Purpose: Physical activity (PA) is considered a potentially effective factor in the primary prevention of gastric cancer (GC). As body mass index (BMI) and waist circumference (WC) differ by sex, particularly with age, this study aimed to investigate the impact of PA on GC development, considering BMI and WC variations by sex. Materials and Methods: We analyzed the impact of PA on GC development using Cox proportional hazard regression in a cohort of 314,525 Korean individuals from the National Health Insurance Service–Health Screening database, using data from 2009–2019.Additionally, subgroup analyses were conducted based on BMI and WC. The models were adjusted for age, sex, smoking status, alcohol consumption, BMI, and comorbidities. Results: The effect of PA on the prevention of GC development was relatively evident in males. The high PA group (metabolic equivalents of task, METs/week of 500–999) showed a lower risk of GC compared to the group with METs/week of 0 (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79–0.98). Especially in males with WC <90 cm and BMI <23 kg/m2 , a lower risk of GC was observed in the group with METs/week of 1–499 compared to the group with METs/week of 0 (HR, 0.80; 95% CI, 0.67–0.96). In contrast, no consistent association was observed between PA levels and risk of GC in females. Conclusions Moderate PA had a preventive effect on GC development in males, particularly in those with low BMI and WC. However, this effect was not observed in females.

Purpose: Physical activity (PA) is considered a potentially effective factor in the primary prevention of gastric cancer (GC). As body mass index (BMI) and waist circumference (WC) differ by sex, particularly with age, this study aimed to investigate the impact of PA on GC development, considering BMI and WC variations by sex. Materials and Methods: We analyzed the impact of PA on GC development using Cox proportional hazard regression in a cohort of 314,525 Korean individuals from the National Health Insurance Service–Health Screening database, using data from 2009–2019.Additionally, subgroup analyses were conducted based on BMI and WC. The models were adjusted for age, sex, smoking status, alcohol consumption, BMI, and comorbidities. Results: The effect of PA on the prevention of GC development was relatively evident in males. The high PA group (metabolic equivalents of task, METs/week of 500–999) showed a lower risk of GC compared to the group with METs/week of 0 (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79–0.98). Especially in males with WC <90 cm and BMI <23 kg/m2 , a lower risk of GC was observed in the group with METs/week of 1–499 compared to the group with METs/week of 0 (HR, 0.80; 95% CI, 0.67–0.96). In contrast, no consistent association was observed between PA levels and risk of GC in females. Conclusions Moderate PA had a preventive effect on GC development in males, particularly in those with low BMI and WC. However, this effect was not observed in females.

Purpose: Physical activity (PA) is considered a potentially effective factor in the primary prevention of gastric cancer (GC). As body mass index (BMI) and waist circumference (WC) differ by sex, particularly with age, this study aimed to investigate the impact of PA on GC development, considering BMI and WC variations by sex. Materials and Methods: We analyzed the impact of PA on GC development using Cox proportional hazard regression in a cohort of 314,525 Korean individuals from the National Health Insurance Service–Health Screening database, using data from 2009–2019.Additionally, subgroup analyses were conducted based on BMI and WC. The models were adjusted for age, sex, smoking status, alcohol consumption, BMI, and comorbidities. Results: The effect of PA on the prevention of GC development was relatively evident in males. The high PA group (metabolic equivalents of task, METs/week of 500–999) showed a lower risk of GC compared to the group with METs/week of 0 (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79–0.98). Especially in males with WC <90 cm and BMI <23 kg/m2 , a lower risk of GC was observed in the group with METs/week of 1–499 compared to the group with METs/week of 0 (HR, 0.80; 95% CI, 0.67–0.96). In contrast, no consistent association was observed between PA levels and risk of GC in females. Conclusions Moderate PA had a preventive effect on GC development in males, particularly in those with low BMI and WC. However, this effect was not observed in females.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Background: The obesity epidemic is associated with the emergence of new kidney diseases including obesity-related glomerulopathy (ORG) and metabolic syndrome-associated disorders. However, the effects of obesity on prevalence and outcome of biopsy-proven kidney disease are not well known. Methods: We analyzed 14,492 kidney biopsies in 18 hospitals from 1979 to 2018 in Korea.Obesity was defined as a body mass index value of ≥ 30 kg/m 2 . Results: The most common disease was IgA nephropathy (IgAN) in both obese and nonobese participants (33.7% vs. 38.9%). Obesity was associated with a higher risk of focal segmental glomerulosclerosis (FSGS) and hypertensive nephropathy (HT-N) (odds ratio [OR], 1.72, 95% confidence interval [CI], 1.37–2.17; OR, 1.96, 95% CI, 1.21–3.19) and a lower risk of IgAN (OR, 0.74, 95% CI, 0.62–0.88). During the median follow up of 93.1 ± 88.7 months, obesity increased the risk of end-stage kidney disease (ESKD) in patients with IgAN (relative risk [RR], 1.49, 95% CI, 1.01–2.20) and lupus nephritis (LN) (RR, 3.43, 95% CI, 1.36–8.67). Of 947 obese individuals, ORG was detected in 298 (31.5%), and 230 participants had other kidney diseases, most commonly, IgAN (40.9%) followed by diabetic nephropathy (15.2%). Participants with ORG, when combined with other renal diseases, showed higher risks for developing ESKD compared to those with ORG alone (RR, 2.48, 95% CI, 1.09–5.64). Conclusion Obesity is associated with an increased risk of FSGS and HT-N, and also increase the ESKD risk in IgAN and LN patients. ORG in obese participants may have favorable renal outcomes if it occurs alone without any other renal disease.

