1.Cancer attributable to tobacco smoking: a focus on primary prevention
Journal of the Korean Medical Association 2025;68(2):91-99
This paper reviews recent research findings on the population-attributable risk (PAR) of tobacco smoking in cancer incidence. It examines the components used in calculating PAR, specifically smoking prevalence and the relative risk of cancer associated with tobacco smoking.Current Concepts: The association between tobacco smoking and cancer risk is typically measured by the relative risk, which indicates how many times higher the cancer risk is in smokers compared to non-smokers. There is robust evidence that tobacco smoking is carcinogenic for cancers of the oral cavity, esophagus, stomach, colorectum, liver, pancreas, larynx, lung, cervix, ovaries, kidneys, bladder, and myeloid leukemia. Numerous epidemiological studies indicate that smoking increases the risk of these cancers by 2 to 10 times or more. The population attributable fraction of tobacco smoking for cancer quantifies the extent to which smoking contributes to cancer risk in a given population. Because PAR depends on smoking prevalence and relative risk, it is calculated and reported for each country and time point. According to a National Cancer Center report, in 2019 tobacco smoking accounted for 47% of esophageal cancers, 28% of stomach cancers, 27% of pancreatic cancers, 53% of lung cancers, and 43% of bladder cancers in Korean men.Discussion and Conclusion: The relative risk and population-attributable fraction serve as important indicators that inform policy development, prevention strategy formulation, resource allocation, health equity initiatives, public health awareness, and clinical practice.
2.Cancer attributable to tobacco smoking: a focus on primary prevention
Journal of the Korean Medical Association 2025;68(2):91-99
This paper reviews recent research findings on the population-attributable risk (PAR) of tobacco smoking in cancer incidence. It examines the components used in calculating PAR, specifically smoking prevalence and the relative risk of cancer associated with tobacco smoking.Current Concepts: The association between tobacco smoking and cancer risk is typically measured by the relative risk, which indicates how many times higher the cancer risk is in smokers compared to non-smokers. There is robust evidence that tobacco smoking is carcinogenic for cancers of the oral cavity, esophagus, stomach, colorectum, liver, pancreas, larynx, lung, cervix, ovaries, kidneys, bladder, and myeloid leukemia. Numerous epidemiological studies indicate that smoking increases the risk of these cancers by 2 to 10 times or more. The population attributable fraction of tobacco smoking for cancer quantifies the extent to which smoking contributes to cancer risk in a given population. Because PAR depends on smoking prevalence and relative risk, it is calculated and reported for each country and time point. According to a National Cancer Center report, in 2019 tobacco smoking accounted for 47% of esophageal cancers, 28% of stomach cancers, 27% of pancreatic cancers, 53% of lung cancers, and 43% of bladder cancers in Korean men.Discussion and Conclusion: The relative risk and population-attributable fraction serve as important indicators that inform policy development, prevention strategy formulation, resource allocation, health equity initiatives, public health awareness, and clinical practice.
3.Cancer attributable to tobacco smoking: a focus on primary prevention
Journal of the Korean Medical Association 2025;68(2):91-99
This paper reviews recent research findings on the population-attributable risk (PAR) of tobacco smoking in cancer incidence. It examines the components used in calculating PAR, specifically smoking prevalence and the relative risk of cancer associated with tobacco smoking.Current Concepts: The association between tobacco smoking and cancer risk is typically measured by the relative risk, which indicates how many times higher the cancer risk is in smokers compared to non-smokers. There is robust evidence that tobacco smoking is carcinogenic for cancers of the oral cavity, esophagus, stomach, colorectum, liver, pancreas, larynx, lung, cervix, ovaries, kidneys, bladder, and myeloid leukemia. Numerous epidemiological studies indicate that smoking increases the risk of these cancers by 2 to 10 times or more. The population attributable fraction of tobacco smoking for cancer quantifies the extent to which smoking contributes to cancer risk in a given population. Because PAR depends on smoking prevalence and relative risk, it is calculated and reported for each country and time point. According to a National Cancer Center report, in 2019 tobacco smoking accounted for 47% of esophageal cancers, 28% of stomach cancers, 27% of pancreatic cancers, 53% of lung cancers, and 43% of bladder cancers in Korean men.Discussion and Conclusion: The relative risk and population-attributable fraction serve as important indicators that inform policy development, prevention strategy formulation, resource allocation, health equity initiatives, public health awareness, and clinical practice.
4.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.
