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Breast Density and Risk of Breast Cancer in Asian Women: A Meta-analysis of Observational Studies
Jong-Myon Bae, Eun Hee Kim
J Prev Med Public Health. 2016;49(6):367-375.   Published online October 21, 2016
DOI: https://doi.org/10.3961/jpmph.16.054
  • 16,541 View
  • 318 Download
  • 58 Crossref
AbstractAbstract PDF
Objectives
The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women.
Methods
PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted.
Results
Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; I2=50.0%). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47).
Conclusions
In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.
Summary

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Helicobacter pylori Infection and Risk of Gastric Cancer in Korea: A Quantitative Systematic Review
Jong-Myon Bae, Eun Hee Kim
J Prev Med Public Health. 2016;49(4):197-204.   Published online July 7, 2016
DOI: https://doi.org/10.3961/jpmph.16.024
  • 12,081 View
  • 228 Download
  • 21 Crossref
AbstractAbstract PDF
Objectives
In the context of the global decrease in mortality due to gastric cancer, previous studies have reported that the effect of chronic Helicobacter pylori (H. pylori) infection on the incidence of gastric cancer varies among regions. This systematic review was conducted to investigate H. pylori as a risk factor for gastric cancer in Korea, where the incidence of gastric cancer is among the highest in the world.
Methods
A search strategy was established to identify articles published in Korean as well as in English. Ultimately, we included observational studies conducted among Korean patients that designed with an age-matched and sex-matched control group that reported the odds ratio associated with H. pylori. Gastric cancer cases were subdivided into overall (OGC), cardia (CGC), non-cardia (NGC), early (EGC), advanced, intestinal (IGC), and diffuse forms of gastric cancer. Summary odds ratios (SORs) with 95% confidence intervals (CIs) were calculated in the meta-analysis using a random-effect model.
Results
Eleven case-control studies were ultimately selected. H. pylori was associated with an SOR of 1.81 (95% CI, 1.29 to 2.54) for OGC. Additionally, statistically significant risks were observed for CGC, NGC, EGC, and IGC.
Conclusions
Chronic H. pylori infection was found to raise the risk of gastric cancer among Koreans, with the highest risk observed for CGC and EGC (SOR=2.88 for both). Follow-up clinical epidemiologic studies are needed to assess the effects of current treatments aimed at eradicating H. pylori infections.
Summary

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Brief Report
Citation Discovery Tools for Conducting Adaptive Meta-analyses to Update Systematic Reviews
Jong-Myon Bae, Eun Hee Kim
J Prev Med Public Health. 2016;49(2):129-133.   Published online March 14, 2016
DOI: https://doi.org/10.3961/jpmph.15.074
  • 10,012 View
  • 110 Download
  • 18 Crossref
AbstractAbstract PDF
Objectives
The systematic review (SR) is a research methodology that aims to synthesize related evidence. Updating previously conducted SRs is necessary when new evidence has been produced, but no consensus has yet emerged on the appropriate update methodology. The authors have developed a new SR update method called ‘adaptive meta-analysis’ (AMA) using the ‘cited by’, ‘similar articles’, and ‘related articles’ citation discovery tools in the PubMed and Scopus databases. This study evaluates the usefulness of these citation discovery tools for updating SRs.
Methods
Lists were constructed by applying the citation discovery tools in the two databases to the articles analyzed by a published SR. The degree of overlap between the lists and distribution of excluded results were evaluated.
Results
The articles ultimately selected for the SR update meta-analysis were found in the lists obtained from the ‘cited by’ and ‘similar’ tools in PubMed. Most of the selected articles appeared in both the ‘cited by’ lists in Scopus and PubMed. The Scopus ‘related’ tool did not identify the appropriate articles.
Conclusions
The AMA, which involves using both citation discovery tools in PubMed, and optionally, the ‘related’ tool in Scopus, was found to be useful for updating an SR.
Summary

