Journal of Preventive Medicine and Public Health

Original Articles

Operational Definitions of Colorectal Cancer in the Korean National Health Insurance Database: Hyeree Park, Yu Rim Kim, Yerin Pyun, Hyundeok Joo, Aesun Shin; J Prev Med Public Health. 2023;56(4):312-318. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.033

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Abstract Summary PDF Supplementary Material

Objectives
We reviewed the operational definitions of colorectal cancer (CRC) from studies using the Korean National Health Insurance Service (NHIS) and compared CRC incidence derived from the commonly used operational definitions in the literature with the statistics reported by the Korea Central Cancer Registry (KCCR).
Methods
We searched the MEDLINE and KoreaMed databases to identify studies containing operational definitions of CRC, published until January 15, 2021. All pertinent data concerning the study period, the utilized database, and the outcome variable were extracted. Within the NHIS-National Sample Cohort, age-standardized incidence rates (ASRs) of CRC were calculated for each operational definition found in the literature between 2005 and 2019. These rates were then compared with ASRs from the KCCR.
Results
From the 62 eligible studies, 9 operational definitions for CRC were identified. The most commonly used operational definition was “C18-C20” (n=20), followed by “C18-C20 with claim code for treatment” (n=3) and “C18-C20 with V193 (code for registered cancer patients’ payment deduction)” (n=3). The ASRs reported using these operational definitions were lower than the ASRs from KCCR, except for “C18-C20 used as the main diagnosis.” The smallest difference in ASRs was observed for “C18-C20,” followed by “C18- C20 with V193,” and “C18-C20 with claim code for hospitalization or code for treatment.”
Conclusions
In defining CRC patients utilizing the NHIS database, the ASR derived through the operational definition of “C18-C20 as the main diagnosis” was comparable to the ASR from the KCCR. Depending on the study hypothesis, operational definitions using treatment codes may be utilized.

Summary

Korean summary
- 국민건강보험공단 자료 기반 연구에서 사용된 대장암의 조작적 정의를 검토하고 각 조작적 정의에 따른 대장암의 연령표준화발생률을 중앙암등록본부에서 보고한 수치와 비교하였다. - 62개의 출판된 문헌을 검토하여 9개의 조작적 정의를 확인하였고 이 중 "C18-C20"이 가장 일반적으로 사용되었다. - "C18-C20"을 주진단으로 정의한 경우의 연령표준화발생률은 중앙암등록본부에서 보고한 연령표준화발생률과 가장 유사하였다.

Citations

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National Trends in Rotavirus Enteritis among Infants in South Korea, 2010–2021: A Nationwide Cohort
Hyun Jee Lee, Yujin Choi, Jaeyu Park, Yong-Sung Choi, Dong Keon Yon, Do Hyun Kim
Children.2023; 10(9): 1436. CrossRef
Real-world data analysis on effectiveness of integrative therapies: A practical guide to study design and data analysis using healthcare databases
Ye-Seul Lee, Yoon Jae Lee, In-Hyuk Ha
Integrative Medicine Research.2023; 12(4): 101000. CrossRef

Adverse Events Following Immunizations in Infants Under 1 Year of Age in Lorestan Province, Western Iran: Anbari khatereh, Ghanadi Koruosh, Toulabipour Alireza, Jamebozuorghi Daryuosh, Baharvand Parastoo; J Prev Med Public Health. 2023;56(2):172-179. Published online March 14, 2023; DOI: https://doi.org/10.3961/jpmph.22.540

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Abstract PDF: Objectives
Vaccination is an important intervention for preventing disease and reducing disease severity. Universal vaccination programs have significantly reduced the incidence of many dangerous diseases among children worldwide. This study investigated the side effects after immunization in infants under 1 year of age in Lorestan Province, western Iran.
Methods
This descriptive analytical study included data from all children <1 year old in Lorestan Province, Iran who were vaccinated according to the national schedule in 2020 and had an adverse event following immunization (AEFI). Data were extracted from 1084 forms on age, sex, birth weight, type of birth, AEFI type, vaccine type, and time of vaccination. Descriptive statistics (frequency, percentage) were calculated, and the chi-square test and Fisher exact test were used to assess differences in AEFIs according to the abovelisted variables.
Results
The most frequent AEFIs were high fever (n=386, 35.6%), mild local reaction (n=341, 31.5%), and swelling and pain (n=121, 11.2%). The least common AEFIs were encephalitis (n=1, 0.1%), convulsion (n=2, 0.2%), and nodules (n=3, 0.3%). Girls and boys only showed significant differences in mild local reactions (p=0.044) and skin allergies (p=0.002). The incidence of lymphadenitis (p<0.001), severe local reaction (p<0.001), mild local reaction (p=0.007), fainting (p=0.032), swelling and pain (p=0.006), high fever (p=0.005), and nodules (p<0.001) showed significant differences based on age at vaccination.
Conclusions
Immunization is a fundamental public health policy for controlling vaccine-preventable infectious diseases. Although vaccines such as the Bacillus Calmette-Guérin vaccine, oral poliovirus vaccine, and pentavalent vaccine are well-researched and reliable, AEFIs are inevitable.; Summary

