Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies / 가정의학회지

BACKGROUND: Previous case-control studies have reported inconsistent findings regarding the association between proton pump inhibitor (PPI) use and colorectal cancer (CRC) risk. We investigated these associations using meta-analysis. METHODS: We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in April 2011. Two evaluators independently reviewed and selected articles, based on pre-determined selection criteria. RESULTS: Out of 737 articles meeting our initial criteria, 5 case-control studies, which involved 120,091 participants (9,514 cases and 110,577 controls), were included in the final analyses. The overall use of PPI (used vs. never or rarely used) was not significantly associated with the risk of CRC in a fixed-effects model meta-analysis of all 5 case-control studies (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.96 to 1.20; I2 = 3.5%). Also, in sensitivity meta-analysis by cumulative duration of PPI use, there was no association between PPI use of 1 year or longer and the risk of colorectal cancer in a fixed-effects meta-analysis (OR, 1.09; 95% CI, 0.98 to 1.22; I2 = 0%). CONCLUSION: Although hypergastrinemia could be an important factor in the pathogenesis of some colorectal cancers, our study suggests that this does not lead to significant clinical risk for most PPI users. Further prospective studies or randomized controlled trials related to PPI use and colorectal cancer risk are needed to investigate this association.

Pneumococcal Vaccination Rate among Elderly in South Korea

BACKGROUND: Pneumococcal vaccination among elderly is important for prevention of pneumonia and invasive pneumococcal disease (IPD). There are few studies of pneumococcal vaccination among elderly in South Korea. The aim of study is to examine the pneumococcal vaccination rate for people aged over 65 in South Korea and identify the proportion of the high risk group. METHODS: We analyzed data from The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005. The subjects of this study include persons over 65 years. We used questionnaires about demographics, chronic diseases and individual health behavioral risk factors, which were needed to indentify the high risk group. RESULTS: There were 1,097 persons of observation. The rate of pneumococcal vaccination among 65 years and over was 0.8%. The proportion of the men and women with one more risk factors was 77.3%, 62.8% respectively. Chronic cardiovascular diseases and diabetes were major risk factors among targets recommended vaccination. In men, the proportion of smoke and chronic alcoholism (33.2%, 12.3%) was higher compare to 7.4%, 0.3% in women (p<0.001, p<0.001). The proportion of chronic cardiovascular diseases (48.0%) in women was higher than (38.7%) in men (p=0.012). CONCLUSION: The rate of pneumococcal vaccination among elderly in South Korea was seriously very low compared to that of influenza vaccination. That might be due to unawareness of the necessity to vaccinate. Clinicians should encourage the vaccination as well take a leading role in government health policy

Coverage of Influenza Vaccination among Elderly in South Korea: A Population Based Cross Sectional Analysis of the Season 2004-2005

BACKGROUND: Influenza vaccine coverage among the elderly is important for informed vaccination policies and programs. There are few studies that define influenza coverage in the elderly in South Korea. The aim of this study is to examine influenza vaccination coverage among those 65 years old and older in South Korea over the 2004-2005 influenza season and to identify the socioeconomic and clinical factors associated with vaccination. METHODS: We analyzed data retrieved from The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 conducted by the Korea Centers for Disease Control and Prevention. Subjects included in this study were older than 65 years. We used questionnaires to obtain information regarding demographics, chronic diseases, and individual health behavioral risk factors. Univariate analysis, logistic regression, and trend test were performed. RESULTS: There were 1,097 persons included in this study. Influenza vaccination among those 65 years old and older was 77.2 %. There was no difference of coverage by sex, education level, and income status. For elderly females, the moreunheal thy lifestyle (currently smoking, heavy alcohol use, and no exercise) that was practiced, the less likely they wereto be vaccinated (p for trend=0.007). CONCLUSION: The influenza vaccination coverage rate among the elderly in South Korea during the 2004-2005 flu season was relatively high compared to that of Europe (19.3-26.5 %) during the same season. Nevertheless, the coverage rate in elderly women with unhealthy lifestyle was not satisfactory causing them to be more vulnerable to related illnesses than those who practiced a healthy lifestyle. To prevent influenza related illnesses, clinicians should, in particular, encourage vaccination in those with an unhealthy lifestyle, as well as, lifestyle modification.