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Cancer Research and Treatment > Volume 54(2); 2022 > Article
Kang, Won, Lee, Jung, Kim, Kong, Im, Seo, and The Community of Population-Based Regional Cancer Registries: Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2019

Abstract

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 (age-standardized rate [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.

Introduction

It is estimated that there were approximately 19.3 million new cancer cases and 10 million deaths from cancer worldwide in 2020 [1]. During this century, cancer is expected to surpass cardiovascular disease as the leading cause of premature death in most countries [2]. Cancer is the leading cause of death in Korea [3]. In order to reduce the pain and social burden caused by cancer and to promote public health, the National Plan for Cancer Control has been implemented since 1996, and the 4th stage is in effect from 2021. As a fundamental part of the Plan, the Korea Central Cancer Registry (KCCR) publishes cancer registration statistics every year. The current study reports the most recent nationwide statistics on cancer incidence, survival, prevalence, and mortality, and their temporal trends.

Materials and Methods

1. Data sources

Annual cancer statistics in Korea are calculated using a national and population-based database of cancer occurrence, the Korea National Cancer Incidence Database (KNCI DB). Every year, the KCCR collects information on patients diagnosed with cancer at hospitals across the country during the past year. The data from previous year is backed up with information compiled by central and 11 regional cancer registries, including information on cancer patients missed in hospital-based registrations. Hence, it takes two years to complete and calculate the year’s KNCI DB and cancer statistics. The KCCR has reported nationwide statistics since 1999; other detailed information on the KCCR and KNCI DB is provided in our previous report [4]. Completeness is an important indicator of data quality, and the 2019 KNCI DB was estimated to be 98.3% complete using the method proposed by Ajiki et al. [5].
Annual mid-year population data and recently updated mortality data including causes of death from 1983 were obtained from Statistics Korea [3]. To confirm the validity of individual vital statuses used in survival and prevalence calculation, the KNCI DB was linked to both mortality and population resident registration data, which were obtained from the Ministry of the Interior and Safety.

2. Cancer classification

All cancer cases had been registered in accordance with the International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) [6]. The range of cancers to be registered and used for the national statistics calculation was limited to records with a behavior code of “/2 (carcinoma in situ)” or “/3 (malignant),” from the morphology (i.e., histology) codes of ICD-O-3, by which a patient was initially enrolled in the KNCI DB. Similar to previous reports, malignant cancer cases and their statistics were mainly assessed in this article. In addition, the supplementary incidence statistics for carcinoma in situ cases were also calculated separately, using 2019 KNCI DB.
For the convenience of classification and reporting, the ICD-O-3 codes were converted to the classification of the International Classification of Diseases, 10th edition (ICD-10) [7]. Exceptionally, some hematopoietic diseases (myeloproliferative disorders/myelodysplastic syndromes) are not classified as malignant cancer in ICD-10 classification, therefore their ICD-O-3 codes were used without any conversion. For mortality data, causes of death were coded according to the ICD-10.
We adopted cancer classifications with 24 and 61 types; the former was a modified classification based on the GLOBOCAN cancer dictionary [8], and the latter was the taxonomy used in “Cancer Incidence in Five Continents” [9], and both of them were provided by the International Association of Cancer Registries. In this article, cancer classification with 24 types of cancer was used for description. The summary staging system developed under the Surveillance, Epidemiology, and End Results (SEER) program (i.e., SEER summary staging) [10] was used to categorize the extent of tumor invasion or metastasis.

3. Statistical analyses

Incidence, mortality, and prevalence rates were expressed as crude rates (CRs) or age-standardized rates (ASRs) per 100,000 people. The CR was defined as the total number of newly diagnosed (for incidence) or deceased (for mortality) cases in a year divided by the mid-year population. The ASR was defined as the weighted average of the age-specific rates in which the weights represent the proportions of people in the corresponding age groups in a standard population [11]. ASRs were standardized using Segi’s world standard population [12]. The cumulative risk of developing cancer from birth to life expectancy during 2019 in Korea were also assessed, assuming no other cause of death (i.e., by simply calculating the sum of the age-specific cancer rates from birth to life expectancy), as follows [11]:
Cumulative risk of developing cancer from birth to life expectancy=100×(1-e-cumulative rate100)
Trends in ASRs were estimated using Joinpoint regression [13], with a maximum number of two joinpoints. The results were summarized as annual percentage changes with the best model fit, based on a linear model for the natural log-transformed ASRs.
The survival rate of cancer patients, diagnosed between 1993 and 2019, was calculated based on the results of follow-up until December 31, 2020. The 5-year relative survival rate was defined as the ratio of observed survival of cancer patients to expected survival in the general population, adjusting the effects of other causes of death using the standard population life table provided by Statistics Korea [3]. Relative survival rates were estimated using the Ederer II method [14] with some minor corrections, based on an algorithm devised by Paul Dickman [15]. Trends in 5-year relative survival rates were evaluated as percent differences in survival rates between 1993–1995 and 2015–2019.
Prevalent cases were defined as the number of cancer patients alive on January 1, 2020 among all the patients diagnosed with cancer between 1999 and 2019. Limited-duration prevalence was calculated using SEER*Stat 8.3.8 software (National Cancer Institute, Bethesda, MD). p < 0.05 was considered statistically significant. SEER*Stat, Joinpoint 4.8.0 (National Cancer Institute), and SAS ver. 9.4 (SAS Institute, Cary, NC) were used for statistical analyses.

