Background: Evaluate the impact of chest X-ray (CXR) screening on mortality and treatment adherence by comparing pulmonary tuberculosis (PTB) cases detected through screening and those routinely diagnosed at healthcare facilities. Methods: A retrospective analysis of 10% randomly sampled National Health Insurance Service claims data assessed PTB cases diagnosed during 2004–2020. Patients were categorized as ‘screening-detected (ACF, active case finding)’ or ‘routinely detected (PCF, passive case finding)’ based on CXR screening history. Cox proportional hazards model determined the association between screening and all-cause or tuberculosis (TB)-specific mortality. Treatment adherence was also measured. Results: Among 84,828 PTB patients, 18.76% were ACF (15,916), and 81.24% were PCF (68,912). ACF exhibited lower risks in all-cause mortality (adjusted hazard ratio [aHR], 0.70;95% confidence interval [CI], 0.67–0.73) and TB-specific mortality (aHR, 0.38; 95% CI, 0.32–0.46) compared to PCF. In the ACF group, 91.39% initiated anti-TB treatment, with 45.99% adherence. For PCF, 92.87% initiated treatment, and only 45.44% were adherent. Conclusion Individuals undergoing CXR screening have a lower risk of both all-cause and TB-specific mortality compared to PCF, but treatment adherence is similar between the two groups, emphasizing the need to improve the linkage between screening, diagnosis, and treatment for the screened population.

Background: Evaluate the impact of chest X-ray (CXR) screening on mortality and treatment adherence by comparing pulmonary tuberculosis (PTB) cases detected through screening and those routinely diagnosed at healthcare facilities. Methods: A retrospective analysis of 10% randomly sampled National Health Insurance Service claims data assessed PTB cases diagnosed during 2004–2020. Patients were categorized as ‘screening-detected (ACF, active case finding)’ or ‘routinely detected (PCF, passive case finding)’ based on CXR screening history. Cox proportional hazards model determined the association between screening and all-cause or tuberculosis (TB)-specific mortality. Treatment adherence was also measured. Results: Among 84,828 PTB patients, 18.76% were ACF (15,916), and 81.24% were PCF (68,912). ACF exhibited lower risks in all-cause mortality (adjusted hazard ratio [aHR], 0.70;95% confidence interval [CI], 0.67–0.73) and TB-specific mortality (aHR, 0.38; 95% CI, 0.32–0.46) compared to PCF. In the ACF group, 91.39% initiated anti-TB treatment, with 45.99% adherence. For PCF, 92.87% initiated treatment, and only 45.44% were adherent. Conclusion Individuals undergoing CXR screening have a lower risk of both all-cause and TB-specific mortality compared to PCF, but treatment adherence is similar between the two groups, emphasizing the need to improve the linkage between screening, diagnosis, and treatment for the screened population.

Background: The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs. Methods: Levin’s formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used. Results: The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030. Conclusion The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.

OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

Background: The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs. Methods: Levin’s formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used. Results: The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030. Conclusion The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.

OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

Background: The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs. Methods: Levin’s formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used. Results: The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030. Conclusion The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.

OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

Background: Evaluate the impact of chest X-ray (CXR) screening on mortality and treatment adherence by comparing pulmonary tuberculosis (PTB) cases detected through screening and those routinely diagnosed at healthcare facilities. Methods: A retrospective analysis of 10% randomly sampled National Health Insurance Service claims data assessed PTB cases diagnosed during 2004–2020. Patients were categorized as ‘screening-detected (ACF, active case finding)’ or ‘routinely detected (PCF, passive case finding)’ based on CXR screening history. Cox proportional hazards model determined the association between screening and all-cause or tuberculosis (TB)-specific mortality. Treatment adherence was also measured. Results: Among 84,828 PTB patients, 18.76% were ACF (15,916), and 81.24% were PCF (68,912). ACF exhibited lower risks in all-cause mortality (adjusted hazard ratio [aHR], 0.70;95% confidence interval [CI], 0.67–0.73) and TB-specific mortality (aHR, 0.38; 95% CI, 0.32–0.46) compared to PCF. In the ACF group, 91.39% initiated anti-TB treatment, with 45.99% adherence. For PCF, 92.87% initiated treatment, and only 45.44% were adherent. Conclusion Individuals undergoing CXR screening have a lower risk of both all-cause and TB-specific mortality compared to PCF, but treatment adherence is similar between the two groups, emphasizing the need to improve the linkage between screening, diagnosis, and treatment for the screened population.

Background: The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs. Methods: Levin’s formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used. Results: The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030. Conclusion The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.