Cancer Research and Treatment

Original Articles

General

Estimation of Population Attributable Fraction by Hormone and Reproductive Factors on Female Cancer in the Republic of Korea, 2015 to 2030: Youjin Hong, Soseul Sung, Woojin Lim, Sungji Moon, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seung-Ho Ryu, Sun Young Yang, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Jeong-Soo Im, Hong Gwan Seo, Sue K. Park; Cancer Res Treat. 2025;57(3):649-658. Published online November 19, 2024; DOI: https://doi.org/10.4143/crt.2024.707

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Purpose
Population attributable fractions (PAFs) for hormone and reproductive factors have been estimated in several countries. International Agency for Research on Cancer (IARC) designated as group 1 and group 2A carcinogen for hormone factors in breast, ovarian, endometrial and uterine cervix cancer. This study aimed to estimate the PAFs of hormone/reproductive factor attributed to cancer incidence and deaths in Korean women and projected trends from 2015 to 2030.
Materials and Methods
The PAF was estimated with using the 2005 standardized prevalence rates and 2020 incidence and deaths with a 15-year latency. Based on the Levin’s formula, prevalence rates were calculated using the Korea National Health and Nutrition Examination Survey (KNHANES) and the relative risks, which were the risk of selected female cancer associated with oral contraceptive, hormone replacement therapy and duration of breastfeeding, were estimated from the meta-analysis of studies performed in Korean women population. Studies based on the Asian and Global populations were calculated as a sensitivity analysis.
Results
The estimation PAFs for hormone was 1.02% with 1,192 cases and reproductive was 2.67% with 3,112 cases. Moreover, 0.40% (125 deaths) and 1.09% (342 deaths) in female-related cancer deaths in order. Estrogen-progesterone combined hormone replacement therapy (HRT) accounted the most proportion in hormone factors and breastfeeding in reproductive factors. Also, the breast cancer had the highest percent in both hormone and reproductive factors.
Conclusion
Through this study, 1.02% and 2.67% of female-related cancer incidence will be reduced by encouraging avoiding the use of oral contraceptives and HRT and breastfeeding for more than 6 months in reproductive factors. Additionally, among four selected female cancers in this study, breast cancer was observed to be a significant level of prevention.

Citations

Citations to this article as recorded by

Application and interpretation of attributable fraction measures from clinical practice to policy: a narrative review
Sue Kyung Park
Journal of the Korean Medical Association.2026; 69(5): 411. CrossRef
Fraction of cancer incidence and mortality attributable to dietary factors in Korea from 2015 to 2030
Hyun Jeong Cho, Jin Young Yoo, Ga-Eun Yie, An Na Kim, Soseul Sung, Sungji Moon, Youjin Hong, Sangjun Lee, Inah Kim, Kwang-Pil Ko, Sun-Seog Kweon, Jung Eun Lee, Sue K. Park
Epidemiology and Health.2025; 47: e2025065. CrossRef

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Gastrointestinal Cancer

Association between ALDH2 and ADH1B Polymorphisms and the Risk for Colorectal Cancer in Koreans: Chang Kyun Choi, Min-Ho Shin, Sang-Hee Cho, Hye-Yeon Kim, Wei Zheng, Jirong Long, Sun-Seog Kweon; Cancer Res Treat. 2021;53(3):754-762. Published online December 24, 2020; DOI: https://doi.org/10.4143/crt.2020.478

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Purpose
Excessive alcohol consumption has been linked to an increased risk of colorectal cancer (CRC). We evaluated the association between alcohol-related genetic variants and CRC risk.
Materials and Methods
The study cohort consisted of 5,435 CRC cases and 3,553 population-based cancer-free controls. Genotype data were generated from germline DNA using the Infinium OncoArray-500K BeadChip in 2,535 cases and 2,287 controls and the Infinium Multi-Ethnic Global BeadChip in 2,900 cases and 1,266 controls. The associations between aldehyde dehydrogenase 2 (ALDH2) rs671 and alcohol dehydrogenase 1B (ADH1B) rs1229984 polymorphisms and CRC risk were assessed using multivariate logistic regression analyses.
Results
Compared with the major homozygous ALDH2 genotype (GG), heterozygous or minor homozygous ALDH2 genotype (GA or AA, related to a low alcohol consumption) was significantly associated with a reduced risk for CRC in men (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.68 to 0.90), but not in women (OR, 0.70; 95% CI, 0.47 to 1.05). A stronger association was found among regular drinkers (OR, 0.58; 95% CI, 0.47 to 0.71 in men and OR, 0.33; 95% CI, 0.18 to 0.58 in women). No association of CRC risk with ADH1B rs1229984 genotype was found. The association between alcohol-related combined genotypes and risk of CRC was significant (p for linear=0.001). The combined genotype with the highest genetically predicted alcohol consumption (ALDH2 rs671 GG and ADH1B rs1229984 AG/GG) was associated with a high risk for CRC (OR, 1.35; 95% CI, 1.11 to 1.63).
Conclusion
Our study provides strong evidence for a possible causal association between alcohol consumption and CRC risk.