Results

1. Incidence

In 2019, a total of 254,718 people were newly diagnosed with cancer in Korea, of which 52.7% (134,180 cases) were men and 47.3% (120,538 cases) were women (Table 1). The five most diagnosed cancers in Korea were thyroid, lung, stomach, colorectal, and breast cancers; in men, lung and stomach cancers were followed by colorectal, prostate, and liver cancers, whereas breast and thyroid cancers were followed by colorectal, stomach, and lung cancers in women. These top five cancers in each sex accounted for 63.8% and 65.7% of all cancer cases in men and women, respectively. Thyroid cancer was the most frequent cancer from 2010 to 2014: its ranking fell after the debate on overdiagnosis in 2014, but recently rose again and regained the first rank in 2019. Excluding thyroid cancer, it is the first time in 2019 that lung cancer has surpassed stomach cancer to rank first in the incidence rate in Korea. Table 2 provides the CRs and ASRs of cancer incidence in 2019. The CR and ASR of all cancer incidence were 496.2 per 100,000 (523.9 for men and 468.5 for women) and 275.4 per 100,000 (296.6 for men and 267.4 for women), respectively. The difference between CR and ASR implies that majority of cancer patients in Korea belong to the elderly, as opposed to the world’s standard population, which has a higher proportion of young people. The overall lifetime probability of being diagnosed with any cancer was 37.9%, under the condition that one survives to the age that matches the life expectancy of the Korean population. That probability was higher in men (39.9%) than in women (35.8%) (data not shown).
There were marked differences in age-specific incidence rates (Fig. 1). In the childhood population (0–14 years), leukemia, brain and central nervous system (CNS) cancer, and non-Hodgkin lymphoma were the top three cancers in both sexes, accounting for 31.3%, 14.7%, and 13.9% of all cancer cases diagnosed in this age group, respectively. Thyroid cancer was the most common cancer in both sexes among the adolescent and young adult populations (15–34 years), accounting for 52.1% of all cancers diagnosed. The most common cancers in that age group, excluding thyroid cancer, were leukemia and colorectal cancer in men, and breast and cervical cancer in women. In the 35–64-year age group, men were most commonly diagnosed with stomach, colorectal, liver, and lung cancers (collectively accounting for 52.5%), while breast and thyroid cancers were the most common in women (collectively accounting for 54.8%). For those aged 65 years and above, lung and prostate cancers were the most common in men, while colorectal and lung cancers were the most common in women. Most cancers have shown to increase in incidence with age; the exceptions were thyroid cancer in both sexes and breast cancer in women, which showed the highest incidence in those in their 30–40s and 40–50s age groups, respectively (Fig. 2).

2. Mortality

Since the causes-of-death statistics were published in 1983, cancer has been the number one cause of death in Korea. As of 2019, a total of 81,203 people (61.9% men and 38.1% women) died of cancer, accounting for 27.5% of all deaths in Korea (Tables 1 and 3). The overall CR for cancer deaths was 158.2 per 100,000, and the rate was approximately 1.6 times higher for men than for women (Table 4). Lung cancer was the leading cause of cancer death in both sexes (CR, 53.5 per 100,000 in men and 19.0 per 100,000 in women), followed by liver and colorectal cancers in men, and colorectal and pancreatic cancers in women. When stratified according to the age at the time of death, the most common causes of cancer mortality in both sexes were as follows: leukemia in their 10s and 20s, breast cancer in their 30s, liver cancer in their 40s and 50s, and lung cancer among those 60 years old or older (data not shown).

