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Keun-Young Yoo 7 Articles
The Korea Cohort Consortium: The Future of Pooling Cohort Studies
Sangjun Lee, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Aesun Shin, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Daehee Kang, Keun-Young Yoo, Sue K. Park
J Prev Med Public Health. 2022;55(5):464-474.   Published online September 12, 2022
DOI: https://doi.org/10.3961/jpmph.22.299
  • 2,995 View
  • 115 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
We introduced the cohort studies included in the Korea Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies.
Methods
We mainly focused on the characteristics of individual cohort studies from the KCC. We developed “PROFAN”, a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated.
Results
The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102.
Conclusions
We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.
Summary
Korean summary
한국 코호트 컨소시엄(KCC)은 “2015년 한국의 생활 습관 및 환경 요인에 따른 암 기여분율” 프로젝트의 3단계 과업으로써, 본 프로젝트에 참여한 기존의 구축된 개인 코호트 연구의 연구자들을 주도로 다수의 대규모 한국 코호트 연구를 기반으로 구성되었다. 따라서 본 연구는 KCC에 포함된 한국 코호트 연구를 소개하는 것을 목표로 하였다. 또한 여러 기 확립된 국제 컨소시엄을 기반으로 빅데이터 기반 코호트 풀링 연구의 중요성을 제시하였다.

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  • The relationship between regional inequalities in the provision of emergency health services and other health services
    Erkan Boğa
    Medicine.2023; 102(45): e35930.     CrossRef
Risk Reduction of Breast Cancer by Childbirth, Breastfeeding, and Their Interaction in Korean Women: Heterogeneous Effects Across Menopausal Status, Hormone Receptor Status, and Pathological Subtypes
Seok Hun Jeong, Yoon Suk An, Ji-Yeob Choi, Boyoung Park, Daehee Kang, Min Hyuk Lee, Wonshik Han, Dong Young Noh, Keun-Young Yoo, Sue K. Park
J Prev Med Public Health. 2017;50(6):401-410.   Published online November 10, 2017
DOI: https://doi.org/10.3961/jpmph.17.152
  • 8,522 View
  • 263 Download
  • 9 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype.
Methods
BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs).
Results
BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ≥13 months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58).
Conclusions
This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ≥13 months can reduce their BC risk by about 50%.
Summary

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    ASIMENIA MAMAKOU
    European Journal of Midwifery.2019;[Epub]     CrossRef
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    Patricia Catala, Cecilia Peñacoba, Javier Carmona, Dolores Marin
    Breastfeeding Medicine.2018; 13(10): 680.     CrossRef
The Effect of Breastfeeding Duration and Parity on the Risk of Epithelial Ovarian Cancer: A Systematic Review and Meta-analysis
Ho Kyung Sung, Seung Hyun Ma, Ji-Yeob Choi, Yunji Hwang, Choonghyun Ahn, Byoung-Gie Kim, Yong-Man Kim, Jae Weon Kim, Sokbom Kang, Jaehoon Kim, Tae Jin Kim, Keun-Young Yoo, Daehee Kang, Suekyung Park
J Prev Med Public Health. 2016;49(6):349-366.   Published online September 8, 2016
DOI: https://doi.org/10.3961/jpmph.16.066
  • 14,601 View
  • 295 Download
  • 49 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
We conducted a systematic review and meta-analysis to summarize current evidence regarding the association of parity and duration of breastfeeding with the risk of epithelial ovarian cancer (EOC).
Methods
A systematic search of relevant studies published by December 31, 2015 was performed in PubMed and EMBASE. A random-effect model was used to obtain the summary relative risks (RRs) and 95% confidence intervals (CIs).
Results
Thirty-two studies had parity categories of 1, 2, and ≥3. The summary RRs for EOC were 0.72 (95% CI, 0.65 to 0.79), 0.57 (95% CI, 0.49 to 0.65), and 0.46 (95% CI, 0.41 to 0.52), respectively. Small to moderate heterogeneity was observed for one birth (p<0.01; Q=59.46; I2=47.9%). Fifteen studies had breastfeeding categories of <6 months, 6-12 months, and >13 months. The summary RRs were 0.79 (95% CI, 0.72 to 0.87), 0.72 (95% CI, 0.64 to 0.81), and 0.67 (95% CI, 0.56 to 0.79), respectively. Only small heterogeneity was observed for <6 months of breastfeeding (p=0.17; Q=18.79, I2=25.5%). Compared to nulliparous women with no history of breastfeeding, the joint effects of two births and <6 months of breastfeeding resulted in a 0.5-fold reduced risk for EOC.
Conclusions
The first birth and breastfeeding for <6 months were associated with significant reductions in EOC risk.
Summary

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Association of Selected Medical Conditions With Breast Cancer Risk in Korea
Sun Jae Jung, Minkyo Song, Ji-Yeob Choi, Nan Song, Sue Kyung Park, Keun-Young Yoo, Daehee Kang
J Prev Med Public Health. 2013;46(6):346-352.   Published online November 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.6.346
  • 9,856 View
  • 94 Download
  • 12 Crossref
AbstractAbstract PDF
Objectives

To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study.

Methods

The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer.

Results

Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer.

