BACKGROUND: Although change in the birth cohort effect on cancer mortality rates is known to be highly associated with the decreasing rates of age-standardized cancer mortality rates in Japan, the differences in the trends of cohort effect for representative cancer types among the prefectures remain unknown. This study aimed to investigate the differences in the decreasing rate of cohort effects among the prefectures for representative cancer types using age-period-cohort (APC) analysis. METHODS: Data on stomach, colorectal, liver, and lung cancer mortality for each prefecture and the population data from 1999 to 2018 were obtained from the Vital Statistics in Japan. Mortality data for individuals aged 50 to 79 years grouped in 5-year increments were used, and corresponding birth cohorts born 1920-1924 through 1964-1978 were used for analysis. We estimated the effects of age, period, and cohort on each type of mortality rate for each prefecture by sex. Then, we calculated the decreasing rates of cohort effects for each prefecture. We also calculated the mortality rate ratio of each prefecture compared with all of Japan for cohorts using the estimates. RESULTS: As a result of APC analysis, we found that the decreasing rates of period effects were small and that there was a little difference in the decreasing rates among prefectures for all types of cancer among both sexes. On the other hand, there was a large difference in the decreasing rates of cohort effects for stomach and liver cancer mortality rates among prefectures, particularly for men. For men, the decreasing rates of cohort effects in cohorts born between 1920-1924 and 1964-1978 varied among prefectures, ranging from 4.1 to 84.0% for stomach cancer and from 20.2 to 92.4% for liver cancers, respectively. On the other hand, the differences in the decreasing rates of cohort effects among prefectures for colorectal and lung cancer were relatively smaller. CONCLUSIONS The decreasing rates of cohort effects for stomach and liver cancer varied widely among prefectures. It is possible that this will influence cancer mortality rates in each prefecture in the future.
Aged ; Cohort Studies ; Colorectal Neoplasms/mortality* ; Female ; Humans ; Japan/epidemiology* ; Liver Neoplasms/mortality* ; Lung Neoplasms/mortality* ; Male ; Middle Aged ; Risk Factors ; Stomach Neoplasms/mortality*

Little is known about the benefits of statin use on liver cancer mortality among patients with chronic hepatitis B (CHB) considering hypercholesterolemia and obesity. A nationwide retrospective cohort study was conducted using data from a Health Examination Cohort of the National Health Insurance Service of Korea. Data on CHB patients with no other concurrent liver disease were acquired, and statin use was defined as a cumulative daily dose ≥28. A 3-year landmark analysis was performed to avoid immortal time bias. Patients who started statin therapy within the landmark date were considered statin users. A Cox regression analysis was applied to assess associations between statin use and liver cancer mortality considering hypercholesterolemia and obesity. Among 13063 patients, 193 (1.5%) died of liver cancer during the mean follow-up period of 10.6 years. After adjusting for demographic and metabolic factors, statin use [hazard ratio (HR), 0.17; 95% confidence interval (CI), 0.04–0.70] and hypercholesterolemia (HR, 0.46; 95% CI, 0.24–0.88 for total cholesterol ≥240 mg/dL) were associated with a decreased risk of liver cancer mortality, whereas body mass index (BMI) ≥30 kg/m² was associated with an increased risk of liver cancer mortality (HR, 2.46; 95% CI, 1.20–5.06). This study showed that statin use was associated with decreased liver cancer mortality when adjusting for cholesterol levels and BMI. This study found that hypercholesterolemia was independently associated with decreased liver cancer mortality regardless of statin use.
Bias (Epidemiology) ; Body Mass Index ; Carcinoma, Hepatocellular ; Cholesterol ; Cohort Studies ; Follow-Up Studies ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Korea ; Liver Diseases ; Liver Neoplasms ; Liver ; Mortality ; National Health Programs ; Obesity ; Retrospective Studies

The incidence rate of primary liver cancer in Korea, the majority of which is hepatocellular carcinoma, has been decreasing steadily since 1999. However, Korea still has one of the highest incidence rates of liver cancer worldwide. Currently, liver cancer is the fifth most common cancer type in men and sixth in women. A total of 15,771 cases (11,774 men and 3,997 women) were identified, with an age-standardized incidence rate of 18.0 persons per 100,000 (29.2 in men and 7.9 in women) in 2016. Mortality from liver cancer has also decreased since 2002 in both sexes, although it is still the second most common cause of cancer deaths with 10,721 deaths (7,982 in men and 2,739 in women) in 2017. The 5-year relative survival rate was 13.2% in those diagnosed in 1996–2000, and it increased to 34.3% in those diagnosed in 2012–2016. Hepatitis B (HBV) and C (HCV) viruses are the most important causes of liver cancer, accounting for approximately 70% and 10% of liver cancer cases, respectively. Recently, the seroprevalence of HBV has markedly decreased to less than 3%, and the HCV antibody positivity rate has been estimated as about 0.7% in a nationwide survey. The participation rate of patients with hepatitis in liver cancer screening, a part of the National Cancer Screening Program, was still low at about 60% in 2018. Recent advances in the treatment of HBV and HCV could further reduce the burden of liver cancer despite its limited accessibility.
Carcinoma, Hepatocellular ; Early Detection of Cancer ; Epidemiology ; Female ; Hepatitis ; Hepatitis B ; Humans ; Incidence ; Korea ; Liver Neoplasms ; Liver ; Male ; Mass Screening ; Mortality ; Seroepidemiologic Studies ; Survival Rate