Projection of Cancer Incidence and Mortality From 2020 to 2035 in the Korean Population Aged 20 Years and Older: Youjin Hong, Sangjun Lee, Sungji Moon, Soseul Sung, Woojin Lim, Kyungsik Kim, Seokyung An, Jeoungbin Choi, Kwang-Pil Ko, Inah Kim, Jung Eun Lee, Sue K. Park; J Prev Med Public Health. 2022;55(6):529-538. Published online October 17, 2022; DOI: https://doi.org/10.3961/jpmph.22.128

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to identify the current patterns of cancer incidence and estimate the projected cancer incidence and mortality between 2020 and 2035 in Korea.
Methods
Data on cancer incidence cases were extracted from the Korean Statistical Information Service from 2000 to 2017, and data on cancer-related deaths were extracted from the National Cancer Center from 2000 to 2018. Cancer cases and deaths were classified according to the International Classification of Diseases, 10th edition. For the current patterns of cancer incidence, age-standardized incidence rates (ASIRs) and age-standardized mortality rates were investigated using the 2000 mid-year estimated population aged over 20 years and older. A joinpoint regression model was used to determine the 2020 to 2035 trends in cancer.
Results
Overall, cancer cases were predicted to increase from 265 299 in 2020 to 474 085 in 2035 (growth rate: 1.8%). The greatest increase in the ASIR was projected for prostate cancer among male (7.84 vs. 189.53 per 100 000 people) and breast cancer among female (34.17 vs. 238.45 per 100 000 people) from 2000 to 2035. Overall cancer deaths were projected to increase from 81 717 in 2020 to 95 845 in 2035 (average annual growth rate: 1.2%). Although most cancer mortality rates were projected to decrease, those of breast, pancreatic, and ovarian cancer among female were projected to increase until 2035.
Conclusions
These up-to-date projections of cancer incidence and mortality in the Korean population may be a significant resource for implementing cancer-related regulations or developing cancer treatments.

Summary

Korean summary
최근 고령화 시대로 접어들고 암의 위험요인들에 대한 노출률이 변화함에 따라 암의 발생률 및 사망률에 대해서 관찰하는 것은 중요한 일이 되었다. 따라서, 본 연구는 한국인에서 2035년까지의 암에 대한 발생률과 사망률을 Joinpoint regression 모델을 이용하여 예측하였다. 남성에서는 전립선암, 여성에서는 유방암이 연령표준화 발생률이 가장 높았으며 대부분의 연령표준화 사망률은 감소하는 것으로 예상되지만 여성의 유방암, 췌장암, 난소암이 증가될 것으로 예상된다.

Citations

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Changes in metabolic syndrome and the risk of breast and endometrial cancer according to menopause in Korean women
Thi Xuan Mai Tran, Soyeoun Kim, Boyoung Park
Epidemiology and Health.2023; 45: e2023049. CrossRef

Review

DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach: Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon; J Prev Med Public Health. 2022;55(1):10-18. Published online January 19, 2022; DOI: https://doi.org/10.3961/jpmph.21.597

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Abstract Summary PDF

Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers’ ability to critically interpret burden of disease studies.

Summary

Korean summary
장애보정생존연수 산출 방법은 발생률 접근법, 순수 유병률 접근법 및 하이브리드 접근법으로 나뉜다. 이러한 3가지 장애보정생존연수 산출 접근법은 각각 고유한 특성을 가지고 질병부담에 대한 다양한 관점을 반영하기 때문에, 연구 목적에 따라 산출 접근법의 선택이 달라질 수 있다. 이번 연구의 결과는 연구자들이 장애보정생존연수 산출 방법의 타당성을 향상시키기 위하여 질병부담 연구에 사용할 산출 접근법을 결정하는 데 도움이 될 것이다.

