ABSTRACT
This study aimed to estimate the medical cost of cancer in the first five years of diagnosis and in the final six months before death in people who developed cancer after human immunodeficiency virus (HIV) infection in Korea. The study utilized the Korea National Health Insurance Service-National Health Information Database (NHIS-NHID). Among 16,671 patients diagnosed with HIV infection from 2004 to 2020 in Korea, we identified 757 patients newly diagnosed with cancer after HIV diagnosis. The medical costs for 60 months after diagnosis and the last six months before death were calculated from 2006 to 2020. The mean annual medical cost due to cancer in HIV-infected people with cancer was higher for acquired immunodeficiency syndrome (AIDS)-defining cancers (48,242 USD) than for non-AIDS-defining cancers (24,338 USD), particularly non-Hodgkin's lymphoma (53,007 USD), for the first year of cancer diagnosis. Approximately 25% of the cost for the first year was disbursed during the first month of cancer diagnosis. From the second year, the mean annual medical cost due to cancer was significantly reduced. The total medical cost was higher for non-AIDS-defining cancers, reflecting their higher incidence rates despite lower mean medical costs. The mean monthly total medical cost per HIV-infected person who died after cancer diagnosis increased closer to the time of death. The estimated burden of medical costs in patients with HIV in the present study may be an important index for defining healthcare policies in HIV patients in whom the cancer-related burden is expected to increase.
ABSTRACT
Objective: This study aimed to identify the association between various obesity indexes, including waist circumference (WC), waist−hip ratio (WHR), waist−height ratio (WHTR), and BMI, and their combinations with body mass index (BMI) and thyroid cancer risk. Methods: Of the 65,639 participants who completed a follow-up survey of the Health Examinee Study (HEXA), a prospective cohort of the Korean Genome and Epidemiology Study, 412 female incident thyroid cancer cases, and 1648 birth year- and enrollment year-matched female controls were included. Multiple conditional logistic regression was used to estimate the association between obesity indexes and thyroid cancer risk. Results: The risk of developing thyroid cancer was increased by 1.37-fold (95% confidence interval (CI) = 1.03−1.81) higher in the obese BMI group (≥25.0 Kg/m2) compared to that in the normal BMI group (<23.0 Kg/m2). Obesity in terms of WC (≥85.0 cm) and WHTR (≥0.5) was associated with an increased risk of thyroid cancer (OR 1.55, 95% CI = 1.16−2.07; OR 1.37, 95% CI = 1.07−1.75, respectively). However, increased WHR levels did not show any significant association. Women with both obese levels of BMI (≥25.0 Kg/m2) and other obesity indexes (WC ≥ 85.0 cm, WHR ≥ 0.85, or WHTR ≥ 0.5) showed an increased risk of thyroid cancer with OR of 1.63 (95% CI = 1.14−2.31), 1.49 (95% CI = 1.05−2.12), and 1.42 (95% CI = 1.04−1.94), compared to those with normal levels of BMI and each obesity index. Conclusion: These results provide evidence of the contribution of both total and central adiposity across the lifespan of thyroid cancer incidence. Risk factor modifications must be considered to explain the current thyroid cancer epidemic.
ABSTRACT
COVID-19 exposed the vulnerability of compact cities against shock events. As the impact of COVID-19 not only persists, but also expands throughout the world, this study questions whether the compact city model would be sustainable in the post-COVID-19 era. As such, this study examines the dynamics among major COVID-19 outbreak events, government interventions, and subway ridership in two compact cities, Seoul and New York City. Then, to gain thorough understanding of the impact of risks on compact urban form, it narrows the scope to Seoul in comparing subway ridership patterns in 2019 and 2020, and identifying characteristics that affect the volatility of subway ridership levels. The results affirm that individual mobility, COVID-19 outbreaks, and government interventions are closely related, and reveal that the extent of social distancing measures in compact cities is limited. This finding aligns with existing literature that link diseases transmission with dense population and mixed land use, accentuating the vulnerability of the compact city model against shocks. As a result, a multidimensional urban planning approach that incorporates polycentric and decentralized urban form is recommended to effectively and sustainably control disease outbreaks in compact cities.
ABSTRACT
The editors-in-chief of the Annals of Regional Science offer an overview and analysis of recent developments at the journal from January 2020 through December 2021, a time period hampered by the COVID-19 pandemic. Annal's Impact Factor increased substantially to 2.646 in 2020. Moreover, submissions increased from pre-COVID times. A new development is the shifting of source regions for articles accepted for publication. For the first time, China tied with the USA to lead the distribution of acceptances by country. Special Issues continue to be important components of the journal.