Liver cancer is the sixth most common cancer (fourth in men and sixth in women) and the second largest cause of cancer mortality in South Korea. The crude incidence rate of liver cancer was 31.9/100,000 (47.5/100,000 in men and 16.2/100,000 in women) and the age-standardized incidence rate was 19.9/100,000 (32.4/100,000 in men and 8.8/100,000 in women) in 2014. The crude incidence rate increased from 1999 to 2011 and thereafter showed a subtle decreasing tendency. The crude prevalence rate was 113.6/100,000 (170.2/100,000 in men and 57.1/100,000 in women) and the age-standardized prevalence rate was 72.6/100,000 (115.7/100,000 in men and 33.7/100,000 in women) in 2014, which increased from 2010 to 2014. Survival from liver cancer has improved over the last two decades. The 5-year relative survival rate was markedly increased from 10.7% in those diagnosed with liver cancer between 1993 and 1995 to 32.8% in those diagnosed between 2010 and 2014. The epidemiology of liver cancer is influenced by that of underlying liver diseases such as viral hepatitis. Substantial progress has been made in the prevention and treatment of viral hepatitis; however, uncontrolled alcoholic liver disease, obesity and diabetes appears to have the potential to emerge as major causes for liver cancer. Depending on the success of the control of risk factors, the epidemiology of liver cancer in Korea may change.
Carcinoma, Hepatocellular ; Epidemiology* ; Hepatitis ; Humans ; Incidence ; Korea* ; Liver Diseases ; Liver Diseases, Alcoholic ; Liver Neoplasms* ; Liver* ; Male ; Mortality ; Obesity ; Prevalence ; Risk Factors ; Survival Rate

Cancer is a major cause of morbidity and the most common cause of death in Korea. There are currently approximately 200,000 incident cancer cases and 78,000 individuals die from cancer every year. The factors directly related to cancer incidence, including aging, smoking, obesity, and Westernized dietary habits, have been increasing during the past several decades. Since 1999, trends toward increased incidence have been observed for thyroid, breast (in women), colorectal, and prostate cancer. Currently, these trends have changed direction, and the incidence of stomach and liver cancer in both sexes, and cervical cancer in women have continually declined. Although the number of cancer deaths increased by a factor of 2.7 from 1983 to 2016, the age-standardized mortality associated with cancer has been decreasing by 3% every year. The 5-year relative survival rate (RSR) has also improved over the past several decades, especially for stomach, prostate, and breast cancer, which had 5-year RSRs greater than 90% in the most recent report.
Aging ; Breast ; Breast Neoplasms ; Cause of Death ; Epidemiology* ; Female ; Food Habits ; Humans ; Incidence ; Korea* ; Liver Neoplasms ; Mortality ; Obesity ; Prostate ; Prostatic Neoplasms ; Republic of Korea ; Smoke ; Smoking ; Stomach ; Survival Rate ; Thyroid Gland ; Uterine Cervical Neoplasms

Hepatocellular carcinoma (HCC) is one of the most prevalent malignant tumors worldwide. Liver transplantation (LT) is known as a curative and therapeutic modality. However, the survival rates of recipients after LT are still not good enough because of tumor recurrence. To improve the survival rates of recipients after LT, identifying predictive factors for prognosis after LT and establishing a model assessing prognosis are very important to HCC patients. There has recently been a lot of clinical and basic research on recurrence and prognosis after LT. Progress has been made, especially in selection criteria for LT recipients and risk factors for predicting prognosis after LT. Hangzhou criteria, in line with China's high current incidence rate of primary liver, are first proposed by Chinese scholars of LT, and are accepted world-wide, and make an important contribution to the development of LT.
Carcinoma, Hepatocellular ; mortality ; surgery ; China ; epidemiology ; Humans ; Liver Neoplasms ; mortality ; surgery ; Liver Transplantation ; Neoplasm Recurrence, Local ; mortality ; Patient Selection ; Prognosis ; Risk Factors ; Survival Rate