3. Trends in cancer incidence and mortality

Changes in cancer incidence rates from 1999 to 2019 and mortality rates from 1983 to 2019 are depicted in Fig. 3. Compared to 1999, cancer incidence rates increased about 29.8% and mortality rates decreased about 37.3%, in 2019 (Table 5). The overall cancer incidence rates increased by approximately 3.3% per year until 2012, followed by a decline until 2015 with an annual decrease of 5.3%, and thereafter showed nonsignificant changes. In contrast, cancer mortality rates demonstrated nonsignificant changes until 2002, and decreased thereafter with an annual decrease of 2.7% until 2013, and a further decrease of 3.3% per year until 2019. These trends were observed similarly in both men and women, although the slopes of change were much more pronounced in women for incidence, and in men for mortality rates (S1 and S2 Tables).
Since 1999, breast, pancreas, kidney, and hematologic (leukemia and lymphoma) cancers, and that of some male or female reproductive organs (ovary, corpus uteri, prostate, and testis) have been continuously increasing. In both sexes combined, breast (especially for women) and kidney cancers displayed initial rapid increases and then lessened increases after 2007 and 2009, respectively. Prostate cancer demonstrated distinguished increase until 2009, followed by nonsignificant trend until 2015, and regained increasing trend thereafter. The remaining cancers with increasing trend revealed steady increases throughout the entire period. On the other hand, the incidences of colorectal and bladder cancers demonstrated increasing trends that have recently reversed significantly, with decreases starting in 2011 and 2004, respectively. In contrast, stomach and liver cancers demonstrated initial moderate decreasing trends until 2011 and 2009, respectively, followed by more rapid decreases thereafter; and cervical cancer showed marked decrease until 2007, however it showed lessened decrease thereafter until now. Lastly, the incidence of thyroid cancer increased significantly between 1999 and 2011, decreased significantly between 2011 and 2016, and increased again from 2016 (Table 5). These trends were observed similarly in both men and women, except for breast cancer in men and bladder cancer in women that revealed partially different results of trends from those described above. In men, decreasing trend of stomach, lung, and liver cancer throughout the period and colorectal cancer since 2011 were significant while prostate and kidney cancer had an increasing trend. In women, stomach, colorectal, liver, and cervix cancer had decreasing trend while breast and lung cancer revealed an increasing trend. The characteristic trend of thyroid cancer which changed rapidly in a short period of time, was more pronounced in women than in men (Fig. 4, S1 and S2 Tables).
The ASRs for mortality in most cancers have shown decreasing trends in Korea. Stomach cancer revealed continuous decreasing trends throughout the entire observed period for mortality, with more pronounced decreasing slopes in more recent periods. Liver and lung cancer mortality rates began to decrease in 2002 and 2001, respectively, followed by further rapid decreases starting in 2014. On the other hand, the mortality rates of colorectal, cervical, and thyroid cancers initially increased significantly until 2003; since then, the mortality rate from cervical cancer and thyroid cancer has decreased, and colorectal cancer has shown insignificant changes for 10 years and started to decrease from 2012 (Table 5). These trends were observed similarly in both sexes. However, breast cancer in women displayed significantly increasing mortality trends throughout the entire observed period, with less increasing trend after 2005 (Fig. 5, S1 and S2 Tables).

4. Survival rates

Over the past two decades, when cancer survival statistics have been compiled, the relative survival rates of cancer patients have increased significantly and steadily. The 5-year relative survival rates for all patients diagnosed with cancer in the recent 5 years, from 2015 to 2019 were 70.7% in both sexes; 64.5% in men and 77.3% in women (Table 6). The temporal increasing trends in survival rates, from 42.9% in 1993–1995 to 70.7% in 2015–2019, were maintained even after excluding thyroid cancer (from 41.2% in 1993–1995 to 66.5% in 2015–2019), which has an excellent prognosis with a 5-year relative survival rate of 100%.
After thyroid cancer, survival rates were the highest for testis and prostate cancers in men (95.0% and 94.4%, respectively) and breast cancer in women (93.6%). On the contrary, the survival rates were the lowest for cancers of the pancreas (13.9%), and gallbladder plus other and unspecified parts of the biliary tract (28.5%) in both sexes. Stomach cancer (both sexes), prostate cancer (men), lung cancer, and leukemia (women) were associated with outstanding improvements in survival rates over the observed period. In contrast, advances have been slow for cancers of the brain and CNS, pancreas in both sexes.
In terms of stage distribution at diagnosis and recent survival rates according to the SEER summary stage in each cancer, Fig. 6 shows the top 10 most common cancers for each sex in 2019. In men, stomach, kidney, and bladder cancers revealed the highest proportions of patients who were diagnosed at the localized stage (64.8%, 72.5%, and 72.2%, respectively), accompanied by the 5-year survival rates of 97.5%, 97.5%, and 86.4%, respectively. In contrast, lung and pancreatic cancers demonstrated the highest proportions of patients diagnosed at the distant metastatic stage, which approximated to 50%, with corresponding 5-year survival rates of 7.6% and 2.2%, respectively. In women, 58.7%, 63.4%, and 72.4% of breast, stomach, and uterine corpus cancers, respectively, were diagnosed at the localized stage, with 5-year survival rates of 98.8%, 95.9%, and 96.6%, respectively. However, more than 40% of lung and pancreatic cancers were diagnosed at the distant metastatic stage, with 5-year survival rates of 5.7% and 2.3%, respectively.

5. Prevalence rates

The total prevalent cancer cases in 2019 (identified as survivor at the time of January 1, 2020) were 2,147,503, surpassing 2 million since 2018 (Table 1). It suggested that one in 25 people (4.2% of the entire Korean population; 3.7% of men and 4.7% of women) has a history of being diagnosed with cancer. Of these, 996,051 (46.4% of all prevalent cases) were aged ≥ 65 years, indicating that one in eight people in that age group (16.4% of, or one in six, men and 10.3% of, or one in ten, women) would have experienced cancer (data not shown).
Table 7 provides the CRs and ASRs of prevalence for all cancers combined and for specific cancers. In total, the cancer prevalence rate for 2019 in Korea was 4,183.1 per 100,000 people. Thyroid cancer had the highest prevalence (CR, 900.2 per 100,000; 330.2 per 100,000 for men and 1,467.6 per 100,000 for women), followed by stomach cancer (CR, 621.3 per 100,000) and colorectal cancer (CR, 544.9 per 100,000). Prostate cancer in men and breast cancer in women revealed the highest prevalence rates (CR, 425.1 and 1,003.5 per 100,000, respectively).
The number of prevalent cases for common cancers, according to the time since cancer diagnosis, are described in Fig. 7. In total, 1,268,265 (59.1% of all prevalent cases) had survived > 5 years after cancer diagnosis, majority of them being survivors of thyroid, stomach, colorectal, and breast cancers. Another 462,265 (21.5% of all prevalent cases) have been alive 2–5 years after their cancer diagnosis, in which period they need regular follow-up; and the rest were 416,973 (19.4% of all prevalent cases) for whom it had been < 2 years since their cancer diagnosis, in which period they still need active cancer treatment.

