Cancer Research and Treatment

Original Articles

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; Received July 26, 2024 Accepted November 18, 2024 Published online November 19, 2024; DOI: https://doi.org/10.4143/crt.2024.707 [Accepted]

Abstract PDF: Purpose
Population attributable fractions (PAFs) for hormone and reproductive factors have been estimated in several countries. 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 (RRs), 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. EP combined 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 (OCs) and hormone replacement therapy (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.

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Fraction of Cancer Attributable to Carcinogenic Drugs in Korea from 2015 to 2030: Woojin Lim, Soseul Sung, Youjin Hong, Sungji Moon, Sangjun Lee, Kyungsik Kim, Jung Eun Lee, Inah Kim, Kwang-Pil Ko, Sue K. Park; Received June 28, 2024 Accepted November 5, 2024 Published online November 6, 2024; DOI: https://doi.org/10.4143/crt.2024.644 [Accepted]

Abstract PDF: Purpose
This study aims to estimate and project the Population Attributable Fraction (PAF) of cancer incidence and death due to carcinogenic drug use in Korea from 2015 to 2030, to estimate the degree of cancer prevention from exposure to carcinogenic drugs in Korea. Selected carcinogenic drugs were immunosuppressive and antineoplastic drugs classified as group I by the International Agency for Research on Cancer (IARC).
Materials and Methods
Systematic review and meta-analyses were conducted to estimate the relative risk (RR) of cancer associated with carcinogenic drug use. Age was standardized using the annual prevalence rate of the National Health Insurance Service sample cohort (NHIS-NSC) from 2002 to 2013 to calculate the standardized prevalence rate of carcinogenic drug use each year. The PAF of specific cancer incidence and death were calculated using Levin's formula and Monte Carlo methods. The prevalence rates were extrapolated to estimate the trend of PAF from 2015 to 2030.
Results
In 2015, carcinogenic drugs attributed to 0.003% and 0.002% among the causes of cancer incidence and death in Korea. However, carcinogenic drugs attributed to 1.1% among the causes of both cancer incidence and death in patients with clinical indications of carcinogenic drugs.
Conclusion
The PAF in patients with clinical indications of carcinogenic drugs were significantly high and expected to increase rapidly over time. Since these drugs are listed as essential by the World Health Organization (WHO), and may be difficult to replace, a surveillance system on susceptible populations using group I carcinogenic drugs must be discussed and implemented.

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Gastrointestinal Cancer

Population Attributable Fraction of Helicobacter pylori Infection–Related Gastric Cancer in Korea: A Meta-Analysis: Yoon Park, Moran Ki; Cancer Res Treat. 2021;53(3):744-753. Published online December 15, 2020; DOI: https://doi.org/10.4143/crt.2020.610

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to determine the proportion of gastric cancer attributable to Helicobactor pylori in the Korean population. Infection with H. pylori has been recognized as the most significant risk factor for gastric cancer. In Korea, gastric cancer is the most common cancer that accounted for 13.3% of all cancers in 2016. In particular, men are most commonly diagnosed with gastric cancer; the age-standardized incidence rate in men is 49.6 per 100,000, which is more than twice the incidence in women.
Materials and Methods
The population attributable fraction (PAF) was calculated as a function of the relative risk (RR) of gastric cancer associated with H. pylori infections. To estimate PAF of gastric cancer due to H. pylori, the prevalence of H. pylori infections was extrapolated for the year of 1990 and a pooled RR was obtained by conducting a meta-analysis of studies recently published in Korea.
Results
The estimated prevalence of H. pylori was 76.4% in men and 71.9% in women. The RRs (95% confidence interval) pooled from case-control studies using a random effects model was 1.69 (1.29-2.22) for overall gastric cancer and 2.17 (1.04-4.55) for non-cardia gastric cancer. Using the RR for overall gastric cancer, the estimated PAFs due to H. pylori were 34.5% in men and 33.2% in women.
Conclusion
The occurrence of gastric cancer in Koreans may be affected by other risk factors in addition to H. pylori infection, which may contribute to increasing baseline risk for gastric cancer.