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Original Articles

Trends and Spatial Pattern Analysis of Dengue Cases in Northeast Malaysia: Afiqah Syamimi Masrani, Nik Rosmawati Nik Husain, Kamarul Imran Musa, Ahmad Syaarani Yasin; J Prev Med Public Health. 2022;55(1):80-87. Published online January 6, 2022; DOI: https://doi.org/10.3961/jpmph.21.461

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Abstract PDF

Objectives
Dengue remains hyperendemic in Malaysia despite extensive vector control activities. With dynamic changes in land use, urbanisation and population movement, periodic updates on dengue transmission patterns are crucial to ensure the implementation of effective control strategies. We sought to assess shifts in the trends and spatial patterns of dengue in Kelantan, a north-eastern state of Malaysia (5°15’N 102°0’E).
Methods
This study incorporated data from the national dengue monitoring system (eDengue system). Confirmed dengue cases registered in Kelantan with disease onset between January 1, 2016 and December 31, 2018 were included in the study. Yearly changes in dengue incidence were mapped by using ArcGIS. Hotspot analysis was performed using Getis-Ord Gi to track changes in the trends of dengue spatial clustering.
Results
A total of 10 645 dengue cases were recorded in Kelantan between 2016 and 2018, with an average of 10 dengue cases reported daily (standard deviation, 11.02). Areas with persistently high dengue incidence were seen mainly in the coastal region for the 3-year period. However, the hotspots shifted over time with a gradual dispersion of hotspots to their adjacent districts.
Conclusions
A notable shift in the spatial patterns of dengue was observed. We were able to glimpse the shift of dengue from an urban to peri-urban disease with the possible effect of a state-wide population movement that affects dengue transmission.

Summary

Citations

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Digital Health Interventions in Dengue Surveillance to Detect and Predict Outbreak: A Scoping Review
Marko Ferdian Salim, Tri Baskoro Tunggul Satoto, Danardono Danardono, D. Daniel
The Open Public Health Journal.2024;[Epub] CrossRef
Solid waste management and Aedes aegypti infestation interconnections: A regression tree application
Fernanda Klafke, Virgínia Grace Barros, Elisa Henning
Waste Management & Research: The Journal for a Sustainable Circular Economy.2023; 41(11): 1684. CrossRef
Entomo-Virological Aedes aegypti Surveillance Applied for Prediction of Dengue Transmission: A Spatio-Temporal Modeling Study
André de Souza Leandro, Mario J. C. Ayala, Renata Defante Lopes, Caroline Amaral Martins, Rafael Maciel-de-Freitas, Daniel A. M. Villela
Pathogens.2022; 12(1): 4. CrossRef

The Burden of Stroke in Kurdistan Province, Iran From 2011 to 2017: Shahram Moradi, Ghobad Moradi, Bakhtiar Piroozi; J Prev Med Public Health. 2021;54(2):103-109. Published online February 1, 2021; DOI: https://doi.org/10.3961/jpmph.20.335

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Abstract PDF: Objectives
The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017.
Methods
Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs).
Results
The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively.
Conclusions
The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.; Summary

Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort: Jeongmook Kang, Yoon-Hyung Park, Kwang Ik Yang, Jose Rene Bagani Cruz, Young Hwangbo; J Prev Med Public Health. 2020;53(1):37-44. Published online November 6, 2019; DOI: https://doi.org/10.3961/jpmph.19.248

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Abstract Summary PDF

Objectives
This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients.
Methods
As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated.
Results
Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44).
Conclusions
Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.

Summary

Korean summary
본 연구 결과 심뇌혈관 합병증이 없었던 30세 이상 신규 일차성 고혈압 환자에서 고혈압 진단시 수면장애을 동반한 경우 심뇌혈관합병증 발생율은 78.3/1000인년(95% CI 75.8-80.9)으로 나타났으며, 수면장애을 동반하지 않은 경우 심뇌혈관합병증 발생율은 58.6/1000인년(95%CI 57.9-59.3)인 것으로 관찰되었다. 고혈압 진단시의 연령, 성별, 수입, 거주지역, 동반된 당뇨병력을 보정한 다중회귀분석에서 수면장애병력이 있는 고혈압 환자군의 심뇌혈관합병증 발생 위험도는 수면장애병력이 없는 환자에 비하여 1.21배(95% CI 1.17-1.25) 높은 것으로 나타났으며, 연구대상자에게 발생한 심뇌혈관합병증의 약 2%는 고혈압 진단시 동반된 수면장애가 기여한 것으로 분석되었다.

