1.Discrepancy between Genetically Predicted and Observed Alcohol Intake and Its Impact on Gastric Cancer Susceptibility
Ga-Eun YIE ; Cheol Min SHIN ; Kyungtaek PARK ; Jinyeon JO ; Ah Ra DO ; Sungkyoung CHOI ; Jung Hun OHN ; Sejoon LEE ; Jeongseon KIM ; Sun Ha JEE ; Seung Joo KANG ; Nayoung KIM ; Sungho WON
Cancer Research and Treatment 2026;58(2):563-572
Purpose:
We aimed to investigate how genetic predisposition to drinking and gastric cancer (GC) modifies the association between alcohol consumption and GC risk in the Korean population.
Materials and Methods:
Polygenic risk scores for GC (PRS-GC) and alcohol consumption (PRS-Alcohol) were formulated using genome-wide association results from BioBank Japan. Validation was performed using Korean cohorts (SNUBH-GENIE cohort), incorporating 8,846 controls and 531 patients with GC. Subsequently, these PRSs were applied to an independent Korean cohort of 67,771 participants, including 313 patients with GC during the follow-up for 14 years (KoGES cohort).
Results:
In KoGES cohort, the influence of alcohol consumption on GC risk was significantly altered by the PRS-GC and exhibited a synergistic interaction effect. PRS-Alcohol itself shows a negative correlation with GC risk. However, when actual alcohol consumption significantly exceeded genetically predicted levels, the risk of alcohol-related GC was notably increased (adjusted hazard ratio, 1.32; 95% confidence interval, 1.01 to 1.72). Heavy drinkers in the high–PRS-GC/low–PRS-Alcohol group had a 2.16 times higher risk of GC than non-to-light drinkers, which was prominent in males.
Conclusion
Korean drinkers with higher PRS-GC who consume alcohol more than genetically predicted levels are susceptible to GC. PRS-GC and PRS-Alcohol may be beneficial for assessing the impact of alcohol consumption on GC risk in Koreans.
2.Associations of Dietary Intake With Cardiovascular Diseases, Blood Pressure, and Lipid Profile in the Korean Population: An Updated Systematic Review and Meta-Analysis
Jeongseon KIM ; Madhawa GUNATHILAKE ; Tung HOANG ; Oh Yoen KIM
Journal of Lipid and Atherosclerosis 2026;15(1):111-137
Objective:
This systematic review and meta-analysis of observational studies aimed to update the evidence regarding the association between dietary factors and cardiovascular disease (CVD) and related outcomes in the Korean population.
Methods:
In total, 151 studies were included: 62 from a previous study and 89 identified through an updated search in PubMed and Embase. A random-effects model was applied to analyze pooled relative risks (RRs) and their 95% confidence intervals (CIs) for the consumption of 19 food items, 5 macronutrients, 14 micronutrients, 18 dietary indices, and 2 dietary patterns.
Results:
Overall, higher fruit intake was associated with a lower risk of elevated blood pressure (BP)/hypertension (RR, 0.74; 95% CI, 0.65-0.84) and elevated/high triglycerides (TG) (RR, 0.82; 95% CI, 0.71–0.95). Higher vegetable intake was associated with a lower risk of elevated/high TG (RR, 0.92; 95% CI, 0.87–0.97). Inverse associations were observed between higher milk and dairy consumption and elevated BP/hypertension (RR, 0.89; 95% CI, 0.83–0.95), elevated/high TG (RR, 0.82; 95% CI, 0.76–0.89), and lower high-density lipoprotein cholesterol (HDL-C) levels (RR, 0.82; 95% CI, 0.75–0.89). Coffee consumption was inversely associated with the risk of CVD (RR, 0.80; 95% CI, 0.67–0.95) and elevated/ high TG (RR, 0.84; 95% CI, 0.79–0.89). Consumption of sugar-sweetened beverages was positively associated with an increased risk of elevated BP/hypertension (RR, 1.21; 95% CI, 1.09–1.33) and elevated/high TG (RR, 1.20; 95% CI, 1.03–1.41).
Conclusion
This study suggests that higher intake of fruits, vegetables, milk and dairy, and coffee may confer potential benefits for CVD and its associated risk factors, such as BP and lipid profiles. In contrast, sugar-sweetened beverages appear detrimental to cardiovascular health.
