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국민건강보험공단 자료를 활용한 전립샘암 발생의 위험요인 연구: 연령별 BMI 영향
김혜심 ( Hye Sim Kim ),고태화 ( Tae Hwa Go ),강대용 ( Dae Ryong Kang ),정재흥 ( Jae Hung Jung ),권성원 ( Sung Won Kwon ),김세철 ( Sae Chul Kim ),송재만 ( Jae Mann Song ),정현철 ( Hyun Chul Chung ),고상백 ( Sang Baek Koh ) 한국보건정보통계학회(구 한국보건통계학회) 2019 보건정보통계학회지 Vol.44 No.4
Objectives: To provide evidences for effective management and prevention of prostate cancer (PCa) by analyzing risk factors of prostate cancer in Korea. Methods: This study utilized the Korean National Health Insurance Service data of patients diagnosed with PCa between 2013 and 2017 and the risk factors were identified using the health checkup records from 2009 to 2010. To identify risk factors that affect the incidence of prostate cancer, the Cox proportional hazard model was used to analyze. Results: The hazard ratio (HR) of incidence of PCa was 1.37 times higher (95% CI, 1.22-1.56) people with body mass index (BMI) over 30.0 k/m2 than those with BMI below 18.5 k/m2. And age stratification analysis has shown that increased BMI at 50 years old or older increases the risk of incidence prostate cancer from 1.35 to 2.38. Conclusions: Among the many risk factors affecting the development of prostate cancer, BMI has been identified as a risk factor for most ages. Therefore, it is necessary to consider the results of this study when establishing a policy for preventing the occurrence of prostate cancer. Through this, it is expected that not only the prevention of early prostate cancer but also the cost of socioeconomic loss can be lowered by lowering the incidence of prostate cancer.
우리나라 전립샘비대증 유병률: 국민건강보험공단자료를 이용하여
김혜심 ( Hye Sim Kim ),고태화 ( Tae Hwa Go ),강대용 ( Dae Ryong Kang ),정재흥 ( Jae Hung Jung ),권성원 ( Sung Won Kwon ),김세철 ( Sae Chul Kim ),송재만 ( Jae Mann Song ),정현철 ( Hyun Chul Chung ),고상백 ( Sang Baek Koh ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.3
Objectives: To provide evidences for effective management and prevention of benign prostate hyperplasia (BPH) by analyzing the status of the prevalence of BPH in Korea. Methods: This study was conducted on patients diagnosed with BPH from the claim data of the Korean National Health Insurance Service between 2012 and 2016. We calculated the age-standardization prevalence of patients with BPH and conducted comparative analysis by region and year. Results: The prevalence of age-standardization was 10,847.09 per 100,000 population in 2012 (95% CI, 10,828.72-10,865.47) and 23,552.31 in 2016 (95% CI, 23,526.70-23,577.92). According to comparative analysis by administrative districts, the cumulative prevalence was the highest at in Daejeon (26,076.23, 95% CI, 25,912.82-26,239.64) and the lowest in Ulsan (20,966.97, 95% CI, 20,795.85-21,138.08) in 2016. Also, the proportion of patients who did not visit continuously was 23.5% in 2013 and 37.1% in 2016. Conclusions: The prevalence of BPH increased by 46% in 2016 compared to 2012, and the prevalence increased with age. Therefore, in order to prevent BPH related health problem, it is necessary to develop a systematic management and preventive policy for a super-aged society.
기초자치단체별 급성기 뇌졸중 사망률과 지역사회 위험요인 분석
고미선(Mi Seon Ko),이준영(Jun Young Lee),박홍준(Hong Jun Park),정재흥(Jae Hung Jung) 한국보건사회학회 2022 보건과 사회과학 Vol.- No.60
노인인구에서 발생률이 높은 뇌졸중 질환은 우리나라의 주요 사망원인이며 초고령사회에 접어든 우리나라의 주요한 보건 문제로 인식되고 있다. 이에 본 연구는 급성기 뇌졸중 사망률의지역별 영향요인을 파악하여 지역사회 건강 결과 향상에 도움이 되고자 하였다. 2017년 1월 1일부터 2019년 12월 31일까지 건강보험심사평가원의 급성기뇌졸중 적정성 평가자료를 활용하여 뇌졸중으로 진단되어 입원 후 30일 이내에 사망한 환자를 대상으로 기초자치 단체별 사망률을 분석하고 인구학적 (고령인구 비율, 남녀성비, 음주율, 흡연율, 주관적 건강수준 인지율, 스트레스 인지율), 사회경제적 (노후주택 비율, 재정자주도, 의료급여 수급자 비율), 의료 자원 (병원 수, 의료기관 종사 의사 수) 요인을 비교 분석하였다. 전국 226개 기초자치 단체의 급성기 뇌졸중 사망률은 12.1 ± 2.2 %였으며 사망률이 가장낮은 지역은 11%로 경기도, 사망률이 높은 지역은 충청북도와 전라남도로 각각 14.0%, 13.2% 로 관찰되었다. 사망률 상위 10개 기초자치단체는 모두 지방 소도시 (군 단위) 기초자치단체였다. 사망률에 영향을 미치는 요인으로는 전국 기초자치단체 분석 결과 고령인구비율 (β=0.326, p=0.001) 이었으며 대도시 권역 기초자치단체 분석의 경우에는 남녀성비 (β=-0.352, p=0.001), 음주율 (β=0.232, p=0.003), 노후주택비율 (β=0.354, p=0.001), 의료급여 수급자비율 (β=0.312, p=0.018), 병원 수 (β-0.177, p=0.027)가 통계학적으로 유의하게 관찰되었다. 지방 소도시 기초자치단체 분석 결과 고령인구 비율 (β=0.252, p=0.049), 재정자주도 (β =-0.166, p=0.014)가 사망률에 유의한 영향을 주는 요인으로 확인되었다. 급성기 뇌졸중 사망률은 지방소도시 기초자치단체에서 높게 관찰되었으며 인구학적 요인 외에도 지역의 사회경제적 요인 (재정자주도)과의 연관성을 확인하였다. 