Citations

Citations to this article as recorded by

ADH1B acts as a tumor suppressor in hepatocellular carcinoma: evidence from multi-omics integration and experimental validation
Fang-Cheng Jiang, Xin-Min Liang, Zhi-Heng Chen, Ye-Hui He, Jiao-Jiao Chen, Harivignesh Murugesan, Zhen-Bo Feng, Li Gao
European Journal of Medical Research.2026;[Epub] CrossRef
ADH1B regulates tumor stemness by activating the cAMP/PKA/CREB1 signaling axis to inhibit recurrence and metastasis of lung adenocarcinoma
Hairong Shi, Youtao Xu, Guoxin Song, Tianzhu Qiu
Biochemical and Biophysical Research Communications.2025; 760: 151681. CrossRef
Alcohol-Metabolizing Enzymes, Liver Diseases and Cancer
Tao Liu, FeiYu Zhang, Yue Feng, PanShiLi Han, YanHang Gao
Seminars in Liver Disease.2025; 45(01): 099. CrossRef
Genetic Polymorphisms of ALDH2 and ADH1B in Alcohol-Induced Liver Injury: Molecular Mechanisms of Inflammation and Disease Progression in East Asian Populations
Tomoko Tadokoro, Kyoko Oura, Mai Nakahara, Koji Fujita, Joji Tani, Asahiro Morishita, Hideki Kobara
International Journal of Molecular Sciences.2025; 26(17): 8328. CrossRef
Establishment and validation of a prognostic model based on vasculogenic mimicry-related gene clustering in ovarian cancer
Xueyuan Zhao, Yan Jia, Weijia Wen, Caixia Shao, Qiaojian Zou, Linna Chen, Hongye Jiang, Guofen Yang, Wei Wang, Chunyu Zhang, Shuzhong Yao
Frontiers in Oncology.2025;[Epub] CrossRef
Potentially functional genetic variants in interferon regulatory factor family genes are associated with colorectal cancer survival
Xiaoxia Tong, Chenghui Li, Li Ma, Di Wu, Yonglei Liu, Liqin Zhao, Mengyun Wang
Molecular Carcinogenesis.2024; 63(9): 1669. CrossRef
Impacts of ADH1B rs1229984 and ALDH2 rs671 polymorphisms on risks of alcohol‐related disorder and cancer
Ting‐Gang Chang, Ting‐Ting Yen, Chia‐Yi Wei, Tzu‐Hung Hsiao, I‐Chieh Chen
Cancer Medicine.2023; 12(1): 747. CrossRef
TP73-AS1 rs3737589 Polymorphism is Associated With the Clinical Stage of Colorectal Cancer
Yichang Gao, Shulong Zhang, Xueren Gao, Vijaya Anand
Evidence-Based Complementary and Alternative Medicine.2023;[Epub] CrossRef
Identifying and analyzing the key genes shared by papillary thyroid carcinoma and Hashimoto’s thyroiditis using bioinformatics methods
Ting-ting Liu, De-tao Yin, Nan Wang, Na Li, Gang Dong, Meng-fan Peng
Frontiers in Endocrinology.2023;[Epub] CrossRef
No association between genetically predicted C-reactive protein levels and colorectal cancer survival in Korean: two-sample Mendelian randomization analysis
Chang Kyun Choi, Jung-Ho Yang, Min-Ho Shin, Sang-Hee Cho, Sun-Seog Kweon
Epidemiology and Health.2023; 45: e2023039. CrossRef
Genetically determined alcohol consumption and cancer risk in Korea
Keum Ji Jung, Ji Woo Baek, Sang Yop Shin, Sun Ha Jee
Epidemiology and Health.2023; 45: e2023077. CrossRef
Dysregulated Expression of Three Genes in Colorectal Cancer Stratifies Patients into Three Risk Groups
Alba Rodriguez, Luís Antonio Corchete, José Antonio Alcazar, Juan Carlos Montero, Marta Rodriguez, Luis Miguel Chinchilla-Tábora, Rosario Vidal Tocino, Carlos Moyano, Saray Muñoz-Bravo, José María Sayagués, Mar Abad
Cancers.2022; 14(17): 4076. CrossRef
Alcohol metabolism genes and risks of site‐specific cancers in Chinese adults: An 11‐year prospective study
Pek Kei Im, Ling Yang, Christiana Kartsonaki, Yiping Chen, Yu Guo, Huaidong Du, Kuang Lin, Rene Kerosi, Alex Hacker, Jingchao Liu, Canqing Yu, Jun Lv, Robin G. Walters, Liming Li, Zhengming Chen, Iona Y. Millwood
International Journal of Cancer.2022; 150(10): 1627. CrossRef
The Roles of Drug Metabolism-Related ADH1B in Immune Regulation and Therapeutic Response of Ovarian Cancer
Zhijie Xu, Bi Peng, Fanhua Kang, Wenqin Zhang, Muzhang Xiao, Jianbo Li, Qianhui Hong, Yuan Cai, Wei Liu, Yuanliang Yan, Jinwu Peng
Frontiers in Cell and Developmental Biology.2022;[Epub] CrossRef
Alcoholic liver disease: a new insight into the pathogenesis of liver disease
Seol Hee Park, Young-Sun Lee, Jaemin Sim, Seonkyung Seo, Wonhyo Seo
Archives of Pharmacal Research.2022; 45(7): 447. CrossRef
MMP2 Polymorphisms and Colorectal Cancer Susceptibility in a Chinese Han Population
Xu Liu, Kelaier Yang, Zhangfu Li, Jikui Liu
International Journal of General Medicine.2022; Volume 15: 6009. CrossRef
ALDH2 gene rs671 G > a polymorphism and the risk of colorectal cancer: A hospital‐based study
Zhuoxin Zhang, Yijin Chen, Qingqing Zhuo, Changqing Deng, Yang Yang, Wen Luo, Shixun Lai, Hui Rao
Journal of Clinical Laboratory Analysis.2022;[Epub] CrossRef