3.Ethnic Heterogeneity in Reproductive Risk Factors for Breast Cancer, With a Focus on Asian Populations:A Meta-analysis
Youjin HONG ; Soseul SUNG ; Woojin LIM ; Sungji MOON ; Kwang-Pil KO ; Jung Eun LEE ; Inah KIM ; Sun Ha JEE ; Sun-Seog KWEON ; Min-Ho SHIN ; Sangmin PARK ; Seung-Ho RYU ; Sun Young YANG ; Jeongseon KIM ; Sang-Wook YI ; Sue K. PARK
Journal of Cancer Prevention 2026;31(1):20-27
suggest that some reproductive factors associated with BC differ across ethnicities and time trends, perhaps due to the prevalence of reproductive factors and the baseline hazard of BC.
4.Cancer incidence attributable to dietary factors in Korea
Ji Hyun KIM ; Minhee CHO ; Jung Eun LEE ; Jeongseon KIM
Journal of the Korean Medical Association 2025;68(2):108-120
The population attributable fraction (PAF) indicates the proportion of disease cases in a given population that can be attributed to a specific factor, assuming a causal relationship. In other words, it quantifies the extent to which that factor contributes to disease occurrence. PAF calculation methods have been applied to studies factors and several, studies have reported PAFs for dietary contributors to overall or specific cancer risks. Our team has conducted several PAF studies and presents findings on the contributions of dietary factors to cancer risk in the Korean population.Current Concepts: For colorectal cancer, the PAF of dietary factors is 34.9%, with insufficient whole grain intake contributing the largest share (16.6%). For gastric cancer, dietary factors have a PAF of 18.6%, with excessive intake of salted vegetables contributing the most (16.0%). Notably, the PAFs for inadequate whole grain and milk consumption were higher than those reported in previous studies, while the PAFs for other dietary factors fell within the expected range. These findings emphasize the need to prioritize interventions that effectively reduce the diet-attributable cancer burden.Discussion and Conclusion: Country-specific PAF estimates are crucial for developing effective cancer prevention strategies tailored to the Korean population. To better apply dietary PAF estimates, future studies should (1) integrate data from existing and ongoing cohort studies to determine Korea-specific relative risks, (2) estimate dietary prevalence using assessment tools that capture long-term dietary habits, and (3) establish optimal intake levels specific to the Korean context.
5.Fecal Microbial Dysbiosis Is Associated with Colorectal Cancer Risk in a Korean Population
Jeongseon KIM ; Madhawa GUNATHILAKE ; Hyun Yang YEO ; Jae Hwan OH ; Byung Chang KIM ; Nayoung HAN ; Bun KIM ; Hyojin PYUN ; Mi Young LIM ; Young-Do NAM ; Hee Jin CHANG
Cancer Research and Treatment 2025;57(1):198-211
Purpose:
The association between the fecal microbiota and colorectal cancer (CRC) risk has been suggested in epidemiologic studies. However, data from large-scale population-based studies are lacking.
Materials and Methods:
In this case-control study, we recruited 283 CRC patients from the Center for Colorectal Cancer, National Cancer Center Hospital, Korea to perform 16S rRNA gene sequencing of fecal samples. A total of 283 age- and sex-matched healthy participants were selected from 890 cohort of healthy Koreans that are publicly available (PRJEB33905). The microbial dysbiosis index (MDI) was calculated based on the differentially abundant species. The association between MDI and CRC risk was observed using conditional logistic regression. Sparse Canonical Correlation Analysis was performed to integrate species data with microbial pathways obtained by PICRUSt2.
Results:
There is a significant divergence of the microbial composition between CRC patients and controls (permutational multivariate analysis of variance p=0.001). Those who were in third tertile of the MDI showed a significantly increased risk of CRC in the total population (odds ratio [OR], 6.93; 95% confidence interval [CI], 3.98 to 12.06; p-trend < 0.001) compared to those in the lowest tertile. Similar results were found for men (OR, 6.28; 95% CI, 3.04 to 12.98; p-trend < 0.001) and women (OR, 7.39; 95% CI, 3.10 to 17.63; p-trend < 0.001). Bacteroides coprocola and Bacteroides plebeius species and 12 metabolic pathways were interrelated in healthy controls that explain 91% covariation across samples.
