Long-term Survivorship and Non-cancer Competing Mortality in Head and Neck Cancer: A Nationwide Population-Based Study in South Korea / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#As the survival of head and neck cancer (HNC) improves, survivors increasingly confront non-cancer–related deaths. This nationwide population-based study aimed to investigate non-cancer–related deaths in HNC survivors. @*Materials and Methods@#Data from the Korean Central Cancer Registry were obtained to characterize causes of death, mortality patterns, and survival in patients with HNC between 2006 and 2016 (n=40,890). Non-cancer-related mortality relative to the general population was evaluated using standardized mortality ratios (SMRs). The 5- and 10-year cause-specific competing risks probabilities of death (cumulative incidence function, CIF) and subdistribution hazards ratios (sHR) from the Fine-Gray models were estimated. @*Results@#Comorbidity-related mortality was frequent in older patients, whereas suicide was predominant in younger patients. The risk of suicide was greater in patients with HNC than in the general population (SMR, 3.1; 95% confidence interval [CI], 2.7 to 3.5). The probability of HNC deaths reached a plateau at 5 years (5-year CIF, 33.9%; 10-year CIF, 39.5%), whereas the probability of non-HNC deaths showed a long-term linear increase (5-year, CIF 5.6%; 10-year CIF, 11.9%). Patients who were male (sHR, 1.56; 95% CI, 1.41 to 1.72), diagnosed with early-stage HNC (localized vs. distant: sHR, 1.86; 95% CI, 1.58 to 2.21) and older age (65-74 vs. 0-44: sHR, 6.20; 95% CI, 4.92 to 7.82; ≥ 75 vs. 0-44: sHR, 9.81; 95% CI, 7.76 to 12.39) had an increased risk of non-cancer mortality. @*Conclusion@#Non-HNC–related deaths continue increasing. HNC survivors are at increased risk of suicide in the younger and comorbidity-related death in the older. Better population-specific surveillance awareness and survivorship plans for HNC survivors are warranted.

Cause of death and cause-specific mortality for primary liver cancer in South Korea: A nationwide population-based study in hepatitis B virus-endemic area

Background/Aims@#Primary liver cancer is one of the leading causes of cancer mortality worldwide. However, the causes of death have not been studied in detail in patients with liver cancer. @*Methods@#The causes of death and cause-specific mortality risks in patients with primary liver cancer, diagnosed during 2000–2016, were investigated using the nationwide population-based cancer registry data in South Korea (n=231,388). The cumulative incidence function and Fine-Gray models were used to estimate the cause-specific mortality under the competing risks. Risks of non-cancer deaths relative to the general population were compared by standardized mortality ratios (SMRs). @*Results@#Among 179,921 total deaths, 92.4%, 1.7%, and 6.0% of patients died of primary liver cancer, cancer from other sites, and non-cancer illnesses, respectively. Proportionate mortality from liver cancer remained high. The 5-year competing risks probability of death from liver cancer varied by tumor stage, from 42% to 94%, and it remained high 10 years after the diagnosis (61–95%). Competing mortality from other causes has continuously increased. The most common non-cancer causes of death were underlying liver diseases (SMR, 15.6; 95% confidence interval [CI], 15.1–16.1) and viral hepatitis (SMR, 46.5; 95% CI, 43.9–49.2), which demonstrated higher mortality risks compared to the Korean general population. Higher mortality risks of suicide (SMR, 2.6; 95% CI, 2.4–2.8) was also noted. @*Conclusions@#Patients with liver cancer are most likely to die from liver cancer and related liver disease, even 10 years after the diagnosis, highlighting a need for specialized long-term follow-up care.

