate analysis, HRS significantly influenced the incidence of melanoma in high sun-exposed sites (p < 0.001). There was no significant change in annual mortality. Women had a higher 5-year survival rate than men (78.4% vs. 72.8%). Mortality by the administrative district was highly correlated with HRS.
Conclusion
The incidence of melanoma is increasing in South Korea. A low HRS is associated with both higher incidence and mortality. The findings of this study could be utilized as a guideline for treating melanoma patients.

Citations

Citations to this article as recorded by  
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Close layer
General
Validation of Cancer Diagnosis Based on the National Health Insurance Service Database versus the National Cancer Registry Database in Korea
Min Soo Yang, Minae Park, Joung Hwan Back, Gyeong Hyeon Lee, Ji Hye Shin, Kyuwoong Kim, Hwa Jeong Seo, Young Ae Kim
Cancer Res Treat. 2022;54(2):352-361.   Published online August 2, 2021
DOI: https://doi.org/10.4143/crt.2021.044
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to assess the feasibility of operational definitions of cancer patients in conducting cancer-related studies using the claims data from the National Health Insurance Service (NHIS).
Materials and Methods
Cancer incidence data were obtained from the Korean Central Cancer Registry, the NHIS primary diagnosis, and from the rare and intractable disease (RID) registration program.
Results
The operational definition with higher sensitivity for cancer patient verification was different by cancer type. Using primary diagnosis, the lowest sensitivity was found in colorectal cancer (91.5%; 95% confidence interval [CI], 91.7 to 92.0) and the highest sensitivity was found in breast cancer (97.9%; 95% CI, 97.8 to 98.0). With RID, sensitivity was the lowest in liver cancer (91.9%; 95% CI, 91.7 to 92.0) and highest in breast cancer (98.1%; 95% CI, 98.0 to 98.2). In terms of the difference in the date of diagnosis in the cancer registration data, > 80% of the patients showed a < 31-day difference from the RID definition.
Conclusion
Based on the NHIS data, the operational definition of cancer incidence is more accurate when using the RID registration program claims compared to using the primary diagnosis despite the relatively lower concordance by cancer type requires additional definitions such as treatment.

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Sarcoma
Incidence Patterns and Outcomes of Ewing Sarcoma in South Korea (1999-2017): A Retrospective Analysis Using Korea Central Cancer Registry Data
Jun Ah Lee, Jiwon Lim, Dayeon Park, Hye Young Jin, Meerim Park, Hyeon Jin Park, Jong Woong Park, June Hyuk Kim, Hyun Guy Kang, Young-Joo Won
Cancer Res Treat. 2022;54(2):590-596.   Published online July 20, 2021
DOI: https://doi.org/10.4143/crt.2021.311
AbstractAbstract PDFPubReaderePub
Purpose
Due to low incidence, epidemiologic data of Ewing sarcoma in the Asian population are scarce. We aimed to examine the incidence pattern and outcome of patients with Ewing sarcoma in the Republic of Korea.
Materials and Methods
Data of patients with Ewing sarcoma diagnosed between 1999 and 2017 were obtained from the Korea Central Cancer Registry (KCCR). Incidence, clinical characteristics, and survival rates were analyzed and compared between different age groups.
Results
There were 788 cases (459 males, 329 females), with a median age at diagnosis of 20 years. The age-standardized rate of Ewing sarcoma was 1.01. The number of cases and incidence rates in each age group were as follows: children, 1.6; adolescents and young adults (AYA), 0.93; adults, 0.44; and elderly, 0.53. There were more male cases in children and the AYA group (p < 0.001). Extraskeletal tumors (p < 0.001), primary sites other than extremity (p=0.007), and presence of metastasis at diagnosis (p=0.031) were more frequent in the adults and elderly group. With a median survival time of 78 months, the 5-year overall survival (OS) rate of the entire cohort was 52%. Children fared best (5-year OS, 75%), and the 5-year OS of AYA patients (51%) approximated the OS of the entire cohort. A two-fold difference of 5-year OS was observed between adults and elderly patients (42% vs. 19%). On univariate and multivariate analyses, age ≥ 15 years and presence of metastasis were adverse prognostic factors.
Conclusion
This was the first epidemiologic study of Ewing sarcoma using the KCCR data. With a similar incidence to other Asian countries, the survival rate was slightly lower than that of Euro-American cases. Collaborative clinical studies are necessary to improve the outcome of Ewing sarcoma in low-incidence populations.