Background and Objectives: Heart failure (HF) is a leading cause of hospitalization and death worldwide. The Steady Movement with Innovating Leadership for Heart Failure (SMILE HF) aims to evaluate the clinical characteristics, management, hospital course, and long-term outcomes of patients hospitalized for acute HF in South Korea. Methods: This prospective, observational multicenter cohort study was conducted on consecutive patients hospitalized for acute HF in nine university hospitals since September 2019. Enrolment of 2000 patients should be completed in 2024, and follow-up is planned through 2025. Results: Interim analysis of 1,052 consecutive patients was performed to understand the baseline characteristics. The mean age was 69±15 years; 57.6% were male. The mean left ventricular ejection fraction was 39±15%. The prevalences of HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction were 50.9%, 15.3%, and 29.2%. Ischemic cardiomyopathy (CMP) was the most common etiology (32%), followed by tachycardia-induced CMP (12.8%) and idiopathic dilated CMP (9.5%). The prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin receptor/ neprilysin inhibitor, beta-blockers, spironolactone, and sodium-glucose cotransporter-2 inhibitors at discharge were 76.8%, 66.5%, 50.0%, and 17.5%, respectively. The post-discharge 90-day mortality and readmission rates due to HF aggravation were 2.0% and 6.4%, respectively. Our analysis reveals the current state of acute HF in South Korea. Conclusions Our interim analysis provides valuable insights into the clinical characteristics, management, and early outcomes of acute HF patients in South Korea, highlighting the current state and treatment patterns in this population.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Background: This study investigated trends in national expenditures on anticancer and immunomodulating agents from 2013 to 2022. Methods: Information was obtained from the National Health Insurance claims data spanning a period of 10 years, from 2013 to 2022. The subjects of this study are patients diagnosed with cancer who used anticancer agents between January 1, 2013, and December 31, 2022. Trends were examined across various categories, including sex, age groups, routes of healthcare use, and types of healthcare institutions. We calculated the compound annual growth rate in both the number of patients and expenditures by year. Results: In 2013, pharmaceutical expenditures amounted to USD 11,984 million, representing 25.5% of the total healthcare expenditures, which were USD 46,984 million.Within this pharmaceutical expenditure, anticancer medications constituted USD 584 million, or 4.9%. By 2022, pharmaceutical expenditures had risen to USD 22,093 million, accounting for 22.8% of the total healthcare expenditures of USD 96,904 million. Of this amount, USD 1,566 million was allocated to anticancer drugs, which represented 7.1% of the total pharmaceutical expenditures. Between 2013 and 2022, total healthcare expenditures experienced a significant increase of 106.2%, reaching USD 49,920 million. Concurrently, pharmaceutical expenditures rose by 91.1% to USD 10,919 million, while expenditures on anticancer drugs surged by 168.2% to USD 982 million. In 2022, the category with the highest expenditures was ATC L01FF, which includes programmed cell death protein 1/death ligand 1 inhibitors such as nivolumab, totaling USD 266.2 million. This was followed by L01FD at USD 198.8 million and L01EA at USD 140.4 million. Since 2018, however, spending on immune checkpoint blockers targeting cell death proteins or ligands has continued to rise and currently ranks first. Conclusion The number of patients using anticancer drugs and the associated drug expenditures have risen between 2013 and 2022. As the share of anticancer drugs in total drug expenditures grows, so too do the overall expenditures. This escalating financial burden highlights the necessity for policymakers to thoroughly understand the appropriate and costeffective usage of anticancer drugs, as it directly influences the affordability and accessibility of healthcare services.

Purpose: Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer receiving cytotoxic chemotherapy. To prevent FN, standard precautions including hand and respiratory hygiene are generally recommended, but the exact effect of non-pharmacologic intervention has not been clearly proven in the clinical setting. We aimed to compare the incidence of FN between the pre-coronavirus disease 19 (COVID-19) era vs. the postCOVID-19 era. Methods: We retrospectively enrolled patients with breast cancer who received an adriamycin and cyclophosphamide (AC) regimen containing adjuvant chemotherapy at Jeju National University Hospital. We compared the incidence of FN between the pre- and post-COVID-19 period and analyzed characteristics of the event and other clinical risk factors. Results: In total, 149 patients were enrolled, including 94 who received AC chemotherapy in the pre-COVID-19 era and 55 who received it in the post-COVID-19 era. Sixteen patients (10.7%) experienced FN. Fourteen (14.9%) and 2 events (3.6%) occurred in pre-COVID-19 and post-COVID-19 eras, respectively. The post-COVID-19 era was the only risk factor for FN (P = 0.032). Conclusion We found an association between FN occurrence and the COVID-19 outbreak, providing indirect evidence of the importance of non-pharmacological measures to reduce FN risk in patients with breast cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.