Omental Free-Shaped Flap Reinforcement on Anastomosis and Dissected Area (OFFROAD) Following Reconstruction after Gastrectomy: A Retrospective Case-Control Study

Purpose@#We devised omental free-shaped flap reinforcement on anastomosis and dissected area (OFFROAD) following reconstruction after gastrectomy. This study aimed to evaluate its safety and early clinical outcomes. @*Methods@#One hundred fifty-six patients who underwent totally laparoscopic distal gastrectomy with delta anastomosis from July 2016 to April 2018 were divided into the OFFROAD group (80 patients) and non-OFFROAD group (76 patients). Differences in short-term operative outcomes and surgical complications were compared between the groups. All patients’ inflammatory marker levels were measured to monitor flap necrotic change and inflammatory reactions. The clinical features of both groups in terms of anastomotic leakage were transcribed. @*Results@#Pain score in postoperative day1 was significantly lower in OFFROAD group. The serum WBC count on POD 1 was significantly lower in OG than in NOG. The mean duration of OFFROAD was shorter than five minutes. There were no statistical differences in short-term outcomes and surgical complications between two groups. Anastomotic leakage occurred in three patients in each group and there was no statistical difference in incidence. However, clinical features were notable when anastomotic leakage occurs. Unlike all three patients of non-OFFROAD group manifested every features of peritonitis, each patient of OFFROAD group just manifested only one of the three. @*Conclusion@#This study showed the safety and feasibility of OFFROAD procedure. It might mitigate septic complications when there is an anastomotic leakage. Additional large-scale study is needed to assess the versatile usefulness of OFFROAD aside from its role as a physical barrier.

Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital. MATERIALS AND METHODS: Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient's current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors. RESULTS: Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival(aHR, 0.83). CONCLUSION: Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.

Incidence and Overall Survival of Biliary Tract Cancers in South Korea from 2006 to 2015: Using the National Health Information Database

BACKGROUND/AIMS: There have been no nationwide studies to investigate the trends in incidence and 5-year survival rates of intra- and extrahepatic bile duct cancers and gall-bladder cancer. Therefore, our study aimed to describe the incidence and 5-year survival rates of biliary tract cancers by subsites in South Korea. METHODS: A total of 86,134 patients with biliary tract cancers were selected from the National Health Information Database. Age-standardized incidence rates and annual percentage changes were calculated. Life-table methods and log-rank tests were used to determine the differences in survival rates. Cox-proportional hazard models were used to estimate the hazard ratio of the patients with biliary tract cancers. RESULTS: The incidence rate of intra-hepatic bile duct cancer decreased by 1.3% annually from 8.8 per 100,000 in 2006 to 7.8 per 100,000 in 2015. Extrahepatic bile duct cancer also showed a decreasing trend by 2.2% per year from 8.7 per 100,000 in 2006 to 6.7 per 100,000 in 2015. Gallbladder cancer showed the greatest decline, with an annual percentage change of 2.8% from 6.3 per 100,000 to 5.2 per 100,000 during the same period. The 5-year survival rates were 30.0% in gallbladder cancer, 27.8% in extrahepatic bile duct cancer, and 15.9% in intra-hepatic bile duct cancer. CONCLUSIONS: The overall incidence rates of intrahepatic and extrahepatic bile duct cancer and gallbladder cancer decreased from 2006 to 2015. Among biliary tract cancers, intrahepatic bile duct cancers exhibited the highest incidence rate and the worst survival rate.

Socioeconomic Inequalities in Cervical and Breast Cancer Screening among Women in Korea, 2005–2015

PURPOSE: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprived women. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalities among Korean women from 2005 to 2015. MATERIALS AND METHODS: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey, were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income status were estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percent changes (APCs), to show trends in cancer screening rates. RESULTS: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to 61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of household income and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooled SII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening were shown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educational inequalities appeared to diminish over the study period for both cervical and breast cancer screening. CONCLUSION: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancer screening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these were constant from 2005 to 2015 for both cervical and breast cancer screening.