Citations

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Special Articles
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2018
Seri Hong, Young-Joo Won, Jae Jun Lee, Kyu-Won Jung, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2021;53(2):301-315.   Published online March 17, 2021
DOI: https://doi.org/10.4143/crt.2021.291
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2018.
Materials and Methods
Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2018, with survival follow-up until December 31, 2019. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, prevalence, and 5-year relative survival rates were calculated, and temporal trends for incidence and mortality rates were evaluated, with annual percentage changes.
Results
In 2018, newly diagnosed cancer cases and deaths from cancer were reported as 243,837 (ASR, 270.4 per 100,000) and 79,153 (ASR, 73.3 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.4% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2007 to 2014; 3.7% from 2014 to 2018). The 5-year relative survival between 2014 and 2018 was 70.3%, which contributed to prevalent cases reaching over 2 million by the end of 2018.
Conclusion
Cancer statistics have improved significantly during the past two decades. However, there remain important challenges to be solved, such as controlling cancers with low survival rates. Cancer statistics can be used to discover blind spots in cancer control, and as evidence for developing and implementing future cancer control strategies.

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Prediction of Cancer Incidence and Mortality in Korea, 2021
Kyu-Won Jung, Young-Joo Won, Seri Hong, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo
Cancer Res Treat. 2021;53(2):316-322.   Published online March 17, 2021
DOI: https://doi.org/10.4143/crt.2021.290
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to report the projected cancer incidence and mortality for the year 2021 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2018 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2019 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2021. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend.
Results
In total, 259,999 new cancer cases and 81,567 cancer deaths are expected to occur in Korea in 2021. The most common cancer site is expected to be the lung, followed by the thyroid, colon and rectum, breast, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and stomach cancers.
Conclusion
The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

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Original Articles
Gynecologic Cancer
Cervical Cancer in Women with Normal Papanicolaou Tests: A Korean Nationwide Cohort Study
Miseon Kim, Hyeongsu Kim, Dong Hoon Suh, Yong Beom Kim
Cancer Res Treat. 2021;53(3):813-818.   Published online December 10, 2020
DOI: https://doi.org/10.4143/crt.2020.826
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to evaluate the risk of cervical cancer diagnosed within 1 year after the last of multiple consecutive normal Papanicolau (Pap) tests.
Materials and Methods
The database of the National Health Insurance Service was used. We obtained Pap test data for 11,052,116 women aged 30-79 between 2007-2012. The cumulative incidence rates and 5-year overall survival rates of cervical cancer diagnosed within 1 year after the last normal Pap test were compared between women with one (N1), two (N2), and three consecutive normal Pap tests (N3). Women who did not receive a Pap test during the study period were assigned in the N0 group.
Results
The 1-year cumulative incidence rates of cervical cancer were 58.9, 24.6, 20.3, and 14.2 per 105 in the N0, N1, N2, and N3 groups, respectively. Compared to the N1 group, the risk of cervical cancer diagnosed within 1 year of the last normal Pap test decreased by 17% (relative risk [RR], 0.825; 95% confidence interval [CI], 0.716 to 0.951) in the N2 group and 42% (RR, 0.578; 95% CI, 0.480 to 0.695) in the N3 group. However, the 5-year survival rate in women diagnosed with cervical cancer within 1 year of the last normal Pap test in the N3 group was not higher than that of the N1 group (79.6% vs. 81.3%, p=0.706).
Conclusion
As normal Pap tests are consecutively repeated, cervical cancer risk significantly decreases. However, previous consecutive normal Pap tests are not associated with improving survival outcomes in women shortly diagnosed with cervical cancer after the last normal Pap test.

