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.The annual trends of national incidence and mortality of prostate and kidney cancers provided by the Korean Statistical Information Service were evaluated.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.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.
The establishment of clinical epidemiology has meant the improvement of the quality and quantity of clinical science because clinical epidemiology has contributed to the process of decision making across the full scope of clinical practice, including diagnosis, treatment, and care, as well as prevention. Epidemiological and statistical methodologies have been used to analyze scientific evidence on clinical problems. The orientation of evidence-based medicine introduced in the mid-1990s is the application of clinical epidemiology to clinical practice for individual patients. The concept of evidence-based medical practice has triggered the expansion of the scope and range of methods of clinical epidemiology. In spite of the global situation, the formal activity in the area of clinical epidemiology in Korean Medical Academic Association is negligible, with few clinical epidemiologists involved. One of several approaches to stimulating the practice of clinical epidemiology in Korea would be to foster clinical epidemiology as a specialization of clinical preventive medicine, which is one of the sub-specialties of preventive medicine in Korea.
Background: The tuberculin skin test (TST) has limitations in diagnosing a latent tuberculosis infection (LTBI). The interferon-gamma release assay (IGRA) was introduced to middle- and high-school students since 2009 by the Korea Centers for Disease Control and Prevention. The aim was to evaluate the utility of IGRA in diagnosing LTBI in middle- and high-school students.
Objectives : This study aimed to calculate the survival rates of cancer patients in Jeju Island residents from 2000 to 2001, based on their major primary sites of occurrence.Methods : Data were extracted from the database of the Jejudo Cancer Registry (JCR).The eligible population comprised 2,382 cancer cases, whose cancers were diagnosed from 1 January 2000 through 31 December 2001.Of the eligible population, 1,438 patients with 5 major cancers defined by the level of incidence rates were selected as the study participants.The period of survival for each case was calculated from the date of first diagnosis to the date of death, or the end of follow-up, i.e., 31 December 2003.The observed survival rates (OSR) and relative survival rates (RSR) were calculated according to sex, age-group, and primary sites of occurrence.Results : The 3-year OSR and RSR in 5 major cancers were higher in women than in men except 75 year-old over group.The 3-year RSR of stomach, colorectum, liver, and lung in both sexes were 61.0%, 62.6%, 24.7%, and 22.8%, respectively.The respective rates in JCR showed some statistically significant differences from those in the Korea Central Cancer Registry (KCCR).Conclusions : These results would suggest some clues about prognostic factors of major cancers in Korean, and could apply to planning and evaluating of cancer control strategies in Jeju Island.
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.
Purpose To estimate the current cancer burden in Korea, newly diagnosed cancer cases and cancer incidence rates were calculated for the years 2003~2005. Materials and Methods The cancer incidence cases and rates were calculated from the Korea National Cancer Incidence Database. Crude and age-standardized incidence rates were calculated by gender for specified cancer sites in 5-year age groups. Results From 2003 to 2005, 398,824 cases of cancer were newly diagnosed in Korea (218,856 in men and 179,968 in women). For all sites combined, the crude incidence rate (CR) was 300.0 and 248.2 for men and women and the age-standardized incidence rate (ASR) was 297.0 and 191.2 per 100,000, respectively. Among men, five leading cancers were stomach (CR 66.0, ASR 64.2), lung (CR 48.5, ASR 50.3), liver (CR 44.9, ASR 42.1), colon and rectum (CR 37.9, ASR 37.2), and prostate cancer (CR 12.7, ASR 13.8). Among women, five leading cancers were breast (CR 37.3, ASR 29.0), thyroid (CR 36.2, ASR 28.8), stomach (CR 34.1, ASR 25.4), colon and rectum (CR 28.0, ASR 21.1), and lung cancer (CR 17.9, ASR 12.8). In the 0~14-year-old group, leukemia was the most common in both sexes; in the 15~34 group, the most common cancer was stomach cancer for men and thyroid cancer for women; in the 35~64 group, stomach cancer for men and breast cancer for women; among those 65 and over, lung cancer for men and stomach cancer, for women, respectively. Conclusion The cancer incidence rates have increased in recent years, and more cancers are expected to develop as Korea is quickly becoming an aged society. The cancer incidence statistics in this report can be used as an important source to effectively plan and evaluate the cancer control program in Korea. Key words: Cancer incidence, Nationwide cancer registry, Korea