Socioeconomic Inequalities in Colorectal Cancer Screening in Korea, 2005–2015: After the Introduction of the National Cancer Screening Program

PURPOSE: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. MATERIALS AND METHODS: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. RESULTS: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. CONCLUSION: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

Socioeconomic Inequalities in Stomach Cancer Screening in Korea, 2005–2015: After the Introduction of the National Cancer Screening Program

PURPOSE: This study aimed to investigate socioeconomic inequalities in stomach cancer screening in Korea and trends therein across income and education groups. MATERIALS AND METHODS: Data from the Korean National Cancer Screening Survey, a nationwide cross-sectional survey, were utilized. A total of 28913 men and women aged 40 to 74 years were included for analysis. Prior experience with stomach cancer screening was defined as having undergone either an endoscopy or gastrointestinal series within the past two years. The slope index of inequality (SII) and relative index of inequality (RII) were evaluated to check inequalities. RESULTS: Stomach cancer screening rates increased from 40.0% in 2005 to 74.8% in 2015, with an annual percent change of 5.8% [95% confidence interval (CI) 4.2 to 7.5]. Increases in stomach cancer screening rates were observed for all age, education, and household income groups. Inequalities in stomach cancer screening were noted among individuals of differing levels of education, with a pooled SII estimate of 6.14% (95% CI, 3.94 to 8.34) and RII of 1.26 (95% CI, 1.12 to 1.40). Also, income-related inequalities were observed with an SII of 6.93% (95% CI, 4.89 to 8.97) and RII of 1.30 (95% CI, 1.17 to 1.43). The magnitude of inequality was larger for income than for education. CONCLUSION: Both education and income-related inequalities were found in stomach cancer screening, despite a continuous increase in screening rate over the study period. Income-related inequality was greater than education-related inequality, and this was more apparent in women than in men.

Beliefs and Intentions to Undergo Lung Cancer Screening among Korean Males / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Low-dose computed tomography (LDCT) has been reported as an effective screening method for lung cancer in high-risk populations. We aimed to examine willingness to be screened among Korean males using LDCT and to determine factors associated with lung cancer screening intentions (LCS) based on the Health Belief Model (HBM). MATERIALS AND METHODS: Data were obtained from the 2015 Korean National Cancer Screening Survey, a cross-sectional survey that utilized nationally representative random sampling. The survey included 1,730 male participants 40-74-year-old. Respondents were questioned regarding their willingness to undergo LCS and components of HBM. Factors associated with intentions to undergo screening were explored using logistic regression. RESULTS: Among participants, 65.2% were current smokers. Among high-risk subjects, 60.6% of men reported intentions to undergo LCS, compared to 49.9% of average-risk males. Men with higher perceived susceptibility in the average- and high-risk groups were, respectively, 1.63 (95% confidence interval [CI], 1.39 to 1.91) and 2.30 (95% CI, 1.14 to 4.63) times more likely to intend to undergo LCS compared to those with lower perceived barriers. Also, men in the average- and high-risk groups with higher perceived barriers to screening were, respectively, 0.79 (95% CI, 0.68 to 0.91) and 0.52 (95% CI, 0.29 to 0.92) times less likely to intend to undergo LCS compared to those with lower perceived barriers. CONCLUSION: Tailored interventions designed to promote accurate perceptions of susceptibility and risk, as well as to reduce perceived barriers to screening, may effectively increase adherence to recommendations for LCS among high-risk Korean men.

Nationwide Trends in the Incidence of Melanoma and Non-melanoma Skin Cancers from 1999 to 2014 in South Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This descriptive study was aimed to examine trends in the incidence of melanoma and nonmelanoma in South Korea. MATERIALS AND METHODS: The nationwide incidence data for melanoma and non-melanoma skin cancer was obtained from the Korea Central Cancer Registry. Age-standardized rates were calculated and analyzed, using a Joinpoint regression model. RESULTS: The incidence of basal cell carcinoma has increased dramatically both in men (average annual percentage change [AAPC], 8.0 [95% confidence interval (CI), 6.0 to 10.1]) and women (AAPC, 9.0 [95% CI, 7.5 to 10.4]). Squamous cell carcinoma has also steadily increased both in men (AAPC, 3.3 [95% CI, 2.6 to 4.0]) and women (AAPC, 6.8 [95% CI, 5.3 to 8.4]). Cutaneous melanoma increased continuously from 1999 to 2014 inwomen (AAPC, 3.5 [95% CI, 2.4 to 4.6]), whilst rapidly increasing in men until 2005 (APC, 7.9 [95% CI, 2.4 to 13.7]) after which no increase has been observed (APC, -0.2 [95% CI, -2.3 to 2.0]). CONCLUSION: The incidence rates of melanoma and non-melanoma skin cancer have increased over the past years, with the exception of melanoma in men. Further studies are required to investigate the reasons for the increased incidence of these skin cancers in South Korea.