따라서 지역 수준에 따라맞춤형 보건 의료 정책을 수립하고 해결책을 모색할 필요가 있을 것으로 생각된다. We aim to elucidate the discrepancies in acute stroke mortality among primary local governments and identify the risk factors of the mortality at loco-regional level to establish tailored health policies in Korea. From January 1, 2017 to December 31, 2019, the mortality rates of patients who died from stroke within 30 days of hospitalization in 226 municipalities were analyzed using the claims data accumulated by Health Insurance Review and Assessment Service. Demographic factors (elderly population ratio, gender ratio, alcohol consumption rate, smoking rate, subjective health status awareness), socioeconomic factors (ratio of old houses, financial autonomy rate, rate of medical aid beneficiaries) and medical resource factors (number of hospitals/ doctors) were analyzed. Acute stroke mortality rate in Korea is 12.1 ± 2.2%. The region with the lowest mortality rate is Gyeonggi Province (local government mainly consisting of urban cities) and regions with the highest mortality rates are North Chungcheong Province and South Jeolla. The elderly population is associated with mortality using overall nationwide data. It was also risk factor for stroke mortality in the cities or counties in rural areas. The male-female ratio, alcohol consumption rate, financial autonomy rate, and number of hospitals in the region were also mortality risk factors based on the data of urban cities. Based on the results from counties, the proportion of elderly population and financial autonomy rate were found to be a significant risk factor for stroke mortality in small towns in rural areas. Regional differences of acute stroke mortality were also found. Aside from demographic factors (proportion of elderly population), socioeconomic factors (financial autonomy rate) were identified as risk factors for acute stroke mortality. Collectively, it is necessary to build health care policies that address the health inequality at the loco-regional level.
우리나라 전립샘비대증 발생률: 국민건강보험공단자료를 이용하여
고태화 ( Tae-hwa Go ),김혜심 ( Hye Sim Kim ),강대용 ( Dae Ryong Kang ),정재흥 ( Jae Hung Jung ),권성원 ( Sung Won Kwon ),김세철 ( Sae Chul Kim ),송재만 ( Jae Mann Song ),정현철 ( Hyun Chul Chung ),고상백 ( Sang Baek Koh ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.3
Objectives: We investigated the incidence rate of benign prostatic hyperplasia (BPH) in Korean adult males. Methods: Data were obtained from 2008 to 2016 in the National Health Insurance Service. The incidence was defined as a newly diagnosed patients with BPH in 2012-2016 after excluding patients with BPH in 2008-2011. The incidence rate was confirmed by age, administrative districts, and scale of city. Results: The age-standardized incidence rate of BPH was 16.3% from 2012 to 2016. The incidence rate was presented to be 8.9%, 16.8%, 25.0%, 26.7%, and 30.4%, respectively, in the 40s to 80s or over. According to administrative districts, the highest incidence rate was 18.2% and 17.3% in Daejeon and Gwangju, respectively, and the lowest incidence rate was 15.0% in Gangwon. And the highest incidence of 16.5% was observed in the big city among big city, small-to-medium city and rural area. Conclusions: The age-standardized incidence rate in Korea was 16.3% and incidence rate of BPH increased with age.
한국인에서 전립선암을 예측하는 데 있어 Prostate Health Index Density의 임상적 유용성에 관한 전향적, 다기관 연구
송기현(Geehyun Song),박홍주(Hongzoo Park),이상욱(Sang Wook Lee),강태욱(Tae Wook Kang),정재흥(Jae Hung Jung),정현철(Hyun Chul Chung),김성진(Sung Jin Kim),박종연(Jong Yeon Park),김정현(Jeong Hyun Kim) 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.2
Purpose: We evaluated the clinical performance of Prostate Health Index (PHI) density with [-2]proPSA (p2PSA) and its derivatives in predicting the presence of prostate cancer (PCa) in Korean men. Materials and Methods: A total of 706 men with total prostate-specific antigen (tPSA)≥2.5 ng/mL who underwent their first prostate biopsy were included in this prospective, multicenter, observational study. Diagnostic accuracy of tPSA, free-to-total PSA ratio (%fPSA), p2PSA, %p2PSA, the Beckman Coulter PHI, and PHI density was assessed by receiver operating characteristic curve analyses and logistic regression analyses. PHI was calculated as [(p2PSA/free PSA)×tPSA½], and density calculations were performed using prostate volume as determined by transrectal ultrasonography. Results: Overall, PCa was detected in 367 of all subjects (52%). In men with tPSA 2.5-10 ng/mL, the detection rate of PCa was 41.1% (188 of 457). In this group, PHI and PHI density were the most accurate predictors of PCa and significantly outperformed tPSA and %fPSA; area under the curve for tPSA, %fPSA, %p2PSA, PHI, and PHI density was 0.58, 0.68, 0.70, 0.75, 0.73 respectively. PHI and PHI density were also the strongest predictor of PCa with Gleason score ≥7. Conclusions: Based on the present prospective multicenter experience, PHI and PHI density demonstrate the superior clinical performance in predicting the presence of PCa in Korean men with tPSA 2.5-10 ng/mL.