Citations

Citations to this article as recorded by

Trends of gastric cancer burdens attributable to risk factors in China from 2000 to 2050
Feifan He, Shaoming Wang, Rongshou Zheng, Jianhua Gu, Hongmei Zeng, Kexin Sun, Ru Chen, Li Li, Bingfeng Han, Xinqing Li, Wenqiang Wei, Jie He
The Lancet Regional Health - Western Pacific.2024; 44: 101003. CrossRef
Estimation of the benefit from pre‐emptive genotyping based on the nationwide cohort data in South Korea
Ki Young Huh, Sejung Hwang, Joo Young Na, Kyung‐Sang Yu, In‐Jin Jang, Jae‐Yong Chung, Seonghae Yoon
Clinical and Translational Science.2024;[Epub] CrossRef
Unveiling the Younger Face of Gastric Cancer: A Comprehensive Review of Epidemiology, Risk Factors, and Prevention Strategies
Kai Kang, Mary Angelica Bagaoisan, YuXin Zhang
Cureus.2024;[Epub] CrossRef
Gastric cancer—Epidemiology, modifiable and non-modifiable risk factors, challenges and opportunities: An updated review
Tajul Islam Mamun, Sabrina Younus, Md. Hashibur Rahman
Cancer Treatment and Research Communications.2024; 41: 100845. CrossRef
Risk factors for gastric cancer: A comprehensive analysis of observational studies
Yuqing Hui, Chunyi Tu, Danlei Liu, Huijie Zhang, Xiaobing Gong
Frontiers in Public Health.2023;[Epub] CrossRef
Cardia and non‐cardia gastric cancer risk associated with Helicobacter pylori in East Asia and the West: A systematic review, meta‐analysis, and estimation of population attributable fraction
Zhongxue Han, Jing Liu, Wenlin Zhang, Qingzhou Kong, Meng Wan, Minjuan Lin, Boshen Lin, Yuming Ding, Miao Duan, Yueyue Li, Xiuli Zuo, Yanqing Li
Helicobacter.2023;[Epub] CrossRef
Impact of Disability Status on Mortality in Patients with Gastric Cancer: A Nationwide Study Focusing on Regional Disparities
Woo-Ri Lee, Kyu-Tae Han, Mingee Choi, Seojin Park, Woorim Kim
Healthcare.2023; 11(5): 641. CrossRef
Characteristics of phenotypic antibiotic resistance of Helicobacter pylori and its correlation with genotypic antibiotic resistance: A retrospective study in Ningxia
Shengjuan Hu, Yan Zhou, Yanhong Deng, Yang Bo, Xianmei Chen, Wei Yang, Ruichun Shi, Wei Zhao, Zhanbing Hou, Jianping Hu, Jianguo Liu, Xilong Zhang, Heli Yong, Ping Wang, Fei Li, Hailong Qi, Xiaoyun Wang, Lijuan Jin, Ting Cui, Haijiang Yong, Xue Li, Bin Ya
Helicobacter.2023;[Epub] CrossRef
Comparison of the Concordance of Allergic Diseases between Monozygotic and Dizygotic Twins: A Cross-Sectional Study Using KoGES HTS Data
Eun Lee, Joo-Hee Kim, Hyo Choi, Ho Kang, Hyun Lim, Ji Kim, Seong-Jin Cho, Eun Nam, Ha Park, Nan Kim, Mi Kwon
Journal of Personalized Medicine.2023; 13(5): 721. CrossRef
Updated Epidemiology of Gastric Cancer in Asia: Decreased Incidence but Still a Big Challenge
Wing Sum Shin, Fuda Xie, Bonan Chen, Peiyao Yu, Jun Yu, Ka Fai To, Wei Kang
Cancers.2023; 15(9): 2639. CrossRef
Associations between Physical Activity and Incidence of Cancer among Overweight Adults in Korea: Results from the Health Examinees-G Study
Jaesung Choi, JooYong Park, Ji-Eun Kim, Miyoung Lee, Daehee Kang, Aesun Shin, Ji-Yeob Choi
Cancer Prevention Research.2023; 16(7): 405. CrossRef
Risk Factors to Predict Ocular Metastasis in Older Adult Patients With Gastric Cancer:LDL, ApoA1, and CA724
Wen-Qing Shi, Shi-Nan Wu, Tie Sun, Hui-Ye Shu, Qi-Chen Yang, Qiu-Yu Li, Ting Su, Yi-Cong Pan, Rong-Bin Liang, Yi Shao
Technology in Cancer Research & Treatment.2022;[Epub] CrossRef
Effect of gastric cancer screening on long-term survival of gastric cancer patients: results of Korean national cancer screening program
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu-Won Jung, Kui Son Choi
Journal of Gastroenterology.2022; 57(7): 464. CrossRef
Comparison of Concordance of Peptic Ulcer Disease, Non-Adenomatous Intestinal Polyp, and Gallstone Disease in Korean Monozygotic and Dizygotic Twins: A Cross-Sectional Study
Hyo Geun Choi, So Young Kim, Hyun Lim, Joo-Hee Kim, Ji Hee Kim, Seong-Jin Cho, Eun Sook Nam, Kyueng-Whan Min, Ha Young Park, Nan Young Kim, Sangkyoon Hong, Younghee Choi, Ho Suk Kang, Mi Jung Kwon
International Journal of Environmental Research and Public Health.2022; 19(19): 12708. CrossRef
Cancer Etiology and Prevention Principle: “1 + X”
Hui Liu, Zigang Dong
Cancer Research.2021; 81(21): 5377. CrossRef

