Trends of human papillomavirus-related head and neck cancers in Korea: national cancer registry data.

Shin, Aesun,Jung, Yuh-S,Jung, Kyu-Won,Kim, Kyeezu,Ryu, Junsun,Won, Young-Joo Triological Foundation [etc.] 2013 The Laryngoscope Vol.123 No.11

<P>The incidence of human papillomavirus (HPV)-positive head and neck cancers (HNCs) is increasing sharply worldwide, while their HPV-negative counterparts are showing a decreased frequency. However, epidemiologic data related to these changes are sparse in Korea, which is rapidly adopting more westernized lifestyles.</P>

Meat intake, heterocyclic amine exposure, and metabolizing enzyme polymorphisms in relation to colorectal polyp risk.

Shin, Aesun,Shrubsole, Martha J,Rice, Jeffrey M,Cai, Qiuyin,Doll, Mark A,Long, Jirong,Smalley, Walter E,Shyr, Yu,Sinha, Rashmi,Ness, Reid M,Hein, David W,Zheng, Wei American Association for Cancer Research 2008 Cancer Epidemiology, Biomarkers & Prevention Vol.17 No.2

<P>Most colorectal cancers arise from adenomatous polyps or certain hyperplastic polyps. Only a few studies have investigated potential genetic modifiers of the associations between meat intake and polyp risk, and results are inconsistent. Using data from the Tennessee Colorectal Polyp Study, a large colonoscopy-based study, including 1,002 polyp cases (557 adenoma only, 250 hyperplastic polyp only, 195 both polyps) and 1,493 polyp-free patients, we evaluated the association of colorectal polyp risk with carcinogen exposure from meat and genetic polymorphisms in enzymes involved in heterocyclic amine (HCA) metabolism, including N-acetyltransferase 1 (NAT1) and N-acetyltransferase 2 (NAT2), cytochrome P450 1A2 (CYP1A2), and aryl hydrocarbon receptor (AhR). Data on intake levels of meats by preparation methods, doneness preferences, and other lifestyle factors were obtained. Fourteen single nucleotide polymorphisms in the AhR, CYP1A2, NAT1, and NAT2 genes were evaluated. No clear association was found for any polymorphisms with polyp risk. However, apparent interactions were found for intake of meat and HCAs with AhR, NAT1, and NAT2 genotypes, and the interactions were statistically significant for the group with both adenomatous and hyperplastic polyps. Dose-response relationships with meat or HCA intake were found only among those with the AhR GA/AA (rs2066853) genotype, NAT1 rapid, or NAT2 rapid/intermediate acetylators but not among those with other genotypes of these genes. This dose-response relationship was more evident among those with both AhR GA/AA and the NAT1 rapid acetylator than those without this genotype combination. These results provide strong evidence for a modifying effect of metabolizing genes on the association of meat intake and HCA exposure with colorectal polyp risk.</P>

Gastric Cancer Epidemiology in Korea

Aesun Shin,Jeongseon Kim,Sohee Park 대한위암학회 2011 Journal of gastric cancer Vol.11 No.3

Gastric cancer has been the most commonly diagnosed cancer in Korea although the age-standardized mortality and incidence has decreased gradually during last two decades. Helicobacter pylori infection and cigarette smoking are well-established risk factors, and the role of dietary factors, such as salted foods, fresh vegetables and fruits, soy foods, and processed or grilled meats on gastric carcinogenesis has been suggested. In this review, we review national and international gastric cancer statistics, studies on environmental risk factors conducted in the Korean population, and gastric cancer screening activities.

Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea Central Cancer Registry Database

Shin, Aesun,Won, Young‐,Joo,Jung, Hye‐,Kyung,Kong, Hyun‐,Joo,Jung, Kyu‐,Won,Oh, Chang‐,Mo,Choe, Sunho,Lee, Jihyun John Wiley and Sons Inc. 2018 Journal of gastroenterology and hepatology Vol.33 No.12