Current Trends in the Incidence and Survival Rate of Urological Cancers in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This descriptive study assessed the current trends in the incidence of urological cancers and patient survival in Korea. MATERIALS AND METHODS: In this nationwide retrospective observational study based on the data from the Korea National Cancer Incidence Database (KNCIDB), this study analyzed the age-standardized incidence rates (ASRs) and annual percentage changes (APCs) of kidney, bladder, prostate, testicular, and penile cancers as well as cancer of the renal pelvis and ureter between 1999 and 2012. The relative survival rates (RSRs) were calculated for urological cancer patients diagnosed between 1993 and 2012 from the KNCIDB data. RESULTS: Prostate cancer was diagnosed in 66,812 individuals followed by bladder (41,549) and kidney (36,836) cancers. The overall ASR (18.26 per 100,000) increased with age because of the higher ASRs of bladder and prostate cancers in the elderly. The ASR for kidney cancer was highest in the 40-59-year-old group, whereas testicular cancer occurred most frequently before the age of 40. The incidence of most urological cancers increased (overall APC, 6.39%; p < 0.001), except for penile (APC, –2.01%; p=0.05) and bladder (APC, –0.40%; p=0.25) cancers. The overall survival increased steadily (5-year RSR, 66.4% in 1993-1995 vs. 84.2% in 2008-2012; p < 0.001), particularly for prostate (by 34.10%) and kidney (by 16.30%) cancers, but not for renal pelvis and ureter cancers (–7.20%). CONCLUSION: The most common urological cancer in Korea was prostate cancer followed by bladder and kidney cancers. The incidence of most urological cancers, except for penile and bladder cancers, increased. Survival also increased, particularly for prostate and kidney cancers.

Trends and Age-Period-Cohort Effects on the Incidence and Mortality Rate of Cervical Cancer in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study was conducted to describe the trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea. MATERIALS AND METHODS: The incidence and mortality rate of cervical cancer among ≥ 20-year-old women from 1993 to 2012 were obtained from the Korea Central Cancer Registry and the Korean Statistical Information Service. Age-standardized rates were calculated and Joinpoint regression was used to evaluate the trends in the incidence and mortality rate. Age-period-cohort analysis was performed to investigate the independent effects of age, period and cohort. RESULTS: The incidence of cervical cancer decreased from 32.8 per 100,000 in 1993 to 15.9 per 100,000 in 2012 (annual percent change [APC], –3.9%; 95% confidence interval [CI], –4.2% to –3.6%). The mortality rate decreased from 5.2 per 100,000 in 1993 to 2.1 per 100,000 in 2012 (APC, –4.8%; 95% CI, –5.1% to –4.4%); however, the incidence and mortality rates among young women (< 30 years old) increased. An age-period-cohort model of the incidence and mortality rate showed decreasing period effects between 1993 and 2008 and decreasing cohort effects between 1928 and 1973, while birth cohorts after 1973 exhibited slight increases in the incidence and mortality rate of cervical cancer. CONCLUSION: Recent decreases in the incidence and mortality rate of cervical cancer were due to decreases in the period and cohort effects, which reflect the implementation of a cancer screening program and changes in lifestyle. However, our findings also highlighted an increase in cohort effects on the incidence and mortality rate among young women born after 1973.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2013 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study described the 2013 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality. MATERIALS AND METHODS: Cancer incidence data from 1999-2013 were obtained from Korea National Cancer Incidence Database and followed until December 31, 2014. Mortality data from 1983-2013 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2014 among all cancer patients diagnosed since 1999. Crude, and age-standardized and 5-year relative survival rates were also calculated. RESULTS: In 2013, a total of 225,343 and 75,334 Koreans were newly diagnosed and died from cancer, respectively. The age-standardized rates for cancer incidence and mortality in 2013 were 290.5 and 87.9 per 100,000, respectively. The age-standardized cancer incidence rate increased 3.1% annually between 1999 and 2013. However, the overall cancer incidence rates have decreased slightly in recent years (2011 to 2013). The age-standardized rate for all-cancer mortality has decreased 2.7% annually since 2002. Overall, the 5-year relative survival rate for people diagnosed with cancer between 2009 and 2013 was 69.4%, which represents an improved survival rate as compared with 41.2% for people diagnosed between 1993 and 1995. CONCLUSION: Age-standardized cancer incidence rates have decreased between 2011 and 2013; mortality rates have also declined since 2002, while 5-year survival rates have improved remarkably from 1993-1995 to 2009-2013 in Korea.