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Gastrointestinal cancer

Population Attributable Fraction of Established Modifiable Risk Factors on Colorectal Cancer in Korea: Sooyoung Cho, Aesun Shin; Cancer Res Treat. 2021;53(2):480-486. Published online October 6, 2020; DOI: https://doi.org/10.4143/crt.2019.742

Abstract PDF Supplementary Material PubReader ePub

Purpose
We estimated the population attributable fraction (PAF) of established risk factors for colorectal cancer, to provide evidence for prioritizing cancer prevention policy.
Materials and Methods
The exposure prevalence was calculated by using data from the 2005 Korean National Health Examination Survey for tobacco smoking, alcohol consumption, obesity, physical inactivity, and meat intake. Risk estimates (relative risks) were selected from the published meta-analyses. Cancer incidence data from the Korea Central Cancer Registry were used to estimate the preventable number of colorectal cancer cases in 2015.
Results
The PAFs of the tobacco smoking, alcohol consumption, obesity, physical inactivity, and consumption of red and processed meat were as follows: 9.2%, 11.1%, 9.1%, 18.9%, and 10.1% for colon cancer and 21.8%, 12.3%, 3.5%, 5.3%, and 9.2% for rectal cancer among men; 1.0%, 1.3%, 2.7%, 12.3% and 9.2% for colon cancer and 1.7%, 2.3%, 0.8%, 7.2%, and 8.3% for rectal cancer among women. The PAFs of selected risk factors were 46.2% for colon and 42.4% for rectum among men, while 24.3% for colon and 18.9% for rectum among women. The attributable numbers of colon and rectal cancer to selected risk factors were 4,028 and 3,049 cases among men, respectively, while 1,644 and 778 cases among women in the year of 2015.
Conclusion
Changes in modifiable risk factors could prevent half of the colorectal cancer in the Korean population.

Citations

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A historical cohort study with 27,754 individuals on the association between meat consumption and gastrointestinal tract and colorectal cancer incidence
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Usman Saeed, Tor Å. Myklebust, Trude E. Robsahm, Marlene F. Kielland, Bjørn Møller, Bjørn S. Skålhegg, Tom Mala, Sheraz Yaqub
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Associations between Physical Activity and Incidence of Cancer among Overweight Adults in Korea: Results from the Health Examinees-G Study
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Cancer Prevention Research.2023; 16(7): 405. CrossRef
The underestimated impact of excess body weight on colorectal cancer risk: Evidence from the UK Biobank cohort
Fatemeh Safizadeh, Marko Mandic, Dianne Pulte, Tobias Niedermaier, Michael Hoffmeister, Hermann Brenner
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Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history
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