Objectives :The frequency of visiting clinics in Jejudo for treating atopic dermatitis (AD) has been reported to be higher than that for other counties of Korea.The aim of this work was to estimate the prevalence of AD for the students of the primary, middle and high schools in Jejudo, Korea.Methods : We planned to evaluate about 5,000 students, so classes were randomly selected by random systematic sampling methods.The parents of all the students in the selected classes were asked to respond to a structured questionnaire concerned with the prevalence of AD.Results : The prevalence of AD based on ever being diagnosed by a doctor, on currently being diagnosed by a doctor, on ever being treated for AD by a doctor, on currently being treated for AD by a doctor was 25.57% (95% CI=25.3-25.8),14.67% (95% CI=14.5-14.9),21.90% (95% CI=21.6-22.2) and 14.41% (95% CI=14.2-14.6),respectively.Conclusions : On comparing the prevalence of AD, the students in Jejudo had a higher number of recurrence events in spite of their lower number of cases.Further studies are needed to evaluate these aspects of AD.
Objectives :The purpose of this systematic review was to investigate the association between dietary intake of citrus fruits and prostate cancer risk.Methods : Authors searched electronic databases and the reference lists of publications of diet and prostate cancer studies until August 2007.All of the epidemiological studies that obtained individual data on dietary intake of citrus fruits and presented risk estimates of the association between intake of citrus fruits and risk of prostate cancer were identified and included.Using general variance-based methods, study-specific odds ratios (OR)/ relative risk (RR) and associated confidence interval (CI)/ standard error (SE) for highest versus lowest intake of citrus fruits level were extracted from each paper.Results : Eleven articles including six case-control studies, one nested case-control study and four cohort studies, proved eligible.Overall summary OR using random effect model did not show an association in risk of prostate caner with intake of citrus fruits (summary OR=1.03, 95% CI=0.89-1.19)with large heterogeneity across studies that we were unable to explain (I 2 =67.88%).The summary ORs in case-control studies and cohort studies were 1.10 (95% CI=0.97-1.22)and 1.05 (95% CI=0.96-1.14),respectively.Conclusions : Pooled results from observational studies did not show an association between intake of citrus fruits and the risk of prostate cancer, although results vary substantially across studies.
End-of-life (EOL) treatment issues have recently gained societal attention after the Korean Supreme Court's ruling that the presumed wishes of an elderly woman in a persistent vegetative state (PVS) should be honored. We tried to evaluate what Koreans thought about controversial issues regarding EOL treatments.We surveyed Koreans with the following questions: 1) are ventilator-dependent PVS patients candidates for end-of life treatment decisions? 2) Is withholding and withdrawing EOL treatment the same thing? 3) In an unconscious, terminally ill patient, whose wishes are unknown, how should EOL decisions be made? 4) How should we settle disagreement amongst medical staff and the patient's family on EOL decisions?One thousand Koreans not working in healthcare and five hundred healthcare professionals responded to the survey. Fifty-seven percent of Koreans not working in healthcare and sixty seven percent of Korean healthcare professionals agreed that ventilator-dependent PVS patients are candidates for EOL treatment decisions. One quarter of all respondents regarded withholding and withdrawing EOL treatment as equal. Over 50% thought that EOL treatment decisions should be made through discussions between the physician and the patient's family. For conflict resolution, 75% of Koreans not working in healthcare preferred direct settlement between the medical staff and the patient's family while 55% of healthcare professionals preferred the hospital ethics committee.Unsettled issues in Korea regarding EOL treatment decision include whether to include ventilator-dependent PVS patients as candidates of EOL treatment decision and how to sort out disagreements regarding EOL treatment decisions. Koreans viewed withholding and withdrawing EOL treatment issues differently.
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