Prediction of Cancer Incidence and Mortality in Korea, 2016 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To estimate of Korea's current cancer burden, this study aimed to report on projected cancer incidence and mortality rates for the year 2016. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2013 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2014 were acquired from Statistics Korea. Cancer incidence in 2016 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly. RESULTS: A total of 254,962 new cancer cases and 75,172 cancer deaths are expected to occur in Korea in 2016. The five leading primary cancer incident sites in 2016 were estimated colorectal, stomach, lung, liver and thyroid cancer in men; thyroid, breast, colorectal, stomach, and lung cancer in women. CONCLUSION: Currently cancer is one of the foremost public health concerns in Korea. Although cancer rates are anticipated to decrease the nation's cancer burden will continue to increase as the population ages.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2012 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to report nationwide cancer statistics in Korea, including incidence, mortality, survival, and prevalence, and their trends. MATERIALS AND METHODS: Incidence data from 1993 to 2012 were obtained from the Korea National Cancer Incidence Database, and vital status was followed through December 31, 2013. Mortality data from 1983 to 2012 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, and prevalence, and relative survival were calculated. RESULTS: A total of 224,177 cancer cases and 73,759 cancer deaths were reported in 2012, and there were 1,234,879 prevalent cases identified in Korea as of January 1, 2013. Over the past 14 years (1999-2012), overall incidence rates have increased by 3.3% per year. The incidence rates of liver and cervical cancers have decreased, while those of thyroid, breast, prostate, and colorectal cancers have increased. Notably, incidence of thyroid cancer increased by 22.3% per year in both sexes and has been the most common cancer since 2009. The mortality for all cancers combined decreased by 2.7% per year from 2002 to 2012. Five-year relative survival rates of patients diagnosed in the last 5 years (2008-2012) have improved by 26.9% compared with those from 1993 to1995. CONCLUSION: Overall cancer mortality rates have declined since 2002 in Korea, while incidence has increased and survival has improved.

Prediction of Cancer Incidence and Mortality in Korea, 2015 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: For estimation of Korea's current cancer burden, this study aimed to report on the projected cancer incidence and mortality rates for the year 2015. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2012 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2013 were acquired from Statistics Korea. The cancer incidence in 2015 was projected by fitting a linear regression model to the observed age-specific cancer incidence rates against the observed years and then multiplying the projected age-specific rates by the age-specific population. A similar procedure was used for cancer mortality, except a Joinpoint regression model was used to determine at which year the linear trend changed significantly. RESULTS: A total of 280,556 new cancer cases and 76,698 cancer deaths are expected to occur in Korea in 2015. The crude incidence rate per 100,000 of all sites combined will likely reach 551.6 and the age-standardized incidence rate, 347.6. The estimated five leading primary cancer incidence sites are the stomach, colorectum, lung, prostate, and liver in men; and thyroid, breast, colorectum, stomach, and lung in women. The projected crude mortality rate of all sites combined and age-standardized rate is 150.8 and 82.4, respectively. CONCLUSION: Cancer is currently one of the foremost public health concerns in Korea, and as the population ages, the nation's cancer burden will continue to increase.