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Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2022; 55(2): 173. CrossRef

Perspective

What Else Is Needed in the Korean Government’s Master Plan for People With Developmental Disabilities?: Jin Yong Lee, Jieun Yun; J Prev Med Public Health. 2019;52(3):200-204. Published online May 7, 2019; DOI: https://doi.org/10.3961/jpmph.18.249

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Abstract Summary PDF Supplementary Material

On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a ‘welfare society in harmony.’ However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals’ unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

Summary

Korean summary
2018년 9월 대통령이 직접 발표한 “발달장애인 평생케어 종합대책”의 성공적인 수행을 위해 필수적인 정책을 제안하였다. 특히, 발달장애인의 정확한 규모, 유병률, 발생률 등 기초적인 현황 파악과 정책 개발을 뒷받침하기 위한 역학연구, 발달장애인 개인평가에 기반한 미충족 필요의 측정과 이를 바탕으로 한 개인별 맟춤형 서비스 디자인, 서비스의 접근성과 형평성 달성, 그리고 보건-의료-고용-교육-복지서비스를 통합적으로 제공할 수 있는 시스템 구축이 필요함을 지적하였다.

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Original Articles

Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models: Kamyar Mansori, Masoud Solaymani-Dodaran, Alireza Mosavi-Jarrahi, Ali Ganbary Motlagh, Masoud Salehi, Alireza Delavari, Mohsen Asadi-Lari; J Prev Med Public Health. 2018;51(1):33-40. Published online January 2, 2018; DOI: https://doi.org/10.3961/jpmph.17.167

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Abstract PDF

Objectives
The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models.
Methods
This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis.
Results
The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively.
Conclusions
Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.

Summary

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Adeylson Guimarães Ribeiro, Allini Mafra da Costa, Talita Fernanda Pereira, Denise Peixoto Guimarães, José Humberto Tavares Guerreiro Fregnani
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Premature mortality of gastrointestinal cancer in Iran: trends and projections 2001–2030
Fatemeh Khosravi Shadmani, Farshad Farzadfar, Moein Yoosefi, Kamyar Mansori, Reza Khosravi Shadman, Aliakbar Haghdoost
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Correlations Between the Incidence of National Notifiable Infectious Diseases and Public Open Data, Including Meteorological Factors and Medical Facility Resources: Jin-Hwa Jang, Ji-Hae Lee, Mi-Kyung Je, Myeong-Ji Cho, Young Mee Bae, Hyeon Seok Son, Insung Ahn; J Prev Med Public Health. 2015;48(4):203-215. Published online July 27, 2015; DOI: https://doi.org/10.3961/jpmph.14.057

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Abstract PDF Supplementary Material

Objectives
This study was performed to investigate the relationship between the incidence of national notifiable infectious diseases (NNIDs) and meteorological factors, air pollution levels, and hospital resources in Korea.
Methods
We collected and stored 660 000 pieces of publicly available data associated with infectious diseases from public data portals and the Diseases Web Statistics System of Korea. We analyzed correlations between the monthly incidence of these diseases and monthly average temperatures and monthly average relative humidity, as well as vaccination rates, number of hospitals, and number of hospital beds by district in Seoul.
Results
Of the 34 NNIDs, malaria showed the most significant correlation with temperature (r=0.949, p<0.01) and concentration of nitrogen dioxide (r=-0.884, p<0.01). We also found a strong correlation between the incidence of NNIDs and the number of hospital beds in 25 districts in Seoul (r=0.606, p<0.01). In particular, Geumcheon-gu was found to have the lowest incidence rate of NNIDs and the highest number of hospital beds per patient.
Conclusions
In this study, we conducted a correlational analysis of public data from Korean government portals that can be used as parameters to forecast the spread of outbreaks.