5.Relationship between Cancer Incidence and Health Behaviors from Ecological Study in Korea
Journal of Cancer Prevention 2024;29(4):185-189
The aim of this ecological study was to examine the correlation between cancer incidence and health behaviors such as smoking, alcohol consumption, and obesity, and investigated whether there were differences in this correlation between metropolitan areas and other regions. Data on health behaviors exposure/prevalence and cancer incidence rates for 227 administrative districts (cities and counties) were obtained. The average exposure proportion measured annually from 2008 to 2011 in the Korea Community Health Survey data and the age-standardized cancer incidence data from 2014 to 2018, obtained through the cancer registry data, were downloaded from the Statistics Korea website. To examine the relationship between smoking, alcohol consumption, obesity exposure rate (prevalence), and cancer incidence, a correlation analysis was conducted, and Pearson’s correlation coefficient was calculated. The correlation coefficient between male smoking and male cancer incidence rate across 227 districts was 0.259.This significance was more pronounced in large metropolitan areas, where the correlation coefficient was 0.631 in the 73 districts belonging to these areas. In large metropolitan areas, the correlation coefficient between alcohol consumption rate and cancer incidence rate was 0.390. In the correlation analysis between obesity prevalence and cancer incidence rate, no correlation was found in large metropolitan areas, while in areas outside of large cities, the correlation coefficient was –0.295, indicating a significant negative correlation. This ecological study demonstrated that the relationship between cancer incidence and health behaviors differed between large metropolitan areas and areas outside of large cities.
6.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.
7.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.
8.Relationship between Cancer Incidence and Health Behaviors from Ecological Study in Korea
Journal of Cancer Prevention 2024;29(4):185-189
The aim of this ecological study was to examine the correlation between cancer incidence and health behaviors such as smoking, alcohol consumption, and obesity, and investigated whether there were differences in this correlation between metropolitan areas and other regions. Data on health behaviors exposure/prevalence and cancer incidence rates for 227 administrative districts (cities and counties) were obtained. The average exposure proportion measured annually from 2008 to 2011 in the Korea Community Health Survey data and the age-standardized cancer incidence data from 2014 to 2018, obtained through the cancer registry data, were downloaded from the Statistics Korea website. To examine the relationship between smoking, alcohol consumption, obesity exposure rate (prevalence), and cancer incidence, a correlation analysis was conducted, and Pearson’s correlation coefficient was calculated. The correlation coefficient between male smoking and male cancer incidence rate across 227 districts was 0.259.This significance was more pronounced in large metropolitan areas, where the correlation coefficient was 0.631 in the 73 districts belonging to these areas. In large metropolitan areas, the correlation coefficient between alcohol consumption rate and cancer incidence rate was 0.390. In the correlation analysis between obesity prevalence and cancer incidence rate, no correlation was found in large metropolitan areas, while in areas outside of large cities, the correlation coefficient was –0.295, indicating a significant negative correlation. This ecological study demonstrated that the relationship between cancer incidence and health behaviors differed between large metropolitan areas and areas outside of large cities.
9.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.
10.Relationship between Cancer Incidence and Health Behaviors from Ecological Study in Korea
Journal of Cancer Prevention 2024;29(4):185-189
The aim of this ecological study was to examine the correlation between cancer incidence and health behaviors such as smoking, alcohol consumption, and obesity, and investigated whether there were differences in this correlation between metropolitan areas and other regions. Data on health behaviors exposure/prevalence and cancer incidence rates for 227 administrative districts (cities and counties) were obtained. The average exposure proportion measured annually from 2008 to 2011 in the Korea Community Health Survey data and the age-standardized cancer incidence data from 2014 to 2018, obtained through the cancer registry data, were downloaded from the Statistics Korea website. To examine the relationship between smoking, alcohol consumption, obesity exposure rate (prevalence), and cancer incidence, a correlation analysis was conducted, and Pearson’s correlation coefficient was calculated. The correlation coefficient between male smoking and male cancer incidence rate across 227 districts was 0.259.This significance was more pronounced in large metropolitan areas, where the correlation coefficient was 0.631 in the 73 districts belonging to these areas. In large metropolitan areas, the correlation coefficient between alcohol consumption rate and cancer incidence rate was 0.390. In the correlation analysis between obesity prevalence and cancer incidence rate, no correlation was found in large metropolitan areas, while in areas outside of large cities, the correlation coefficient was –0.295, indicating a significant negative correlation. This ecological study demonstrated that the relationship between cancer incidence and health behaviors differed between large metropolitan areas and areas outside of large cities.

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