<P><B>Abstract</B></P><P><B>Background and Aim</B></P><P>The diagnostic and therapeutic modalities of esophageal cancer have recently improved in Asia, and its prognosis is expected to change. This study provides a population‐based report on the epidemiology of esophageal cancer in Korea.</P><P><B>Methods</B></P><P>Cancer incidence data from 1999 to 2013 were obtained from the Korea Central Cancer Registry, covering the entire population. Age‐standardized incidence rates and annual percent changes were calculated according to subsites and histological types. Five‐year relative survival rates were estimated for cases diagnosed between 1993 and 2013. Relative excess rates were compared between patients diagnosed from 2009 to 2013 and 2006 to 2008.</P><P><B>Results</B></P><P>The age‐standardized incidence rates decreased from 8.8 per 100 000 populations in 1999 to 5.9 in 2013 with an annual percent change of −2.6% in men and −2.2% in women. The most common histological type was squamous cell carcinoma, accounting for 90.2% of all esophageal cancers in 2013, followed by adenocarcinomas (3.1%), and their incidences decreased. The proportion of localized and regional cancer tended to increase compared with that of distant cancer. Five‐year relative survival of squamous cell carcinoma improved from 12.1% (1993–1995) to 34.6% (2009–2013). Relative excess rate was 0.72 (95% confidence interval 0.65–0.80) in localized stage and 0.88 (95% confidence interval, 0.82–0.95) in regional stage comparing patients diagnosed from 2009 to 2013 and 2006 to 2008.</P><P><B>Conclusions</B></P><P>The incidence of esophageal cancer has decreased in Korea for the past 15 years, and 5‐year survival rates have improved significantly. These increases may be attributable to more effective detection of early‐stage disease.</P>

Effect modification of meat intake by genetic polymorphisms on colorectal neoplasia susceptibility.

Shin, Aesun,Kim, Jeongseon Asian Pacific Organization for Cancer Prevention 2010 Asian Pacific journal of cancer prevention Vol.11 No.2

<P>Colorectal cancer incidences differ considerably between Western and non-Western countries. In recent years, a dramatic increase in colorectal cancer incidence has been reported in several Asian countries. Immigration studies have suggested that environmental rather than genetic factors are primarily responsible for the international variability and secular trends of colorectal cancer incidence rates. Therefore, not only the main effect of a gene but also the inflkuence of gene-environment interactions on cancer risk are important from the public health perspective. This review encompasses the literature on gene-diet interactions, particularly focusing on meat intake and its association with the risk of colorectal carcinoma or adenomas. It is generally accepted that genotypes which are associated with the higher enzyme activity for metabolic activation or lower activity for detoxification would affect individual's susceptibility to meat carcinogens. The most intensively studied genes were those involved in xenobiotic metabolism, including N-acetyltransferase (NAT), cytochrome P450 (CYP) families, glutathione S-transferase (GST), and sulfotransferase (SULT). However, the associations were not consistent across studies. The role of genetic polymorphisms and their role in effect modification of environmental carcinogens should be assessed in well-designed large-scale epidemiological studies with comprehensive information for risk factors for better understanding the etiologic role of dietary factors and in developing a personalized cancer prevention strategy in the genome-wide association study era.</P>

Descriptive Epidemiology of Cholangiocarcinoma and Clonorchiasis in Korea

Shin, Hai-Rim,Oh, Jin-Kyoung,Lim, Min Kyung,Shin, Aesun,Kong, Hyun-Joo,Jung, Kyu-Won,Won, Young-Joo,Park, Sohee,Park, Sang-Jae,Hong, Sung-Tae The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.7

<P>In 2009, infection with the liver fluke <I>Clonorchis sinensis</I> (<I>C. sinensis</I>) was classified as 'carcinogenic to humans' (Group 1) based on its involvement in the etiology of cholangiocarcinoma by the International Agency for Research on Cancer. However, little is known about the descriptive epidemiology of cholangiocarcinoma in Korea. We examined incidence trends of intrahepatic and extrahepatic cholangiocarcinomas, using data from the Korea National Cancer Incidence database for 1999-2005. The prevalence of <I>C. sinensis</I> infection was estimated from a recent population-based survey in rural endemic areas. Cholangiocarcinoma incidence rates are currently rising, even while primary liver cancer incidence rates are decreasing. Annual percent changes in cholangiocarcinoma incidence rates were 8% for males and 11% in females. Known areas of <I>C. sinensis</I> endemicity showed high incidence rates of cholangiocarcinoma. The positivity of <I>C. sinensis</I> eggs in stool samples from endemic areas was more than 25% of adults tested during 2005-2008. From a meta-analysis, the summary odds ratio for cholangiocarcinoma due to <I>C. sinensis</I> infection was 4.7 (95% confidence interval: 2.2-9.8). Approximately 10% of cholangiocarcinomas in Korea were caused by chronic <I>C. sinensis</I> infections. More specific policies, including health education and an extensive effort for early detection in endemic areas, are needed.</P>

Colorectal cancer mortality in Hong Kong of China, Japan, South Korea, and Singapore.