6. Carcinoma in situ incidence

A summary of carcinoma in situ cases in 2019 is provided as a Supplementary Material (S3S6 Tables, S7S9 Figs.).

Conclusion

Since 2015, the number of new cancer patients in Korea has been increasing, but the ASRs of incidence did not reveal a significant change. In 2019, lung cancer has surpassed stomach cancer to rank first in the incidence rate for the first time, excluding thyroid cancer. During the past decade, the incidence of stomach, colorectal, liver, and cervical cancer has been declining while that of prostate and breast cancer have been on the rise since 1999. Thyroid cancer, which has decreased since 2012, has shown an increasing trend since 2015. The 5-year relative survival rate of cancer patients diagnosed in the past 5 years was 70.7%, which is steadily improving. Since 2018, the number of cancer survivors has exceeded 2 million, of which 59.1% are those who survived over 5 years. Cancer survival rates are increasing, but the number of newly diagnosed cancers and the prevalence of cancer continue to rise. National cancer control strategies should adapt to the changing aspects of cancer statistics.

Acknowledgments

Special thanks to the tumor registrars (health information managers) of the Korea Central Cancer Registry (KCCR)-affiliated and non-KCCR-affiliated hospitals for data collection, abstracting, and coding. Additionally, we acknowledge the cooperation of the National Health Insurance Service and Statistics Korea for data support. This work was supported by the Health Promotion Fund of the Ministry of Health & Welfare (No. 2160830) and a research grant (No. 2211110) from the National Cancer Center, Republic of Korea.

Notes

Author Contributions

Conceived and designed the analysis: Won YJ.

Collected the data: Won YJ, Regional Cancer Registry Committee.

Contributed data or analysis tools: Kang MJ, Won YJ, Lee JJ, Jung KW, Kim HJ, Kong HJ.

Performed the analysis: Lee JJ.

Wrote the paper: Kang MJ, Won YJ.

Interpretation and review: Jung KW, Kong HJ.

Review and comment: Im JS, Seo HG.

Conflicts of Interest

Conflict of interest relevant to this article was not reported.

Fig. 1
The five common sites of cancer incidence by age group and sex for 2019 in Korea. (A) Men. (B) Women. Numbers in parentheses are age-specific incidence rates per 100,000. CNS, central nervous system.
crt-2022-128f1.jpg
Fig. 2
Age-specific incidence rates of common cancers for 2019 in Korea. (A) Men. (B) Women.
crt-2022-128f2.jpg
Fig. 3
Annual age-standardized cancer incidence and mortality rates by sex for all sites from 1983 to 2019 in Korea. Age standardization was based on Segi’s world standard population.
crt-2022-128f3.jpg
Fig. 4
Trends in age-standardized incidences of selected cancers by sex from 1999 to 2019 in Korea. (A) Men. (B) Women. Age standardization was based on Segi’s world standard population.
crt-2022-128f4.jpg
Fig. 5
Trends in age-standardized mortalities of selected cancers by sex from 1983 to 2019 in Korea. (A) Men. (B) Women. Age standardization was based on Segi’s world standard population. a)Cancers of cervix uteri, corpus uteri, and unspecified combined (C53–C55), due to their unclear classifications in the past.
crt-2022-128f5.jpg
Fig. 6
Five-year relative survival rates by stage at diagnosis and stage distribution of selected cancers by sex in Korea, 2015–2019. (A) Men. (B) Women. Staging according to the Surveillance, Epidemiology, and End Results stage categories. For each cancer type, stage categories do not total 100% because sufficient information was not available to stage all cases. a)Includes the gallbladder and other/unspecified parts of the biliary tract.
crt-2022-128f6.jpg
Fig. 7
Prevalent cases of common cancers by time since cancer diagnosis. Prevalent cases were defined as the number of cancer patients alive on January 1, 2020 among all cancer patients diagnosed between 1999 and 2019.
crt-2022-128f7.jpg
Table 1
Cancer incidence, deaths and prevalence by sex in Korea, 2019
Site/Type New cases Deaths Prevalent casesa)



Both sexes Men Women Both sexes Men Women Both sexes Men Women
All sites 254,718 134,180 120,538 81,203 50,281 30,922 2,147,503 943,518 1,203,985

Lip, oral cavity, and pharynx 3,969 2,863 1,106 1,298 997 301 29,516 19,723 9,793

