Breast Neoplasms: Shin HR

Jung KW, Yim SH, Kong HJ, Hwang SY, Won YJ, Lee JK, Shin HR. · Cancer Registration and Biostatistics Branch, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea. · J Korean Med Sci. · Pubmed #17923755 links to  free full text

Abstract: Population-based survival reflect the average prognosis of unselected patients with a variety of natural histories as well as treatment patterns and are also useful for evaluating effectiveness and efficiency of cancer-directed health services in a given region. Although survival data have been reported based on hospital data, the survival data from population-based registry have been rarely reported in Korea. Based on the Korea National Cancer Incidence Database, we report the results from survival analysis for cancer patients diagnosed during 1993-2002 and followed up until 31 December 2005 at primary cancer sites. The five-year relative survival rates (RSR) were calculated using the Ederer II method. The Kaplan-Meier method was used to estimate median survival and the 95% confidence intervals. In males, the five-year RSR for all cancers was 32.5% during 1993-1997 and was 37.8% during 1998-2002. In females, the five-year RSR for all cancers was 53.7% during 1993-1997 and was 57.0% during 1998-2002. The largest improvement in survival was shown in prostate cancer in males and breast and stomach cancer in females. The median survival durations were 16.3 months in males and 81.6 months in females. This result will be useful for evaluation of cancer treatment outcomes in Korea.

Lee JH, Yim SH, Won YJ, Jung KW, Son BH, Lee HD, Lee ES, Yoo KY, Ahn SH, Shin HR, Anonymous00001. · Korea Central Cancer Registry, National Cancer Center, Goyang, Korea. · J Korean Med Sci. · Pubmed #17923736 links to  free full text

Abstract: In 2002, breast became the most common cancer site in Korean women. Using national breast cancer incidence data during 1993-2002, crude, age-standardized, and age-specific rates for incidence and mortality were calculated. Survival was examined for cases diagnosed during 1993-2002 and followed up to 2004. Observed survival was calculated using the life table method and relative survival using the Ederer II method. Age-standardized incidence rates in female increased from 14.5 in 1993 to 26.2 per 100,000 in 2002. Age-specific incidences showed peaks in women in their forties. Mortality rates increased from 3.7 in 1993 to 4.6 per 100,000 in 2002 and showed peaks in women in their fifties. Five-year relative survival for female breast cancer diagnosed during 1993-2002 was 82.2%. When we examined the secular trends using cases diagnosed 1993-1999 for complete 5-yr followup, the 5-yr relative survival increased from 75.2% in 1993 to 83.5% in 1999. The data from this study will provide valuable information to plan and evaluate actions against breast cancer including national breast cancer screening.

Sung NY, Park EC, Shin HR, Choi KS. · Research Institute, National Cancer Center. · J Prev Med Public Health. · Pubmed #16312914 links to  free full text

Abstract: BACKGROUND: Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the 'Ten year Plan for Cancer Control' was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. METHODS: To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. RESULTS: The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. CONCLUSIONS: The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.

Choi Y, Kim YJ, Shin HR, Noh DY, Yoo KY. · Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. · Asian Pac J Cancer Prev. · Pubmed #15780025 No free full text.

Abstract: Not only the incidence but also the mortality of female breast cancer has been steadily increasing in Korea since the 1980s. Epidemiologic evidence on changes in lifestyle and risk factors related with breast cancer, and data from migrant studies strongly suggest that breast cancer might further increase. In order to estimate the long-term trend in mortality of breast cancer in Korean women, we analyzed age-specific mortality rates for breast cancer over the past 20 years, and made a projection up to 2020 using a linear regression model with the Poisson distribution. The age-adjusted mortality rates for breast cancer per 100,000 persons were 2.84 in 1983, 4.91 in 1993, and 6.26 in 2003. The predicted expected age-adjusted mortality rates for breast cancer are 6.51 for 2005, 7.37 for 2010, 8.22 for 2015, and 9.07 for 2020, with an estimated annual increment of breast cancer mortality of 0.1704. Accordingly, 1,564 women in 2005 and 3,087 in 2020 will be expected to die of breast cancer in Korea. Compared with the rate in 1983, this indicates a more than 3-fold increase by 2020. On the basis of our results, female breast cancer in Korea will linearly increase for the forseeable future if the trend over the past 20 years continues.

Moore MA, Tajima K, Anh PH, Aydemir G, Basu PS, Bhurgri Y, Chen K, Gajalakshmi V, Hirose K, Jarrahi AM, Ngoan le T, Qiao YL, Shin HR, Sriamporn S, Srivatanakul P, Tokudome S, Yoo KY, Tsuda H. · · Asian Pac J Cancer Prev. · Pubmed #12875629 No free full text.

Abstract: In response to the request for 'Breakthrough Questions' for 'Grand Challenges in Global Health' recently published in Nature, the Asian Pacific Organization for Cancer Prevention should focus its attention on what projects are of the highest priority for integration with its Practical Prevention Program (PPP). The most common female cancers in most of the countries of Asia are carcinoma of the breast, followed by the uterine cervix. While the incidences of breast adenocarcinomas are still generally lower than in the Western world they are rapidly increasing, and squamous cell carcinomas of the cervix are a major problem. Clearly there are many areas which would reward research. One factor which appears of major relevance in the mammary gland case is the diet, and particularly the phytoestrogens included in 'tofu', along with physical exercise. The age at which these could be operating needs to be elucidated, with reference to timing of menarche and menopause, and also breast mammographic density, another predictor of likelihood of neoplasia. In the cervix, the predominant influence is well established to be persistent infection with a high risk 'oncogenic' type of human papilloma virus (HPV). Vaccines therefore hold much promise, but a better understanding of the mechanisms underlying spontaneous clearance of both infection and cervical intraepithelial neoplasia (CIN) of different grades is also essential for optimal intervention. The roles of smoking and antioxidant intake in particular deserve emphasis. In Asia, with the considerable variation evident in both breast and cervical cancer incidence rates, as well as in cultural and other environmental factors, we are in a very favourable position to meet two specific challenges: 1). elucidation of how diet in adolescence determines susceptibility to neoplasia of the mammary glands; and 2). determination of what governs persistence of HPV infection. Realisation of these pivotal research aims, with especial emphasis on the context of the PPP, is our shared goal.

Choi Y, Kim Y, Park SK, Shin HR, Yoo KY. · Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-799, Korea. · Breast Cancer. · Pubmed #16929120 links to  free full text

Abstract: BACKGROUND: Although breast cancer in women remains relatively rare in Korea, its incidence and mortality figures are increasing, consistent with the increasing risk observed in successive generations of Korean women. The aim of the current study was to examine time trends of breast-cancer mortality during the period 1984-2003 in Korea, assessing the importance of the effects of age, period and birth cohort as risk factors. METHODS: Data on the annual number of deaths due to female breast cancer and on female population statistics from 1984 to 2003 were obtained from the Korean National Statistical Office. A log-linear Poisson age-period-cohort model was used to estimate age, period and cohort effects. RESULTS: The trend of breast cancer mortality was explained by an age-cohort model based on goodness of fit, even though the significance of the cohort effect was marginal (p=0.08) after adjusting for age. The risk of breast cancer death was found to increase with age after adjusting for the cohort effect, and it was different from the cross-sectional age curve. Also, breast cancer mortality increased along with the birth cohort. CONCLUSIONS: Even though the cohort effect was found to have a marginally significant effect on breast cancer mortality, it is expected to be more significant in the future given the recent on-going changes in diet and reproductive behavior shown by Korean women.