Shin, Aesun,Jung, Kyu-Won,Won, Young-Joo WJG Press 2013 World journal of gastroenterology Vol.19 No.7

<P>To clarify the trend in colorectal cancer mortality in Asian countries. We analyzed the colorectal cancer mortality in four Asian countries using the World Health Organization mortality database and the Korea National Statistics Office database. The annual age-standardized rates and truncated rated for the three age groups (30-49, 50-69 and ??? 70 years) for Hong Kong of China (1969-2009), Japan (1955-2009), South Korea (1985-2006), and Singapore (1966-2009) were estimated. A joinpoint regression model was used to detect significant trends in mortality rates. Colorectal cancer mortality in men started to decrease in 1992 in Japan followed by Singapore and Hong Kong of China in 1995. The mortality rates in women stared to decrease in 1980 in Singapore, followed by Hong Kong of China and Japan in 1996. In all countries and both genders, except for women in Singapore, the decrease in mortality began in the younger age groups. The colorectal cancer mortality in the four studied Asian countries has started to decrease, and the decrease occurred first in the younger age groups.</P>

Factors associated with awareness of infection status among chronic hepatitis B and C carriers in Korea.

Shin, Aesun,Cho, Eo Rin,Kim, Jeongseon,Sung, Joohon,Park, Kyung Woo,Lim, Min-Kyung,Shin, Hai-Rim American Association for Cancer Research 2009 Cancer epidemiology, biomarkers & prevention Vol.18 No.6

<P>Hepatitis B (HBV) and hepatitis C (HCV) viral infections are the most important risk factors for hepatocellular carcinoma (HCC), which is responsible for 17.5% of cancer deaths in Korea. The objectives of this study were to identify demographic characteristics that may affect hepatitis carriers' awareness of their infection status, and to assess whether health-related behaviors differed by awareness of the infection. Among 18,636 persons who were recruited from a cancer screenee cohort, 904 were HBV carriers and 146 were HCV carriers. Among the HBV carriers, 74.2% were aware of their infection status. Higher education (odds ratio, 1.8; college versus middle school or less), family history of liver cancer or disease, and marriage were associated with awareness of HBV infection status. Participants who were aware of their HBV carrier status were more likely to be former smokers or drinkers than those who were not aware of their status. Only 34.9% of HCV carriers were aware of their HCV infection status. No demographic characteristics were related to awareness of HCV infection status among HCV carriers. However, HCV carriers who were aware of their infection status were more likely to be former drinkers (odds ratio, 9.2; 95% confidence interval, 1.8-47.2). In conclusion, two thirds of HCV carriers and one fourth of HBV carriers in this study population were not aware of their infection status, and awareness of hepatitis infection status was significantly associated with other risk behaviors, such as alcohol consumption and cigarette smoking.</P>

Increasing Trend of Colorectal Cancer Incidence in Korea, 1999-2009

Shin, Aesun,Kim, Kyee-Zu,Jung, Kyu-Won,Park, Sohee,Won, Young-Joo,Kim, Jeongseon,Kim, Dae Yong,Oh, Jae Hwan Korean Cancer Association 2012 Cancer Research and Treatment Vol.44 No.4

<P><B>Purpose</B></P><P>This study was conducted in order to demonstrate changing trends in colorectal cancer incidence according to sex, age group, and anatomical location in the Korean population.</P><P><B>Materials and Methods</B></P><P>Data from the Korea Central Cancer Registry between 1999 and 2009 were analyzed. Annual percent changes (APCs) of sex- and age-specific incidence rates for cancer of the proximal colon (International Statistical Classification of Diseases and Related Health Problems, 10th revision [ICD-10] code C18.0-18.5), distal colon (C18.6-18.7), and rectum (C19-20), and male-to-female incidence rate ratios (IRR) were calculated.</P><P><B>Results</B></P><P>The age-standardized incidence rate (ASR) of colorectal cancer was 27 (per 100,000) in 1999 and increased to 50.2 in 2009 among men (APC, 6.6%). The ASR for women was 17.2 in 1999 and 26.9 in 2009 (APC, 5.1%). The rectum was the most common site of cancer among both men and women during 1999 and 2009. However, the distal colon had the highest APC (10.8% among men and 8.4% among women), followed by the proximal colon (7.9% among men and 6.6% among women), and rectum (5.2% among men and 2.4% among women). The proportion of rectal cancer decreased from 51.5% in 1999 to 47.1% in 2009 among men, and from 50.5% to 42.8% among women. An increase in the male-to-female IRR was observed for distal colon cancer and rectal cancer, whereas the IRR for proximal colon cancer was stable.</P><P><B>Conclusion</B></P><P>The rapid increase in colorectal cancer incidence is mainly attributed to the increase in colon cancer, especially distal colon cancer, and may be explained by a transition of risk factors for subsites or by the effect of colorectal cancer screening.</P>

The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care

Yoo Shin Hye,Sim Jin-Ah,Shin Jeongmi,김범석,Park Jun-Bean,Shin Aesun 한국역학회 2022 Epidemiology and Health Vol.44 No.-

OBJECTIVES: We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.METHODS: A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.RESULTS: A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.CONCLUSIONS: During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.