Esophagus 2,870 2,573 297 1,554 1,425 129 12,086 10,769 1,317

Stomach 29,493 19,761 9,732 7,624 4,956 2,668 318,948 210,689 108,259

Colon and rectum 29,030 17,119 11,911 8,880 5,016 3,864 279,717 165,962 113,755

Liver 15,605 11,541 4,064 10,586 7,784 2,802 75,261 56,420 18,841

Gallbladderb) 7,383 3,896 3,487 4,988 2,568 2,420 25,505 13,185 12,320

Pancreas 8,099 4,150 3,949 6,396 3,424 2,972 14,964 7,562 7,402

Larynx 1,222 1,154 68 318 289 29 11,902 11,205 697

Lung 29,960 20,331 9,629 18,574 13,698 4,876 103,108 62,105 41,003

Breast 24,933 113 24,820 2,643 21 2,622 259,116 944 258,172

Cervix uteri 3,273 - 3,273 898 - 898 58,983 - 58,983

Corpus uteri 3,287 - 3,287 358 - 358 30,946 - 30,946

Ovary 2,888 - 2,888 1,234 - 1,234 24,259 - 24,259

Prostate 16,803 16,803 - 2,047 2,047 - 108,870 108,870 -

Testis 325 325 - 19 19 - 4,046 4,046 -

Kidney 6,026 4,155 1,871 983 666 317 50,674 34,270 16,404

Bladder 4,895 3,984 911 1,550 1,167 383 39,963 32,592 7,371

Brain and CNS 1,981 1,070 911 1,416 756 660 12,934 6,650 6,284

Thyroid 30,676 7,516 23,160 373 109 264 462,151 84,565 377,586

Hodgkin lymphoma 308 181 127 57 33 24 3,436 2,115 1,321

Non-Hodgkin lymphoma 5,388 3,117 2,271 1,856 1,081 775 37,971 21,544 16,427

Multiple myeloma 1,831 997 834 961 527 434 7,741 4,064 3,677

Leukemia 3,738 2,108 1,630 1,911 1,143 768 25,538 14,178 11,360

Other and ill-defined 20,735 10,423 10,312 4,679 2,555 2,124 149,868 72,060 77,808

CNS, central nervous system.

a) Limited-duration prevalent cases on January 1, 2019. These are patients who were diagnosed between January 1, 1999 and December 31, 2019 and who were alive on January 1, 2020. Multiple primary cancer cases were counted multiple times,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 2
Crude and age-standardized cancer incidence rates by sex in Korea, 2019
Site/Type Crude incidence rate per 100,000 Age-standardized incidence rate per 100,000a)


Both sexes Men Women Both sexes Men Women
All sites 496.2 523.9 468.5 275.4 296.6 267.4

Lip, oral cavity, and pharynx 7.7 11.2 4.3 4.3 6.5 2.4

Esophagus 5.6 10.0 1.2 2.8 5.3 0.6

Stomach 57.4 77.2 37.8 29.6 42.4 18.4

Colon and rectum 56.5 66.8 46.3 28.7 37.0 21.4

Liver 30.4 45.1 15.8 15.6 25.0 7.1

Gallbladderb) 14.4 15.2 13.6 6.5 8.0 5.3

Pancreas 15.8 16.2 15.3 7.6 8.8 6.6

Larynx 2.4 4.5 0.3 1.2 2.4 0.1

Lung 58.4 79.4 37.4 27.7 41.7 16.9

Breast 48.6 0.4 96.5 30.4 0.3 60.5

Cervix uteri 6.4 - 12.7 4.0 - 8.0

Corpus uteri 6.4 - 12.8 4.0 - 7.9

Ovary 5.6 - 11.2 3.5 - 7.0

Prostate 32.7 65.6 - 15.5 34.3 -

Testis 0.6 1.3 - 0.6 1.2 -

Kidney 11.7 16.2 7.3 6.8 9.8 4.1

Bladder 9.5 15.6 3.5 4.4 8.2 1.4

Brain and CNS 3.9 4.2 3.5 2.9 3.2 2.6

Thyroid 59.8 29.3 90.0 42.9 21.0 65.6

Hodgkin lymphoma 0.6 0.7 0.5 0.5 0.6 0.4

Non-Hodgkin lymphoma 10.5 12.2 8.8 6.3 7.8 5.0

Multiple myeloma 3.6 3.9 3.2 1.8 2.1 1.5

Leukemia 7.3 8.2 6.3 5.6 6.7 4.7

Other and ill-defined 40.4 40.7 40.1 21.9 24.3 20.0

CNS, central nervous system.

a) Age-adjusted using the Segi’s world standard population,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 3
The top 10 leading causes of death in Korea, 2019
Rank Cause of death No. of deaths Percentage of all deaths Age-standardized death rate per 100,000a)
All causes 295,039 100.0 254.4
1 Cancer 81,203 27.5 72.2
2 Heart disease 31,030 10.5 24.6
3 Cerebrovascular disease 21,586 7.3 16.9
4 Pneumonia 23,168 7.9 16.4
5 Intentional self-harm (suicide) 13,799 4.7 18.4
6 Diabetes mellitus 8,102 2.7 6.4
7 Disease of liver 6,496 2.2 6.8
8 Chronic lower respiratory diseases 6,176 2.1 4.4
9 Hypertensive diseases 5,631 1.9 3.9
10 Transport accidents 4,221 1.4 5.0
Others 93,698 31.8 79.5

Source: Mortality Data, 2019, Statistics Korea [1].

a) Age-adjusted using the Segi’s world standard population.