Citations

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  • Socioeconomic disparities in Papanicolaou test utilization in Western Iran
    Bahare Safari-Faramani, Roya Safari-Faramani, Farid Najafi, Davoud Khorasani Zavareh, Ali Kazemi Karyani, Mitra Darbandi
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  • 5,844 View
  • 123 Download
  • 3 Web of Science
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Gastrointestinal cancer
Associations of Serum Lipid Level with Gastric Cancer Risk, Pathology, and Prognosis
Gyu Young Pih, Eun Jeong Gong, Ji Young Choi, Min-Ju Kim, Ji Yong Ahn, Jaewon Choe, Suh Eun Bae, Hye-Sook Chang, Hee Kyong Na, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Cancer Res Treat. 2021;53(2):445-456.   Published online November 23, 2020
DOI: https://doi.org/10.4143/crt.2020.599
AbstractAbstract PDFPubReaderePub
Purpose
The association of serum lipids with gastric cancer is controversial. We clarified the role of serum lipids in the development, progression, and prognosis of gastric cancer.
Materials and Methods
In total, 412 patients diagnosed with gastric cancer were prospectively recruited, and 2,934 control subjects who underwent screening endoscopy were enrolled from December 2013 to March 2017 to conduct a case-control study in a tertiary center. Serum lipid profiles, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), apolipoprotein A-I (apoA-I), and apolipoprotein B, and clinicopathologic characteristics were analyzed.
Results
The gastric cancer group showed significantly lower HDL-C, higher LDL-C, and lower apoA-I level than the control group. In multivariate analysis, old age (odds ratio [OR], 1.051; p < 0.001), smoking (OR, 1.337; p < 0.001), a family history of gastric cancer (OR, 2.038; p < 0.001), Helicobacter pylori seropositivity (OR, 4.240; p < 0.001), lower HDL-C (OR, 0.712; p=0.020), and higher LDL-C (p=0.002) were significant risk factors for gastric cancer. Lower HDL-C and higher LDL-C remained significant after adjustments for covariates, including age and sex. In a subgroup analysis of the gastric cancer group, lower TG levels were associated with undifferentiated histology. No serum lipids were associated with overall survival.
Conclusion
Lower HDL-C and higher LDL-C were associated with the risk of gastric cancer, even after adjusting for age, sex, and other factors. In the gastric cancer group, undifferentiated histology was associated with lower TG levels.

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Central nervous system
A Nationwide, Population-Based Epidemiology Study of Primary Central Nervous System Tumors in Korea, 2007-2016: A Comparison with United States Data
Ho Kang, Sang Woo Song, Johyun Ha, Young-Joo Won, Chul-Kee Park, Heon Yoo, Kyu-Won Jung
Cancer Res Treat. 2021;53(2):355-366.   Published online October 7, 2020
DOI: https://doi.org/10.4143/crt.2020.847
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to determine the epidemiologic characteristics and survival of patients with primary brain and other central nervous system (CNS) tumors in Korea and to compare our findings with those from the United States.
Materials and Methods
We collected data on primary brain and CNS tumors diagnosed between 2007 and 2016 from the Korea Central Cancer Registry. The age-standardized incidence rates (ASRs) and 5-year relative survival rates (RSRs) were evaluated. We applied the classification and definitions of the Central Brain Tumor Registry of the United States to our analysis for direct comparison with United States data.
Results
A total of 115,050 primary brain and CNS tumors were identified, and the ASR of all tumors was 22.01 per 100,000 individuals, which was lower than the 23.41 in the United States. However, the ASR of malignant tumors was significantly lower herein (4.27) than in the United States (7.08). Meningeal tumors were the most common histologic group among all tumors (ASR, 8.32). The 5-year RSR of all primary brain and other CNS tumors was 86.4%, and that of all malignant tumors was 44.1%, which was higher than the 35.8% observed in the United States. Among malignant tumors, glioblastomas had the lowest 5-year RSR (12.1%).
Conclusion
In Korea, malignant brain and other CNS tumors have a lower incidence and better survival outcome.