Conclusions

Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

Summary

Citations

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A Prospective Cohort Study on the Relationship of Sleep Duration With All-cause and Disease-specific Mortality in the Korean Multi-center Cancer Cohort Study
Yohwan Yeo, Seung Hyun Ma, Sue Kyung Park, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo
J Prev Med Public Health. 2013;46(5):271-281.   Published online September 30, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.5.271
  • 12,570 View
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  • 68 Crossref
AbstractAbstract PDF
Objectives

Emerging evidence indicates that sleep duration is associated with health outcomes. However, the relationship of sleep duration with long-term health is unclear. This study was designed to determine the relationship of sleep duration with mortality as a parameter for long-term health in a large prospective cohort study in Korea.

Methods

The study population included 13 164 participants aged over 20 years from the Korean Multi-center Cancer Cohort study. Information on sleep duration was obtained through a structured questionnaire interview. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using a Cox regression model. The non-linear relationship between sleep duration and mortality was examined non-parametrically using restricted cubic splines.

Results

The HRs for all-cause mortality showed a U-shape, with the lowest point at sleep duration of 7 to 8 hours. There was an increased risk of death among persons with sleep duration of ≤5 hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of ≥10 hours (HR, 1.36; 95% CI, 1.07 to 1.72). In stratified analysis, this relationship of HR was seen in women and in participants aged ≥60 years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of ≤5 hours (HR, 1.40; 95% CI, 1.02 to 1.93). Risk of death from respiratory disease was associated with sleep duration at both extremes (≤5 and ≥10 hours).

Conclusions

Sleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea.

Summary

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Interaction of Body Mass Index and Diabetes as Modifiers of Cardiovascular Mortality in a Cohort Study
Seung Hyun Ma, Bo-Young Park, Jae Jeong Yang, En-Joo Jung, Yohwan Yeo, Yungi Whang, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo, Sue Kyung Park
J Prev Med Public Health. 2012;45(6):394-401.   Published online November 29, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.6.394
  • 9,954 View
  • 93 Download
  • 13 Crossref
AbstractAbstract PDF
Objectives

Diabetes and obesity each increases mortality, but recent papers have shown that lean Asian persons were at greater risk for mortality than were obese persons. The objective of this study is to determine whether an interaction exists between body mass index (BMI) and diabetes, which can modify the risk of death by cardiovascular disease (CVD).

Methods

Subjects who were over 20 years of age, and who had information regarding BMI, past history of diabetes, and fasting blood glucose levels (n=16 048), were selected from the Korea Multi-center Cancer Cohort study participants. By 2008, a total of 1290 participants had died; 251 and 155 had died of CVD and stroke, respectively. The hazard for deaths was calculated with hazard ratio (HR) and 95% confidence interval (95% CI) by Cox proportional hazard model.

Results

Compared with the normal population, patients with diabetes were at higher risk for CVD and stroke deaths (HR, 1.84; 95% CI, 1.33 to 2.56; HR, 1.82; 95% CI, 1.20 to 2.76; respectively). Relative to subjects with no diabetes and normal BMI (21 to 22.9 kg/m2), lean subjects with diabetes (BMI <21 kg/m2) had a greater risk for CVD and stroke deaths (HR, 2.83; 95% CI, 1.57 to 5.09; HR, 3.27; 95% CI, 1.58 to 6.76; respectively), while obese subjects with diabetes (BMI ≥25 kg/m2) had no increased death risk (p-interaction <0.05). This pattern was consistent in sub-populations with no incidence of hypertension.

Conclusions

This study suggests that diabetes in lean people is more critical to CVD deaths than it is in obese people.

Summary

Citations

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Alcohol Consumption and Mortality in the Korean Multi-center Cancer Cohort Study
En-Joo Jung, Aesun Shin, Sue K. Park, Seung-Hyun Ma, In-Seong Cho, Boyoung Park, Eun-Ha Lee, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo
J Prev Med Public Health. 2012;45(5):301-308.   Published online September 28, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.5.301
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AbstractAbstract PDF
Objectives

To examine the association between alcohol consumption habit, types of beverages, alcohol consumption quantity, and overall and cancer-specific mortality among Korean adults.

Methods

The alcohol consumption information of a total of 16 320 participants who were 20 years or older from the Korean Multi-center Cancer Cohort were analyzed to examine the association between alcohol consumption habit and mortality (median follow-up of 9.3 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) of alcohol consumption to mortality adjusting for age, sex, geographic areas, education, smoking status, and body mass index.

Results

Alcohol drinkers showed an increased risk for total mortality compared with never drinkers (HR, 1.72; 95% confidence interval [CI], 1.38 to 2.14 for past drinkers; HR, 1.21; 95% CI, 1.06 to 1.39 for current drinkers), while past drinkers only were associated with higher risk for cancer deaths (HR, 1.84; 95% CI, 1.34 to 2.53). The quantity of alcohol consumed per week showed a J-shaped association with risk of mortality. Relative to light drinkers (0.01 to 90 g/wk), never drinkers and heavy drinkers (>504 g/wk) had an increased risk for all-cause and cancer deaths: (HR, 1.18; 95% CI, 0.96 to 1.45) and (HR, 1.39; 95% CI, 1.05 to 1.83) for all-cause mortality; and (HR, 1.55; 95% CI, 1.15 to 2.11) and (HR, 2.07; 95% CI, 1.39 to 3.09) for all cancer mortality, respectively. Heavy drinkers (>504 g/wk) showed an elevated risk for death from stomach and liver cancers.

Conclusions

The present study supports the existence of a J-shaped association between alcohol consumption quantity and the risk of all-cause and cancer deaths. Heavy drinkers had an increased risk of death from cancer overall and liver and stomach cancer.

Summary

Citations

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JPMPH : Journal of Preventive Medicine and Public Health