Table 4
Crude and age-standardized cancer mortality rates by sex in Korea, 2019
Site/Type Crude mortality rate per 100,000 Age-standardized mortality rate per 100,000a)


Both sexes Men Women Both sexes Men Women
All sites 158.2 196.3 120.2 72.2 103.6 48.7

Lip, oral cavity, and pharynx 2.5 3.9 1.2 1.2 2.1 0.5

Esophagus 3.0 5.6 0.5 1.4 2.9 0.2

Stomach 14.9 19.4 10.4 6.7 10.3 4.0

Colon and rectum 17.3 19.6 15.0 7.6 10.3 5.4

Liver 20.6 30.4 10.9 9.9 16.4 4.2

Gallbladderb) 9.7 10.0 9.4 4.1 5.1 3.2

Pancreas 12.5 13.4 11.6 5.6 7.1 4.4

Larynx 0.6 1.1 0.1 0.3 0.6 0.0

Lung 36.2 53.5 19.0 15.6 27.1 7.0

Breast 5.1 0.1 10.2 2.9 0.0 5.5

Cervix uteri 1.7 - 3.5 0.9 - 1.7

Corpus uteri 0.7 - 1.4 0.4 - 0.7

Ovary 2.4 - 4.8 1.2 - 2.4

Prostate 4.0 8.0 - 1.5 4.0 -

Testis 0.0 0.1 - 0.0 0.1 -

Kidney 1.9 2.6 1.2 0.9 1.4 0.4

Bladder 3.0 4.6 1.5 1.2 2.3 0.4

Brain and CNS 2.8 3.0 2.6 1.7 2.0 1.4

Thyroid 0.7 0.4 1.0 0.3 0.2 0.3

Hodgkin lymphoma 0.1 0.1 0.1 0.1 0.1 0.0

Non-Hodgkin lymphoma 3.6 4.2 3.0 1.7 2.3 1.2

Multiple myeloma 1.9 2.1 1.7 0.8 1.0 0.6

Leukemia 3.7 4.5 3.0 2.1 2.8 1.5

Other and ill-defined 9.1 10.0 8.3 4.3 5.6 3.3

CNS, central nervous system.

a) Age-adjusted using the world standard population,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 5
Trends in cancer incidence and mortality rates from 1999 to 2019 in Korea, both sexes
Site/Type Incidence Mortality


1999 2019 Trend 1 Trend 2 Trend 3 1999 2019 Trend 1 Trend 2 Trend 3






Years APC Years APC Years APC Years APC Years APC Years APC
All sites 212.1 275.4 1999–2012 3.3a) 2012–2015 −5.3a) 2015–2019 1.1 115.1 72.2 1999–2002 0.9 2002–2013 −2.7a) 2013–2019 −3.3a)

Lip, oral cavity, and pharynx 3.6 4.3 1999–2019 0.7a) - - - - 1.1 1.2 1999–2019 −1.8a) - - - -

Esophagus 4.1 2.8 1999–2017 −2.2a) 2017–2019 1.8 - - 3.1 1.4 1999–2019 −4.43a) - - - -

Stomach 43.6 30.4 1999–2011 −0.2 2011–2018 −4.6a) - - 23.8 7.1 1999–2002 −2.6a) 2002–2010 −6.2a) 2010–2018 −7.4a)

Colon and rectum 20.5 28.7 1999–2006 7.3a) 2006–2011 2.9a) 2011–2019 4.0a) 7.8 7.6 1999–2003 6.4a) 2003–2012 −0.5 2012–2019 −3.6a)

Liver 27.9 15.6 1999–2009 −1.6a) 2009–2019 −4.1a) - - 20.6 9.9 1999–2002 0.6 2002–2014 −3.7a) 2014–2019 −6.1a)

Gallbladderb) 6.5 6.5 1999–2004 1.5 2004–2019 −0.4a) - - 5.2 4.1 1999–2001 7.6 2001–2014 −2.8a) 2014–2019 0.0

Pancreas 5.6 7.6 1999–2019 1.5a) - - - - 5.5 5.6 1999–2019 0.1 - - - -

Larynx 2.4 1.2 1999–2019 −3.5a) - - - - 1.6 0.3 1999–2005 −8.1a) 2005–2008 −15.5a) 2008–2019 −7.2a)

Lung 28.5 27.7 1999–2011 0.1 2011–2015 −1.4a) 2015–2019 0.6 22.5 15.6 1999–2001 3.8 2001–2014 −2.0a) 2014–2019 −3.9a)

Breast 11.0 30.4 1999–2007 6.4a) 2007–2019 4.4a) - - 2.3 2.9 1999–2004 2.9a) 2004–2019 0.8a) - -

Cervix uteri 8.6 4.0 1999–2007 −4.7a) 2007–2019 −3.0a) - - 1.4 0.9 1999–2003 10.1a) 2003–2008 −7.2a) 2008–2019 −4.0a)

Corpus uteri 1.4 4.0 1999–2019 5.1a) - - - - 0.1 0.4 1999–2003 36.0a) 2003–2019 2.4a) - -

Ovary 2.7 3.5 1999–2019 1.7a) - - - - 0.9 1.2 1999–2019 0.6a) - - - -

Prostate 3.1 15.5 1999–2009 14.9a) 2009–2015 0.5 2015–2019 7.3a) 0.9 1.5 1999–2002 15.3a) 2002–2011 1.6a) 2011–2019 −1.4a)

Testis 0.3 0.6 1999–2019 4.7a) - - - - 0.0 0.0 1999–2019 −2.1a) - - - -

Kidney 3.0 6.8 1999–2009 6.3a) 2009–2019 2.3a) - - 1.1 0.9 1999–2016 −0.1 2016–2019 −6.6a) - -