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Patient’s Cognitive Function and Attitudes towards Family Involvement in Cancer Treatment Decision Making: A Patient-Family Caregiver Dyadic Analysis: Dong Wook Shin, Juhee Cho, Debra L. Roter, So Young Kim, Jong Hyock Park, Hyung Kook Yang, Hyun Woo Lee, Sun-Seog Kweon, Yune Sik Kang, Keeho Park; Cancer Res Treat. 2018;50(3):681-690. Published online July 4, 2017; DOI: https://doi.org/10.4143/crt.2017.201

Abstract PDF PubReader ePub

Purpose
Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and family caregivers preferences for family involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and family members agree on preferences.
Materials and Methods
A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forfamily involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment).
Results
Both patients and family caregivers preferred greater family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment.
Conclusion
Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing family involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.

Citations

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Role of the Family in Treatment Decision-Making for Women with Breast Cancer: a Study from China
Xinyu Lin, Nan Lin, Kai Fang, Ying Wang, Wenqing Hu, Lihua Li
Cancer Investigation.2026; 44(2): 136. CrossRef
Deciding on the decision-maker in older adults with cancer: Patient autonomy, physician paternalism, and caregiver support
Clark DuMontier
Journal of Geriatric Oncology.2026; 17(2): 102930. CrossRef
Shared decision-making with family involvement in Korean healthcare: a narrative review
Sang-Ho Yoo
Journal of the Korean Medical Association.2026; 69(7): 577. CrossRef
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Seung Eun Lee, Misun Hwang, Yun Jiang, Monique J Brown
Innovation in Aging.2026;[Epub] CrossRef
The regulation mechanism of perceived stress on cognitive function of patients with breast cancer undergoing chemotherapy: a multiple mediation analysis
Xiaotong Ding, Qing Wang, Houming Kan, Fang Zhao, Mingyue Zhu, Hongli Chen, Enfeng Fu, Zheng Li
Breast Cancer Research and Treatment.2025; 211(1): 245. CrossRef
The impact of end-of-life disability level on middle-aged and older adults’ utilization of medical services
Xiaojing Huang, Wenqing Liu, Qi Pan, Man Yan, Lili Zhu, Chunxia Miao, Yun Zhao
Frontiers in Public Health.2025;[Epub] CrossRef
Comorbid Dementia and Cancer Therapy Decision-Making: A Scoping Review
Sean N. Halpin, Gabriel Alain, Aaron Seaman, Erin E. Stevens, Hui Zhao, Mackenzie E. Fowler, Qiuyang Zhang, Tamara Cadet, Minzhi Ye, Jessica L. Krok-Schoen
Journal of Applied Gerontology.2024; 43(8): 1132. CrossRef
Assessing the association between quantity and quality of family caregiver participation in decision-making clinical encounters on patient activation in the metastatic breast cancer setting
Nicole L. Henderson, Tanvi Padalkar, Garrett Bourne, Emma K. Hendrix, Courtney P. Williams, J. Nicholas Odom, Kristen Triebel, Gabrielle B. Rocque
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Fatalism and metaphor in Confucianism: A qualitative study of barriers to genetic testing among first‐degree relatives of hereditary cancer patients from China
Chaonan Jiang, Li Liu, Ye Wang, Liangzheng Wu, Wenxia Zhang, Xiaodan Wu
Psycho-Oncology.2023; 32(2): 275. CrossRef
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Cancer.2023; 129(9): 1443. CrossRef
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Samar J. Melhem, Shereen Nabhani-Gebara, Reem Kayyali
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