Summary

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Review

Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective: Nina Roswall, Elisabete Weiderpass; J Prev Med Public Health. 2015;48(1):1-9. Published online January 27, 2015; DOI: https://doi.org/10.3961/jpmph.14.052

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Abstract PDF

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization’s prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

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Original Articles

Incidence of and Factors for Self-reported Fragility Fractures Among Middle-aged and Elderly Women in Rural Korea: An 11-Year Follow-up Study: Soon-Ki Ahn, Sin Kam, Byung-Yeol Chun; J Prev Med Public Health. 2014;47(6):289-297. Published online October 2, 2014; DOI: https://doi.org/10.3961/jpmph.14.020

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Abstract PDF

Objectives
This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea.
Methods
The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs).
Results
Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture.
Conclusions
Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

Summary

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The Incidence of Stroke by Socioeconomic Status, Age, Sex, and Stroke Subtype: A Nationwide Study in Korea: Su Ra Seo, Su Young Kim, Sang-Yi Lee, Tae-Ho Yoon, Hyung-Geun Park, Seung Eun Lee, Chul-Woung Kim; J Prev Med Public Health. 2014;47(2):104-112. Published online March 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.2.104

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Abstract PDF

Objectives

To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea.

Methods

Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated.

Results

In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels.

Conclusions

The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.

Summary

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Cancer Incidence in Korean Vietnam Veterans During 1992-2003: The Korean Veterans Health Study: Sang-Wook Yi; J Prev Med Public Health. 2013;46(6):309-318. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.309

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Abstract PDF

Objectives

The aim of this study was to investigate the association between Vietnam experience including exposure to military herbicides and cancer incidence in Korean Vietnam War veterans.

Methods

The cancer cases of 185 265 Vietnam veterans from January 1, 1992 to December 31, 2003 were confirmed from the Korea National Cancer Incidence Database. The age-adjusted incidence and standardized incidence ratios (SIRs) were calculated using the male population during 1992 to 2003 as a standard population.

Results

The age-adjusted overall cancer incidence per 100 000 person-years was 455.3 in Vietnam veterans. The overall cancer incidence was slightly yet significantly lower in veterans (SIR, 0.97; 95% confidence interval, 0.95 to 0.99) than in the general population. The overall cancer incidence in enlisted soldiers was not lower (SIR, 1.00), whereas that in officers was significantly lower (SIR, 0.87) than in the general population. The incidences of prostate cancer and T-cell lymphoma in all veterans, and lung cancer and bladder cancer in enlisted soldiers, and colon cancer and kidney cancer in non-commissioned officers, and colon cancer, kidney cancer, and prostate cancer in officers, were higher than in the general population. The SIR for overall cancer among Vietnam veterans rose from 0.92 for 1992-1997 to 0.99 for 1998-2003.

Conclusions

The overall cancer incidence in Vietnam veterans was not higher than in the general male population. Vietnam veterans and military rank subcohorts experienced a higher incidence of several cancers, including prostate cancer, T-cell lymphoma, lung cancer, bladder cancer, kidney cancer, and colon cancer than the general population. The SIR for overall cancer increased over time in Vietnam veterans.

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Brief Report

Fifteen Years After the Gozan-Dong Glass Fiber Outbreak, Incheon in 1995: Soo-Hun Cho, Joohon Sung, Jonghoon Kim, Young-Su Ju, Minji Han, Kyu-Won Jung; J Prev Med Public Health. 2011;44(4):185-189. Published online July 29, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.4.185

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Abstract PDF: Objectives
In 1995, an outbreak survey in Gozan-dong concluded that an association between fiberglass exposure in drinking water and cancer outbreak cannot be established. This study follows the subjects from a study in 1995 using a data linkage method to examine whether an association existed. The authors will address the potential benefits and methodological issues following outbreak surveys using data linkage, particularly when informed consent is absent.
Methods
This is a follow-up study of 697 (30 exposed) individuals out of the original 888 (31 exposed) participants (78.5%) from 1995 to 2007 assessing the cancer outcomes and deaths of these individuals. The National Cancer Registry (KNCR) and death certificate data were linked using the ID numbers of the participants. The standardized incidence ratio (SIR) and standardized mortality ratio (SMR) from cancers were calculated by the KNCR.
Results
The SIR values for all cancer or gastrointestinal cancer (GI) occurrences were the lowest in the exposed group (SIR, 0.73; 95% CI, 0.10 to 5.21; 0.00 for GI), while the two control groups (control 1: external, control 2: internal) showed slight increases in their SIR values (SIR, 1.18 and 1.27 for all cancers; 1.62 and 1.46 for GI). All lacked statistical significance. All-cause mortality levels for the three groups showed the same pattern (SMR 0.37, 1.29, and 1.11).
Conclusions
This study did not refute a finding of non-association with a 13-year follow-up. Considering that many outbreak surveys are associated with a small sample size and a cross-sectional design, follow-up studies that utilize data linkage should become standard procedure.; Summary

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