Bladder 4.7 4.4 1999–2004 1.8a) 2004–2019 −1.0a) - - 1.3 1.2 1999–2002 9.3a) 2002–2005 −6.1 2005–2019 −1.5a)

Brain and CNS 2.9 2.9 1999–2019 0.2 - - - 1.9 1.7 1999–2003 4.1a) 2003–2008 −4.4a) 2008–2019 −0.7a)

Thyroid 6.5 42.9 1999–2011 22.5a) 2011–2016 −12.3a) 2016–2019 6.2 0.4 0.3 1999–2003 7.5a) 2003–2019 −4.6a) - -

Hodgkin lymphoma 0.3 0.5 1999–2011 4.9a) 2011–2019 1.3 - - 0.0 0.1 1999–2004 23.7a) 2004–2019 −2.1a) - -

Non-Hodgkin lymphoma 4.3 6.3 1999–2019 2.3a) - - - - 2.1 1.7 1999–2019 −1.1a) - - - -

Multiple myeloma 1.0 1.8 1999–2012 3.7a) 2012–2019 1.2a) - - 0.6 0.8 1999–2003 12.7a) 2003–2016 0.9 2016–2019 −7.0a)

Leukemia 4.7 5.6 1999–2019 0.9a) - - - - 2.9 2.1 1999–2019 −1.8a) - - - -

Other and ill-defined 15.0 21.9 1999–2001 −0.9 2001–2007 3.7a) 2007–2019 1.8a) 7.8 4.3 1999–2019 −2.8a) - - - -

APC was calculated using age-standardized incidence data based on the Segi’s world standard population. APC, annual percentage change; CNS, central nervous system.

a) Significantly different from zero (p < 0.05),

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 6
Trends in the 5-year relative survival rates (%) by sex and year of diagnosis from 1993 to 2019 in Korea
Site/Type Both sexes Men Women



1993–1995 1996–2000 2001–2005 2006–2010 2011–2015 2015–2019 Changea) 1993–1995 1996–2000 2001–2005 2006–2010 2011–2015 2015–2019 Changea) 1993–1995 1996–2000 2001–2005 2006–2010 2011–2015 2015–2019 Changea)
All sites 42.9 45.2 54.1 65.5 70.7 70.7 27.8 33.2 36.3 45.6 56.9 63.1 64.5 31.3 55.2 56.4 64.3 74.4 78.3 77.3 22.1

All sites excluding thyroid 41.2 43.4 50.8 59.0 64.2 66.5 25.3 32.7 35.8 44.7 54.6 60.3 62.4 29.7 52.6 53.5 59.1 65.0 69.4 71.5 19.0

Lip, oral cavity, and pharynx 42.2 47.4 54.5 61.1 65.4 68.8 26.6 36.6 41.7 49.6 56.9 61.8 65.9 29.3 59.4 64.5 68.1 72.1 74.5 76.2 16.8

Esophagus 14.0 15.7 21.6 30.0 36.5 40.9 26.9 13.0 14.8 20.8 29.3 36.2 40.6 27.6 25.0 25.9 29.8 37.3 39.6 43.4 18.4

Stomach 43.9 47.3 58.0 68.4 75.9 77.5 33.6 44.0 47.6 58.7 69.1 76.8 78.3 34.3 43.7 46.8 56.6 67.0 74.0 75.8 32.1

Colon and rectum 56.2 58.9 66.9 73.9 76.1 74.3 18.1 56.6 59.8 68.8 75.8 77.8 75.5 18.9 55.7 57.7 64.4 71.1 73.6 72.6 16.9

Liver 11.8 14.1 20.5 28.3 34.4 37.7 25.9 10.8 13.8 20.4 28.3 34.9 38.3 27.5 15.1 15.1 20.9 28.3 32.8 35.8 20.7

Gallbladderb) 18.7 20.7 23.1 26.9 28.7 28.5 9.8 18.0 21.1 23.5 27.8 29.5 28.8 10.8 19.3 20.3 22.7 26.0 28.0 28.1 8.8

Pancreas 10.6 8.7 8.4 8.6 10.8 13.9 3.3 10.0 8.3 8.4 8.3 10.3 13.0 3.0 11.5 9.3 8.4 8.8 11.5 14.9 3.4

Larynx 61.6 63.3 66.5 73.2 75.3 80.4 18.8 62.2 63.7 67.1 73.5 75.7 80.5 18.3 56.3 58.9 58.7 68.0 69.1 78.9 22.6

Lung 12.5 13.6 16.6 20.3 27.6 34.7 22.2 11.6 12.4 15.3 18.0 23.3 28.9 17.3 15.8 17.5 20.2 26.0 37.4 47.4 31.6

Breast 79.2 83.6 88.7 91.2 92.8 93.6 14.4 77.1 84.3 87.5 89.9 90.8 93.3 16.2 79.3 83.6 88.7 91.2 92.8 93.6 14.3

Cervix uteri 78.3 80.3 81.5 80.7 80.3 80.5 2.2 - - - - - - - 78.3 80.3 81.5 80.7 80.3 80.5 2.2

Corpus uteri 82.9 82.0 84.7 86.5 87.7 89.0 6.1 - - - - - - - 82.9 82.0 84.7 86.5 87.7 89.0 6.1