Objective: To understand the distribution of cancer deaths in China in 2015 and provide reference for the prevention and control of cancer. Methods: Based on the results of Global Burden of Disease 2015, the cancer death distributions in different age groups, sex groups, provinces or by different malignant tumor in Chinese were described. Results: The age-standardized mortality rate of cancer was 159.01/100 000 in China in 2015. The mortality rate was highest in age group ≥70 years (1 102.73/100 000), and lowest in age group 5-14 years (5.40/100 000). The mortality rate in males was 2.15 times higher than that in females. The first 5 provinces with high cancer mortality rate were Anhui, Qinghai, Sichuan, Guangxi and Henan. Lung cancer, liver cancer, stomach cancer, esophageal cancer and colorectal cancer ranked 1-5 in term of mortality rate. Conclusion: The cancer mortality differed with age, gender, area and different malignant tumors, suggesting the necessity to develop targeted prevention and control strategies.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Asian People/statistics & numerical data* ; Child ; Child, Preschool ; China/epidemiology* ; Colonic Neoplasms/mortality* ; Colorectal Neoplasms/mortality* ; Female ; Humans ; Liver Neoplasms/mortality* ; Lung Neoplasms/mortality* ; Male ; Middle Aged ; Mortality/ethnology* ; Neoplasms/mortality* ; Residence Characteristics ; Sex Distribution ; Stomach Neoplasms/mortality* ; Young Adult

OBJECTIVETo understand the current status of the disease burden of liver cancer in Jinchang cohort.

METHODSAll the liver cancer death data from 2001 to 2013 and medical records of liver cancer cases from 2001 to 2010 in Jinchang cohort were collected for the analyses of the mortality, standardized mortality, potential years of life lost (PYLL) and working PYLL (WPYLL) associated with liver cancer. Spearman correlation and the average growth rate were used to analyze the trends.

RESULTSA total of 207 liver cancer deaths occurred in Jinchang cohort from 2001 to 2013, accounting for 16.68% of total cancer deaths. There were 259 liver cancer inpatients, accounting for 6.79% of the total cancer cases inpatients, in which 83 died (32.05%). Liver cancer death mainly occurred in males, accounting for 88.89%, and the liver cancer deaths in females accounted for 11.11%. The standardized mortality rate was 42.32/100,000 in males and 15.31/100,000 in females. The growth rate of liver cancer mortality was 5.62% from 2001 to 2013. Liver cancer deaths mainly occurred in age groups 60-69 years (26.57%) and 50-59 years (24.15%). The PYLL was 2906.76 person-years, the average PYLL was 14.04 years. The WPYLL was 1477.00 person-years and the average WPYLL was 7.14 years. The direct economic burden of liver cancer was 6270.78 Yuan per person, 301.75 Yuan per day. The average stay of hospitalization was 21.32 days.

CONCLUSIONThe mortality rate of liver cancer is increasing and the disease burden is still heavy.

Aged ; China ; epidemiology ; Cohort Studies ; Cost of Illness ; Female ; Hospitalization ; economics ; statistics & numerical data ; Humans ; Liver Neoplasms ; economics ; mortality ; Male ; Middle Aged

OBJECTIVETo understand the disease burden caused by cancers in Jinchang cohort, and develop effective strategies for cancer prevention and control in this population.

METHODSThe cancer mortality data from 2001 to 2013 and the medical records for cancer patients from 2001 to 2010 in Jinchang cohort were collected. The disease burden caused by cancer was analyzed by using mortality rate, potential years of life lost (PYLL), working PYLL (WPYLL), and direct economic burden.

RESULTSDuring 2001-2013, in Jinchang cohort, the five leading cancers ranked by mortality rate were lung cancer (78.06/100,000), gastric cancer (38.03/100,000), liver cancer (37.23/100,000), esophageal cancer (19.06/100,000), and colorectal cancer (9.53/100,000). The five leading cancers in terms of PYLL (person-years) and WPYLL (person-years) were lung cancer (3480.33, 1161.00), liver cancer (2809.03, 1475.00), gastric cancer (2120.54, 844.00), esophageal cancer (949.61, 315.00), and colorectal cancer (539.90, 246.00). From 2001 to 2010, the five leading cancers in term of average daily cost of hospitalization were gastric cancer (8,102.23 Yuan), esophageal cancer (7135.79 Yuan), colorectal cancer (7064.38 Yuan), breast cancer (6723.53 Yuan), and lung cancer (6309.39 Yuan).

CONCLUSIONSThe cancers common causing higher disease burden in Jinchang cohort were lung cancer, gastric cancer, liver cancer, esophageal cancer and colorectal cancer. The lung cancer disease burden was the highest.

Breast Neoplasms ; economics ; mortality ; China ; epidemiology ; Cohort Studies ; Colorectal Neoplasms ; economics ; mortality ; Cost of Illness ; Esophageal Neoplasms ; economics ; mortality ; Female ; Hospitalization ; economics ; Humans ; Liver Neoplasms ; economics ; mortality ; Lung Neoplasms ; economics ; mortality ; Male ; Neoplasms ; economics ; mortality ; Stomach Neoplasms ; economics ; mortality

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.
Communication ; Humans ; Incidence ; Internet/statistics & numerical data ; Liver Neoplasms/epidemiology ; Male ; Mass Media/*statistics & numerical data ; Neoplasms/*epidemiology/mortality/prevention & control ; Pancreatic Neoplasms/epidemiology ; Prostatic Neoplasms/epidemiology ; Republic of Korea/epidemiology ; Retrospective Studies ; Stomach Neoplasms/epidemiology