Conclusion
Dysbiosis in the fecal microbiota may be associated with an increased risk of CRC. Due to the potentially modifiable nature of the gut microbiota, our findings may have implications for CRC prevention among Koreans.
6.Fecal Microbial Dysbiosis Is Associated with Colorectal Cancer Risk in a Korean Population
Jeongseon KIM ; Madhawa GUNATHILAKE ; Hyun Yang YEO ; Jae Hwan OH ; Byung Chang KIM ; Nayoung HAN ; Bun KIM ; Hyojin PYUN ; Mi Young LIM ; Young-Do NAM ; Hee Jin CHANG
Cancer Research and Treatment 2025;57(1):198-211
Purpose:
The association between the fecal microbiota and colorectal cancer (CRC) risk has been suggested in epidemiologic studies. However, data from large-scale population-based studies are lacking.
Materials and Methods:
In this case-control study, we recruited 283 CRC patients from the Center for Colorectal Cancer, National Cancer Center Hospital, Korea to perform 16S rRNA gene sequencing of fecal samples. A total of 283 age- and sex-matched healthy participants were selected from 890 cohort of healthy Koreans that are publicly available (PRJEB33905). The microbial dysbiosis index (MDI) was calculated based on the differentially abundant species. The association between MDI and CRC risk was observed using conditional logistic regression. Sparse Canonical Correlation Analysis was performed to integrate species data with microbial pathways obtained by PICRUSt2.
Results:
There is a significant divergence of the microbial composition between CRC patients and controls (permutational multivariate analysis of variance p=0.001). Those who were in third tertile of the MDI showed a significantly increased risk of CRC in the total population (odds ratio [OR], 6.93; 95% confidence interval [CI], 3.98 to 12.06; p-trend < 0.001) compared to those in the lowest tertile. Similar results were found for men (OR, 6.28; 95% CI, 3.04 to 12.98; p-trend < 0.001) and women (OR, 7.39; 95% CI, 3.10 to 17.63; p-trend < 0.001). Bacteroides coprocola and Bacteroides plebeius species and 12 metabolic pathways were interrelated in healthy controls that explain 91% covariation across samples.
Conclusion
Dysbiosis in the fecal microbiota may be associated with an increased risk of CRC. Due to the potentially modifiable nature of the gut microbiota, our findings may have implications for CRC prevention among Koreans.
7.Cancer incidence attributable to dietary factors in Korea
Ji Hyun KIM ; Minhee CHO ; Jung Eun LEE ; Jeongseon KIM
Journal of the Korean Medical Association 2025;68(2):108-120
The population attributable fraction (PAF) indicates the proportion of disease cases in a given population that can be attributed to a specific factor, assuming a causal relationship. In other words, it quantifies the extent to which that factor contributes to disease occurrence. PAF calculation methods have been applied to studies factors and several, studies have reported PAFs for dietary contributors to overall or specific cancer risks. Our team has conducted several PAF studies and presents findings on the contributions of dietary factors to cancer risk in the Korean population.Current Concepts: For colorectal cancer, the PAF of dietary factors is 34.9%, with insufficient whole grain intake contributing the largest share (16.6%). For gastric cancer, dietary factors have a PAF of 18.6%, with excessive intake of salted vegetables contributing the most (16.0%). Notably, the PAFs for inadequate whole grain and milk consumption were higher than those reported in previous studies, while the PAFs for other dietary factors fell within the expected range. These findings emphasize the need to prioritize interventions that effectively reduce the diet-attributable cancer burden.Discussion and Conclusion: Country-specific PAF estimates are crucial for developing effective cancer prevention strategies tailored to the Korean population. To better apply dietary PAF estimates, future studies should (1) integrate data from existing and ongoing cohort studies to determine Korea-specific relative risks, (2) estimate dietary prevalence using assessment tools that capture long-term dietary habits, and (3) establish optimal intake levels specific to the Korean context.