Ovary 60.1 59.4 61.7 61.3 64.8 64.5 4.4 - - - - - - - 60.1 59.4 61.7 61.3 64.8 64.5 4.4

Prostate 59.1 69.4 81.0 92.0 94.2 94.4 35.3 59.1 69.4 81.0 92.0 94.2 94.4 35.3 - - - - - - -

Testis 87.4 90.4 90.7 93.2 94.9 95.0 7.6 87.4 90.4 90.7 93.2 94.9 95.0 7.6 - - - - - - -

Kidney 64.2 67.0 73.7 78.6 82.5 84.7 20.5 63.4 65.4 73.1 78.5 82.1 84.7 21.3 65.8 70.3 74.9 79.0 83.4 84.8 19.0

Bladder 70.7 73.6 76.0 77.3 76.4 76.5 5.8 71.6 75.1 77.8 79.3 78.4 78.1 6.5 67.2 67.2 69.1 69.2 68.5 70.0 2.8

Brain and CNS 40.4 39.9 41.0 42.9 41.7 41.4 1.0 39.1 38.7 40.3 41.4 40.4 40.0 0.9 42.3 41.4 41.8 44.6 43.3 43.0 0.7

Thyroid 94.5 95.0 98.4 100.0 100.2 100.0 5.5 87.9 89.7 96.0 100.2 100.6 100.3 12.4 95.7 96.0 98.7 99.9 100.1 99.9 4.2

Hodgkin lymphoma 70.2 71.9 76.7 81.1 82.3 85.3 15.1 69.4 69.3 74.7 80.8 81.8 84.5 15.1 71.5 77.3 80.7 81.6 83.3 86.5 15.0

Non-Hodgkin lymphoma 48.3 51.1 56.0 59.4 62.8 64.5 16.2 46.8 49.6 55.0 59.2 62.9 65.3 18.5 50.6 53.3 57.5 59.7 62.8 63.5 12.9

Multiple myeloma 23.7 21.0 29.7 34.9 41.5 49.1 25.4 23.2 19.1 29.9 35.1 41.1 49.7 26.5 24.1 23.3 29.5 34.7 42.1 48.6 24.5

Leukemia 27.5 34.3 42.0 47.7 52.0 54.5 27.0 27.3 33.3 41.8 46.9 52.2 54.2 26.9 27.8 35.5 42.2 48.7 51.7 55.0 27.2

Other and ill-defined 44.5 48.3 57.9 67.7 72.7 75.4 30.9 39.6 44.7 54.1 63.8 69.3 72.5 32.9 50.1 52.6 62.0 71.6 76.2 78.3 28.2

CNS, central nervous system.

a) Absolute percentage change in 5-year relative survival from 1993 to 1995 and 2015 to 2019,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 7
Crude and age-standardized rates of cancer prevalence by sex on January 1, 2020 in Korea
Site/Type Crude prevalence rate per 100,000a) Age-standardized prevalence rate per 100,000b)


Both sexes Men Women Both sexes Men Women
All sites 4,183.1 3,684.3 4,679.7 2,305.1 2,081.4 2,612.8

Lip, oral cavity, and pharynx 57.5 77.0 38.1 32.2 44.6 21.2

Esophagus 23.5 42.1 5.1 11.4 22.2 2.4

Stomach 621.3 822.7 420.8 306.6 441.6 194.2

Colon and rectum 544.9 648.1 442.1 266.0 349.9 197.2

Liver 146.6 220.3 73.2 77.5 123.3 35.8

Gallbladderc) 49.7 51.5 47.9 23.0 27.1 19.7

Pancreas 29.1 29.5 28.8 15.3 16.5 14.4

Larynx 23.2 43.8 2.7 11.0 23.0 1.2

Lung 200.8 242.5 159.4 98.0 128.6 74.4

Breast 504.7 3.7 1,003.5 291.5 2.0 574.2

Cervix uteri 114.9 0.0 229.3 65.1 - 127.6

Corpus uteri 60.3 0.0 120.3 34.8 - 68.6

Ovary 47.3 0.0 94.3 29.7 - 59.2

Prostate 212.1 425.1 0.0 91.8 213.8 -

Testis 7.9 15.8 0.0 7.0 13.7 -

Kidney 98.7 133.8 63.8 55.3 78.5 34.2

Bladder 77.8 127.3 28.6 35.7 66.8 11.5

Brain and CNS 25.2 26.0 24.4 20.7 21.9 19.4

Thyroid 900.2 330.2 1,467.6 563.7 212.3 913.4

Hodgkin lymphoma 6.7 8.3 5.1 5.4 6.4 4.3

Non-Hodgkin lymphoma 74.0 84.1 63.8 48.1 57.6 39.1

Multiple myeloma 15.1 15.9 14.3 7.6 8.7 6.7

Leukemia 49.7 55.4 44.2 44.0 49.3 38.6

Other and ill-defined 291.9 281.4 302.4 163.7 173.7 155.4

CNS, central nervous system.

a) Crude prevalence rate: number of prevalent cases divided by the corresponding person-years of observation. Prevalent cases were defined as patients who were diagnosed between January 1, 1999 and December 31, 2019 and who were alive on January 1, 2020. Multiple primary cancer cases were counted multiple times,

b) Age-adjusted using the Segi's world standard opulation

c) Includes the gallbladder and other/unspecified parts of the biliary tract

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