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General
Cancer Incidence and Survival among Adolescents and Young Adults in Korea: An Update for 2016
Meerim Park, Jiwon Lim, Jun Ah Lee, Byung Kiu Park, Kyu-Won Jung, Young-Joo Won, Hyeon Jin Park
Cancer Res Treat. 2021;53(1):32-44.   Published online October 5, 2020
DOI: https://doi.org/10.4143/crt.2020.644
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study investigated the incidence and relative survival rates (RSRs) for cancers among adolescents and young adults (AYAs) aged 15-39 years between 1993 and 2016 in Korea
Materials and Methods
Data from the Korea Central Cancer Registry were used to calculate percent distributions, age-specific incidence rates, age-standardized incidence rates (ASRs) per million, annual percent changes (APCs), average APCs, and RSRs for cancers diagnosed in AYAs.
Results
ASR of all cancers among AYAs was 654.5 per million. The largest diagnosed group of cancers was carcinomas (almost 80%). Crude incidence increased with age, from 170.4 per million for those aged 15-19 years to 1,639.8 per million for those aged 35-39 years. ASR increased from 414.8 per million to 820.4 per million, with an APC of 9.0%. The incidence of thyroid carcinoma showed the most rapid increment (APC, 14.0%), followed by non-Hodgkin lymphoma (APC, 13.4%). The 5-year RSR among AYAs significantly improved from 62.1% to 90.8%. Survival improvement in AYAs was higher than that in children but lower than that in older adults (APC, 2.1% vs. 1.9% vs. 3.1%). The most marked survival improvement was found for leukemia and lymphoma. Astrocytoma, rhabdomyosarcoma, and carcinoma of the trachea, bronchus, and lung had a 5-year RSR of < 50%.
Conclusion
There was an improvement in cancer survivals in AYAs, comparable to that achieved in children. However, survivals in several cancer types do not appear to be improving. Further research focusing on the epidemiology and therapeutic strategies for cancers in AYAs is needed.

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Lymphoma
Increasing Incidence of B-Cell Non-Hodgkin Lymphoma and Occurrence of Second Primary Malignancies in South Korea: 10-Year Follow-up Using the Korean National Health Information Database
Jin Seok Kim, Yanfang Liu, Kyoung Hwa Ha, Hong Qiu, Lee Anne Rothwell, Hyeon Chang Kim
Cancer Res Treat. 2020;52(4):1262-1272.   Published online May 4, 2020
DOI: https://doi.org/10.4143/crt.2020.089
AbstractAbstract PDFPubReaderePub
Purpose
The epidemiology of B-cell non-Hodgkin lymphoma (BNHL) in Asia is not well described, and rates of second primary malignancies (SPM) in these patients are not known. We aimed to describe temporal changes in BNHL epidemiology and SPM incidence in Korea.
Materials and Methods
A retrospective cohort study used claims data from the National Health Insurance Service that provides universal healthcare coverage in Korea. Newly diagnosed patients aged at least 19 years with a confirmed diagnosis of one of six BNHL subtypes (diffuse large cell B-cell lymphoma [DLBCL], small lymphocytic and chronic lymphocytic [CLL/SLL], follicular lymphoma [FL], mantle cell lymphoma [MCL], marginal zone lymphoma [MZL], and lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia [WM]) during the period 2006-2015 were enrolled and followed up until death, dis-enrolment, or study end, whichever occurred first. Patients with pre-existing primary cancers prior to the diagnosis of BNHL were excluded.
Results
A total of 19,500 patients with newly diagnosed BNHL were identified out of 27,866 with non-Hodgkin lymphoma (NHL). DLBCL was the most frequently diagnosed subtype (41.9%-48.4% of NHL patients annually, 2011-2015). Standardized incidence of the six subtypes studied per 100,000 population increased from 5.74 in 2011 to 6.96 in 2015, with most increases in DLBCL, FL, and MZL. The incidence (95% confidence interval) of SPM per 100 person-years was 2.74 (2.26-3.29) for CLL/SLL, 2.43 (1.57-3.58) for MCL, 2.41 (2.10-2.76) for MZL, 2.23 (2.07-2.40) for DLBCL, 1.97 (1.61-2.38) for FL, and 1.41 (0.69-2.59) for WM.
Conclusion
BNHL has been increasingly diagnosed in Korea. High rates of SPM highlight the need for continued close monitoring to ensure early diagnosis and treatment.