Citations

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Review Article
Epstein-Barr Virus and Gastric Cancer Risk: A Meta-analysis With Meta-regression of Case-control Studies
Jong-Myon Bae, Eun Hee Kim
J Prev Med Public Health. 2016;49(2):97-107.   Published online March 4, 2016
DOI: https://doi.org/10.3961/jpmph.15.068
  • 14,673 View
  • 201 Download
  • 47 Crossref
AbstractAbstract PDF
Objectives
Research on how the risk of gastric cancer increases with Epstein-Barr virus (EBV) infection is lacking. In a systematic review that investigated studies published until September 2014, the authors did not calculate the summary odds ratio (SOR) due to heterogeneity across studies. Therefore, we include here additional studies published until October 2015 and conduct a meta-analysis with meta-regression that controls for the heterogeneity among studies.
Methods
Using the studies selected in the previously published systematic review, we formulated lists of references, cited articles, and related articles provided by PubMed. From the lists, only case-control studies that detected EBV in tissue samples were selected. In order to control for the heterogeneity among studies, subgroup analysis and meta-regression were performed.
Results
In the 33 case-control results with adjacent non-cancer tissue, the total number of test samples in the case and control groups was 5280 and 4962, respectively. In the 14 case-control results with normal tissue, the total number of test samples in case and control groups was 1393 and 945, respectively. Upon meta-regression, the type of control tissue was found to be a statistically significant variable with regard to heterogeneity. When the control tissue was normal tissue of healthy individuals, the SOR was 3.41 (95% CI, 1.78 to 6.51; I-squared, 65.5%).
Conclusions
The results of the present study support the argument that EBV infection increases the risk of gastric cancer. In the future, age-matched and sex-matched case-control studies should be conducted.
Summary

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Reviews
Hormonal Replacement Therapy and the Risk of Lung Cancer in Women: An Adaptive Meta-analysis of Cohort Studies
Jong-Myon Bae, Eun Hee Kim
J Prev Med Public Health. 2015;48(6):280-286.   Published online November 9, 2015
DOI: https://doi.org/10.3961/jpmph.15.054
  • 13,114 View
  • 124 Download
  • 26 Crossref
AbstractAbstract PDF
Objectives
Approximately 10% to 15% of lung cancer cases occur in never-smokers. Hormonal factors have been suggested to lead to an elevated risk of lung cancer in women. This systematic review (SR) aimed to investigate the association between hormonal replacement therapy (HRT) and the risk of lung cancer in women using cohort studies.
Methods
We first obtained previous SR articles on this topic. Based on these studies we made a list of refereed, cited, and related articles using the PubMed and Scopus databases. All cohort studies that evaluated the relative risk of HRT exposure on lung cancer occurrence in women were selected. Estimate of summary effect size (sES) with 95% confidence intervals (CIs) were calculated.
Results
A total of 14 cohort studies were finally selected. A random effect model was applied due to heterogeneity (I-squared, 64.3%). The sES of the 14 articles evaluating the impact of HRT exposure on lung cancer occurrence in women indicated no statistically significant increase in lung cancer risk (sES, 0.99; 95% CI, 0.90 to 1.09).
Conclusions
These results showed that HRT history had no effect on the risk of lung cancer in women, even though the sES of case-control studies described in previous SR articles indicated that HRT had a protective effect against lung cancer. It is necessary to conduct a pooled analysis of cohort studies.
Summary