8.Cancer incidence attributable to dietary factors in Korea
Ji Hyun KIM ; Minhee CHO ; Jung Eun LEE ; Jeongseon KIM
Journal of the Korean Medical Association 2025;68(2):108-120
The population attributable fraction (PAF) indicates the proportion of disease cases in a given population that can be attributed to a specific factor, assuming a causal relationship. In other words, it quantifies the extent to which that factor contributes to disease occurrence. PAF calculation methods have been applied to studies factors and several, studies have reported PAFs for dietary contributors to overall or specific cancer risks. Our team has conducted several PAF studies and presents findings on the contributions of dietary factors to cancer risk in the Korean population.Current Concepts: For colorectal cancer, the PAF of dietary factors is 34.9%, with insufficient whole grain intake contributing the largest share (16.6%). For gastric cancer, dietary factors have a PAF of 18.6%, with excessive intake of salted vegetables contributing the most (16.0%). Notably, the PAFs for inadequate whole grain and milk consumption were higher than those reported in previous studies, while the PAFs for other dietary factors fell within the expected range. These findings emphasize the need to prioritize interventions that effectively reduce the diet-attributable cancer burden.Discussion and Conclusion: Country-specific PAF estimates are crucial for developing effective cancer prevention strategies tailored to the Korean population. To better apply dietary PAF estimates, future studies should (1) integrate data from existing and ongoing cohort studies to determine Korea-specific relative risks, (2) estimate dietary prevalence using assessment tools that capture long-term dietary habits, and (3) establish optimal intake levels specific to the Korean context.
9.Fecal Microbial Dysbiosis Is Associated with Colorectal Cancer Risk in a Korean Population
Jeongseon KIM ; Madhawa GUNATHILAKE ; Hyun Yang YEO ; Jae Hwan OH ; Byung Chang KIM ; Nayoung HAN ; Bun KIM ; Hyojin PYUN ; Mi Young LIM ; Young-Do NAM ; Hee Jin CHANG
Cancer Research and Treatment 2025;57(1):198-211
Purpose:
The association between the fecal microbiota and colorectal cancer (CRC) risk has been suggested in epidemiologic studies. However, data from large-scale population-based studies are lacking.
Materials and Methods:
In this case-control study, we recruited 283 CRC patients from the Center for Colorectal Cancer, National Cancer Center Hospital, Korea to perform 16S rRNA gene sequencing of fecal samples. A total of 283 age- and sex-matched healthy participants were selected from 890 cohort of healthy Koreans that are publicly available (PRJEB33905). The microbial dysbiosis index (MDI) was calculated based on the differentially abundant species. The association between MDI and CRC risk was observed using conditional logistic regression. Sparse Canonical Correlation Analysis was performed to integrate species data with microbial pathways obtained by PICRUSt2.
Results:
There is a significant divergence of the microbial composition between CRC patients and controls (permutational multivariate analysis of variance p=0.001). Those who were in third tertile of the MDI showed a significantly increased risk of CRC in the total population (odds ratio [OR], 6.93; 95% confidence interval [CI], 3.98 to 12.06; p-trend < 0.001) compared to those in the lowest tertile. Similar results were found for men (OR, 6.28; 95% CI, 3.04 to 12.98; p-trend < 0.001) and women (OR, 7.39; 95% CI, 3.10 to 17.63; p-trend < 0.001). Bacteroides coprocola and Bacteroides plebeius species and 12 metabolic pathways were interrelated in healthy controls that explain 91% covariation across samples.
Conclusion
Dysbiosis in the fecal microbiota may be associated with an increased risk of CRC. Due to the potentially modifiable nature of the gut microbiota, our findings may have implications for CRC prevention among Koreans.
10.Comparison of Population Attributable Fractions of Cancer Incidence and Mortality Linked to Excess Body Weight in Korea from 2015 to 2030
Youjin HONG ; Jihye AN ; Jeehi JUNG ; Hyeon Sook LEE ; Soseul SUNG ; Sungji MOON ; Inah KIM ; Jung Eun LEE ; Aesun SHIN ; Sun Ha JEE ; Sun-Seog KWEON ; Min-Ho SHIN ; Sangmin PARK ; Seung-Ho RYU ; Sun Young YANG ; Seung Ho CHOI ; Jeongseon KIM ; Sang-Wook YI ; Yoon-Jung CHOI ; Sangjun LEE ; Woojin LIM ; Kyungsik KIM ; Sohee PARK ; Jeong-Soo IM ; Hong Gwan SEO ; Kwang-Pil KO ; Sue K. PARK
Endocrinology and Metabolism 2024;39(6):921-931
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.

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