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    Ya Hwee Tan, Dok Hyun Yoon, Andrew J. Davies, Christian Buske, Yang Liang Boo, Nagavalli Somasundaram, Francesca Lim, Shin Yeu Ong, Anand Jeyasekharan, Koji Izutsu, Won Seog Kim, Jason Yongsheng Chan
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Special Articles
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017
Seri Hong, Young-Joo Won, Young Ran Park, Kyu-Won Jung, Hyun-Joo Kong, Eun Sook Lee, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2020;52(2):335-350.   Published online March 16, 2020
DOI: https://doi.org/10.4143/crt.2020.206
AbstractAbstract PDFPubReaderePub
Purpose
This study reports the cancer statistics and temporal trends in Korea on a nationwide scale, including incidence, survival, prevalence, and mortality in 2017.
Materials and Methods
The incidence, survival, and prevalence rates of cancer were evaluated using data from the Korea National Cancer Incidence Database from 1999 to 2017 with follow-up until December 31, 2018. Deaths from cancer were assessed using cause-of-death data from 1983 to 2017, obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence, and 5-year relative survival rates were calculated and trend analysis was performed.
Results
In 2017, newly diagnosed cancer cases and deaths from cancer numbered 232,255 (ASR, 264.4 per 100,000) and 78,863 (ASR, 76.6 per 100,000), respectively. The overall cancer incidence rates increased annually by 3.5% from 1999 to 2011 and decreased by 2.7% annually thereafter. Cancer mortality rates have been decreasing since 2002, by 2.8% annually. The 5-year relative survival rate for all patients diagnosed with cancer between 2013 and 2017 was 70.4%, which contributed to a prevalence of approximately 1.87 million cases by the end of 2017.
Conclusion
The burden of cancer measured by incidence and mortality rates have improved in Korea, with the exception of a few particular cancers that are associated with increasing incidence or mortality rates. However, cancer prevalence is increasing rapidly, with the dramatic improvement in survival during the past several years. Comprehensive cancer control strategies and efforts should continue, based on the changes of cancer statistics.

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Prediction of Cancer Incidence and Mortality in Korea, 2020
Kyu-Won Jung, Young-Joo Won, Seri Hong, Hyun-Joo Kong, Eun Sook Lee
Cancer Res Treat. 2020;52(2):351-358.   Published online March 16, 2020
DOI: https://doi.org/10.4143/crt.2020.203
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to report the projected cancer incidence and mortality for the year 2020 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2017 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2018 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years and then by multiplying the projected age-specific rates by the age-specific population. A Joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend.
Results
In total, 243,263 new cancer cases and 80,546 cancer deaths are expected to occur in Korea in 2020. The most common cancer site is expected to be the lung, followed by the stomach, thyroid, colon/rectum, and breast. These five cancers types are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer among people who die is expected to be lung cancer, followed by liver, colon/rectal, pancreatic, and stomach cancers.
Conclusion
The incidence rates for all types of cancer in Korea are estimated to decrease gradually. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

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Original Articles
Time Trends for Prostate Cancer Incidence from 2003 to 2013 in South Korea: An Age-Period-Cohort Analysis
Hyun Young Lee, Do Kyoung Kim, Seung Whan Doo, Won Jae Yang, Yun Seob Song, Bora Lee, Jae Heon Kim
Cancer Res Treat. 2020;52(1):301-308.   Published online August 1, 2019
DOI: https://doi.org/10.4143/crt.2019.194
AbstractAbstract PDFPubReaderePub
Purpose
Prostate cancer (PCa) incidence is affected by aging phenomenon and performance of screening test. In United States, PCa incidence is affected by period effect of U.S. Preventive Services Task Force (USPSTF) recommendation. However, no study has reported the effect of USPSTF recommendation or aging phenomenon on PCa incidence in South Korea. Thus, the objective of this study was to investigate effects of age, period, and birth cohort on PCa incidence using age-period-cohort analysis.
Materials and Methods
Annual report of cancer statistics between 2003 and 2013 from National Health Insurance Service (NHIS) in South Korea for the number of PCa patients and Korean Statistical Information Service (KOSIS) data between 2003 and 2013 from national statistics in South Korea for the number of Korean male population were used. Age-period-cohort models were used to investigate effects of age, period, and birth cohort on PCa incidence.
Results
Overall PCa incidence in South Korea was increased 8.8% in annual percentage (95% confidential interval, 6.5 to 11.2; p < 0.001). It showed an increasing pattern from 2003 to 2011 but a decreasing pattern from 2011 to 2013. Age increased the risk of PCa incidence. However, the speed of increase was slower with increasing age. PCa incidence was increased 1.4 times in 2008 compared to that in 2003 or 2013. Regarding cohort effect, the risk of PCa incidence started to increase from 1958 cohort.
Conclusion
PCa incidence was affected by period of specific year. There was a positive cohort effect on PCa incidence associated with age structural change.

