Disability-Adjusted Life Years (DALYs) of lung cancer by genders and smoking status in South Korea : Results from National Health Insurance Services Cohort Database (2004-2010) = 한국인의 성별과 흡연상태에 따른 폐암의 질병부담 (DALY) : 국민 표본 코호트 자료 (2004-2010) 분석 결과

다국어 초록 (Multilingual Abstract)

Background: Lung cancer remains a leading cause of cancer-related deaths in South Korea, primarily due to tobacco smoking, which is a modifiable risk factor. The impact of smoking status and gender on lung cancer burden had not been sufficiently quantified. This study aimed to estimate the lung cancer burden attributable to smoking using disability- adjusted life years (DALYs) across Korean men and women. Methods: We conducted a retrospective cohort study using a one-million representative database from 2004 to 2010, provided by the Korea National Health Insurance Service Database (NHIS). We also utilized demographic and behavioral information obtained from the databases of the screening table database, as well as newly diagnosed cases and death cases from the birth and death table and the medical treatment table. We identified new lung cancer and death cases using Korean Classification of Diseases (KCD) codes “C33” and” C34”, and then stratified by smoking status and sex. Yearly age- standardized DALYs rate (ASDR), comprising age-standardized years of life lost rate (AS YLL) and age-standardized years lost due to disability rate (AS YLD), were calculated per 100,000 population. Results: From the one million cohort data over 2005 to 2010, we found 373 new cases of lung cancer and 35 deaths. The yearly mean ASDR was 424; (95% CI: 147-701) per 100,000. The ASDR was highest among former smokers, 230 (95% CI: 52-409) per 100,000, followed by never smokers (115 (95% CI: 46-184) per 100,000), and among current smokers (78 (95% CI: 38-118) per 100,000). Yearly mean males ASDR was significantly higher than that of females (353 vs 70 per 100,000), primarily due to premature mortality. In contrast, among females, ASYLD accounted for the majority of ASDRs. Conclusion: The ASDR of lung cancer in South Korea has been significantly influenced by smoking history; especially for men, former smoking, and age. However, among females, we found that the ASDR is relatively increasing in the group of current smokers, compared to former or never smokers. These findings emphasize the urgent need for gender-sensitive smoking cessation programs, improved early screening initiatives, and stricter regulations on tobacco.

목차 (Table of Contents)

• LIST OF TABLES iii
• LIST OF FIGURES v
• ABSTRACT vi
• 1. INTRODUCTION 1
• 2. LITERATURE REVIEW 3
• 3. METHODS 7
• 3.1 Data sources and study design 7
• 3.2 Data extraction method 9
• 3.3 Identification of lung cancer 10
• 3.4 Data analysis 11
• 3.5 Methodology of Disability Adjusted Life Years (DALYs) 11
• 4. RESULTS 15
• 4.1 Study population 15
• 4.2 Lung cancer cases 27
• 4.3 Lung cancer deaths 37
• 4.4 The Age-standardized DALYs Results 47
• 4.4.1 Comparison of age-standardized DALY, YLL, YLD rates of lung cancer by gender 47
• 4.4.2 Comparison of age-standardized DALY, YLL, YLD rates of lung cancer by smoking status 57
• 5. DISCUSSION 80
• 5.1 Public Health Policy 82
• 6. CONCLUSIONS 83
• REFERENCES 84
• 국문요약 88
• ACKNOWLEDGMENTS 90