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    Journal of Preventive Medicine and Public Health.2016; 49(2): 129.     CrossRef
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    Jong-Myon Bae, Eun Hee Kim
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Hormone Replacement Therapy and Risk of Breast Cancer in Korean Women: A Quantitative Systematic Review
Jong-Myon Bae, Eun Hee Kim
J Prev Med Public Health. 2015;48(5):225-230.   Published online September 16, 2015
DOI: https://doi.org/10.3961/jpmph.15.046
  • 13,640 View
  • 167 Download
  • 18 Crossref
AbstractAbstract PDF
Objectives
The epidemiological characteristics of breast cancer incidence by age group in Korean women are unique. This systematic review aimed to investigate the association between hormone replacement therapy (HRT) and breast cancer risk in Korean women.
Methods
We searched electronic databases such as KoreaMed, KMbase, KISS, and RISS4U as well as PubMed for publications on Korean breast cancer patients. We also conducted manual searching based on references and citations in potential papers. All of the analytically epidemiologic studies that obtained individual data on HRT exposure and breast cancer occurrence in Korean women were selected. We restricted the inclusion of case-control studies to those that included age-matched controls. Estimates of summary odds ratio (SOR) with 95% confidence intervals (CIs) were calculated using random effect models.
Results
One cohort and five case-control studies were finally selected. Based on the heterogeneity that existed among the six studies (I-squared=70.2%), a random effect model was applied. The summary effect size of HRT history from the six articles indicated no statistical significance in breast cancer risk (SOR, 0.983; 95% CI, 0.620 to 1.556).
Conclusions
These facts support no significant effect of HRT history in the risk of breast cancer in Korean women. It is necessary to conduct a pooled analysis.
Summary

Citations

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Original Articles
Rates of Change to a Positive Result in Subsequent Screening Mammography in Korean Women: A Retrospective Observational Study
Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nam Kim, Chung Mo Nam
J Prev Med Public Health. 2015;48(1):48-52.   Published online December 26, 2014
DOI: https://doi.org/10.3961/jpmph.14.042
  • 10,005 View
  • 82 Download
AbstractAbstract PDF
Objectives
This retrospective cohort study aimed at calculating some parameters of changes in the findings of the subsequent screening mammography (SSM) in female Korean volunteers.
Methods
The study included screenees aged 30 to 79 years who underwent SSM voluntarily after testing negative in the baseline screenings performed between January 2007 and December 2011. A change to a positive result was defined as category 4 or 5 by using the American College of Radiology Breast Imaging Reporting and Data System. The proportion of results that had changed to positive (CP, %) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of study participants. The rate of results that had changed to positive (CR, cases per 100 000 screenee-months) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of months of the follow-up period.
Results
The overall CP and CR in all age groups (n=77 908) were 2.26% and 93.94 cases per 100 000 screenee-months, respectively. The median CP interval in the subjects who had positive SSM results was 30 to 36 months, while that in the age group of 30 to 39 years was shorter.
Conclusions
Different screening intervals should be considered among women aged between 30 and 59 years. In addition, a strategy for a screening program should be developed for the age group of 30 to 39 years, in particular.
Summary
Mean Sojourn Time of Preclinical Gastric Cancer in Korean Men: A Retrospective Observational Study
Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim
J Prev Med Public Health. 2014;47(4):201-205.   Published online July 31, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.4.201
  • 13,343 View
  • 100 Download
  • 11 Crossref
AbstractAbstract PDF
Objectives
This retrospective cohort study aimed to estimate the mean sojourn time (MST) of preclinical gastric cancer in Korean men.
Methods
The subjects consisted of voluntary male screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative at a baseline screening performed between January 2007 and December 2011. A new case was defined if gastric cancer cells were present in the biopsy specimens obtained from gastroscopy. The follow-up period was calculated as the number of person-years between the date of baseline screening gastroscopy and positive findings at a subsequent screening. The MST was calculated using transition rates of gastric cancer to determine the best screening interval.
Results
Of the 171 979 voluntary male screenees, 61 688 (36%) underwent subsequent screening gastroscopies between January 2007 and December 2011. A total of 91 incident cases were found during 19 598 598 person-years of follow-up. The MST of gastric cancer was 2.37 years (95% confidence intervals, 1.92 to 2.96), and those aged 40 to 49 years had a shorter MST than those 50 to 69 years did.
Conclusions
These findings support the 2-year interval of screening recommended by the nationwide gastric cancer screening program in Korea. Further studies for the age-specific MST among women are needed.
Summary

Citations

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