Citations

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Television Viewing Time and Breast Cancer Incidence for Japanese Premenopausal and Postmenopausal Women: The JACC Study
Jinhong Cao, Ehab Salah Eshak, Keyang Liu, Isao Muraki, Renzhe Cui, Hiroyasu Iso, Akiko Tamakoshi, JACC Study Group
Cancer Res Treat. 2019;51(4):1509-1517.   Published online March 21, 2019
DOI: https://doi.org/10.4143/crt.2018.705
AbstractAbstract PDFPubReaderePub
Purpose
The evidence on effects of TV viewing time among premenopausal and postmenopausal women for breast cancer risk remains controversial and limited.
Materials and Methods
A prospective study encompassing 33,276 (17,568 premenopausal, and 15,708 postmenopausal) women aged 40-79 years in whom TV viewing time, menstrual, and reproductive histories were determined by a self-administered questionnaire. The follow-up was from 1988 to 2009 and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for longer TV viewing time in reference to shorter TV viewing time by Cox proportional hazard models.
Results
During 16.8-year median follow-up, we found positive associations between TV viewing time and breast cancer incidence with a borderline significant trend among total women and a significant trend among postmenopausal women. Among total women, the multivariable HRs (95% CIs) for risk of breast cancer in reference to < 1.5 hr/day of TV viewing time were 0.89 (0.59-1.34) for 1.5 to < 3.0 hr/day, 1.19 (0.82-1.74) for 3.0 to < 4.5 hr/day, and 1.45 (0.91-2.32) for ≥ 4.5 hr/day (p for trend=0.053) and among postmenopausal women, the corresponding risk estimates were 1.10 (0.42-2.88), 2.54 (1.11-5.80), and 2.37 (0.92-6.10) (p for trend=0.009), respectively.
Conclusion
Prolonged TV viewing time was associated with increased risk of breast cancer, especially among postmenopausal women.

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Special Articles
Prediction of Cancer Incidence and Mortality in Korea, 2019
Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong, Eun Sook Lee
Cancer Res Treat. 2019;51(2):431-437.   Published online March 18, 2019
DOI: https://doi.org/10.4143/crt.2019.139
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to report on cancer incidence and mortality for the year 2019 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2016 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2017 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly; we used only the data of the latest trend.
Results
A total of 221,347 new cancer cases and 82,344 cancer deaths are expected to occur in Korea in 2019. The most common cancer sites thus far have been the lung, followed by the stomach, colon and rectum, breast, and liver. These five cancers represent half of the overall burden of cancer in Korea. For cancer associated mortality, the most common sites were lung, followed by the liver, colon and rectum, stomach, and pancreas.
Conclusion
The incidence rate of all cancer in Korea is estimated to decrease gradually. These up-todate estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

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Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016
Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong, Eun Sook Lee, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2019;51(2):417-430.   Published online March 18, 2019
DOI: https://doi.org/10.4143/crt.2019.138
AbstractAbstract PDFPubReaderePub
Purpose
This study presents the 2016 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality.
Materials and Methods
Cancer incidence data from 1999 to 2016 were obtained from the Korea National Cancer Incidence Database and followed until December 31, 2017. Mortality data from 1983 to 2016 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2017 among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence and 5-year relative survivals were also calculated.
Results
Overall, 229,180 and 78,194 Koreans were newly diagnosed and died from cancer in 2016, respectively. The ASRs for cancer incidence and mortality in 2016 were 269.0 and 79.8 per 100,000 individuals, respectively. The all-cancer incidence rate increased significantly by 3.6% annually from 1999 to 2011 and started to decrease after 2011 (2011-2016; annual percent change, –3.1%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2012 and 2016 was 70.6%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995.
Conclusion
The cancer prevalence in Korea has increased very fast as survival has improved remarkably. The high prevalence of cancer emphasizes the need for comprehensive cancer control efforts in Korea.

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Original Articles
Risk Assessment of Secondary Primary Malignancies in Nasopharyngeal Carcinoma: A Big-Data Intelligence Platform-Based Analysis of 6,377 Long-term Survivors from an Endemic Area Treated with Intensity-Modulated Radiation Therapy during 2003-2013
Lu-Lu Zhang, Guo-Hong Li, Yi-Yang Li, Zhen-Yu Qi, Ai-Hua Lin, Ying Sun
Cancer Res Treat. 2019;51(3):982-991.   Published online October 11, 2018
DOI: https://doi.org/10.4143/crt.2018.298
AbstractAbstract PDFPubReaderePub
Purpose
The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized.
Methods
and Materials Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival.
Results
Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival.
Conclusion
This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.

Citations

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A Comprehensive Assessment of the Racial and Ethnic Disparities in the Incidence of Gastric Cancer in the United States, 1992-2014
Qiang Yao, Xiaona Qi, Wen Cheng, Shao-Hua Xie
Cancer Res Treat. 2019;51(2):519-529.   Published online June 19, 2018
DOI: https://doi.org/10.4143/crt.2018.146
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the racial and ethnic disparities in the incidence of gastric cancer and their temporal trends in the United States.
Materials and Methods
Using data from 13 cancer registries in the Surveillance, Epidemiology, and End Results database, we assessed such disparities during 1992-2014 in the United States using a variety of disparity metrics.
Results
The age-standardized incidence rate of non-cardia gastric cancer was highest in Asian and Pacific Islanders, while the incidence of cardia gastric was highest in non-Hispanic whites in men and was similarly low in all groups in women. The incidence of non-cardia gastric cancer decreased in all groups over time, particularly in Asian and Pacific Islanders (on average by 3% per year). The incidence of cardia gastric remained relatively stable in virtually all racial/ethnic groups. The racial and ethnic disparities in gastric cancer incidence steadily decreased over time as measured on the absolute scale, which was mainly driven by the reduced disparities in non-cardia gastric cancer. The range difference in the incidence of gastric cancer decreased on average by 4.1% per year in men and by 2.6% per year in women from 1992 to 2014. The between group variance decreased by 5.6% per year in men and by 3.4% per year in women. The relative-scale disparity measures generally remained stable over time.
Conclusion
This study demonstrates decreased racial and ethnic disparities in the incidence of gastric cancer over time in the United States, particularly as measured on the absolute scale.

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Special Article
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2015
Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong, Eun Sook Lee, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2018;50(2):303-316.   Published online March 21, 2018
DOI: https://doi.org/10.4143/crt.2018.143
AbstractAbstract PDFPubReaderePub
Purpose
This study presents the 2015 nationwide cancer statistics in Korea, including the incidence, survival, prevalence, and mortality.
Materials and Methods
Cancer incidence data from 1999 to 2015 was obtained from the Korea National Cancer Incidence Database and followed until December 31, 2016. Mortality data from 1983 to 2015 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2016, among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality and prevalence and 5-year relative survivals were also calculated.
Results
Herein, 214,701 and 76,855 Koreans were newly diagnosed and died from cancer in 2015, respectively. The ASRs for cancer incidence and mortality in 2015 were 258.9 and 82.0 per 100,000, respectively. The overall cancer incidence rate has increased significantly by 3.4% annually from 1999 to 2012, and started to decrease after 2012 (2012-2015, annual percent change, –6.1%). However, the overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2011 and 2015 was 70.7%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995.
Conclusion
Age-standardized cancer incidence rates have decreased since 2012 and mortality rates have declined since 2002; however, the 5-year survival rates have improved remarkably from 1993-1995 to 2011-2015 in Korea.

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