Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004–2018

홍세리,이윤영,이재호,김열,최귀선,전재관,서민아 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2

Purpose The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004-2018. Materials and Methods KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40-74 years and women aged 20-74 years with no cancer histories. Results Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively. Conclusion Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2018

홍세리,원영주,이재준,정규원,공현주,임정수,서홍관,The Community of Population-Based Regional Cancer Registries 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2

Purpose The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2018.Materials and Methods Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2018, with survival follow-up until December 31, 2019. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, prevalence, and 5-year relative survival rates were calculated, and temporal trends for incidence and mortality rates were evaluated, with annual percentage changes.Results In 2018, newly diagnosed cancer cases and deaths from cancer were reported as 243,837 (ASR, 270.4 per 100,000) and 79,153 (ASR, 73.3 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.4% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2007 to 2014; 3.7% from 2014 to 2018). The 5-year relative survival between 2014 and 2018 was 70.3%, which contributed to prevalent cases reaching over 2 million by the end of 2018.Conclusion Cancer statistics have improved significantly during the past two decades. However, there remain important challenges to be solved, such as controlling cancers with low survival rates. Cancer statistics can be used to discover blind spots in cancer control, and as evidence for developing and implementing future cancer control strategies.

Variation in Meal-skipping Rates of Korean Adolescents According to Socio-economic Status: Results of the Korea Youth Risk Behavior Web-based Survey

홍세리,박은철,배홍철,김현수 대한예방의학회 2014 Journal of Preventive Medicine and Public Health Vol.47 No.3

Objectives: To identify and evaluate the trend of meal-skipping rates among Korean adolescents with their contributing causes and the influence of household income level on meal skipping. Methods: Using 2008, 2010, and 2012 data from the Korea Youth Risk Behavior Web-based Survey of 222 662 students, a cross-sectional study with subgroup analysis was performed. We calculated odds ratios for skipping each meal 5 or more times in a week by household socio-economic status using a multiple logistic regression model. The secular change in the meal-skipping rates by the students’ family affluence scale was analyzed by comparing the meal-skipping students within each subgroup and odds ratios for the same event over time. Results: Through 2008 to 2012, most of the meal-skipping rates generally showed a continuous increase or were almost unchanged in both sexes, except for breakfast skipping in several subgroups. Students in low-income households not living with both parents had the highest meal-skipping rates and odds ratios for frequent meal skipping. In a time-series subgroup analysis, the overall odds ratios for the same event increased during 2008 to 2012, with a slight reduction in the gap between low and higher income levels with regard to meal skipping during 2010 to 2012. Conclusions: Household socio-economic status and several other factors had a significant influence on Korean adolescent meal-skipping rates. Although the gap in eating behavior associated with household socio-economic differences is currently decreasing, further study and appropriate interventions are needed.

Development of Pathological Stimulus-activatable Nanoplatforms with Theranostic Functions

홍세리,선세미,정은경,이동원,이하늬 한국고분자학회 2018 한국고분자학회 학술대회 연구논문 초록집 Vol.43 No.2

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017

홍세리,원영주,박영란,정규원,공현주,이은숙,The Community of Population-Based Regional Cancer Registries 대한암학회 2020 Cancer Research and Treatment Vol.52 No.2

Purpose This study reports the cancer statistics and temporal trends in Korea on a nationwide scale, including incidence, survival, prevalence, and mortality in 2017. Materials and Methods The incidence, survival, and prevalence rates of cancer were evaluated using data from the Korea National Cancer Incidence Database from 1999 to 2017 with follow-up until December 31, 2018. Deaths from cancer were assessed using cause-of-death data from 1983 to 2017, obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence, and 5-year relative survival rates were calculated and trend analysis was performed. Results In 2017, newly diagnosed cancer cases and deaths from cancer numbered 232,255 (ASR, 264.4 per 100,000) and 78,863 (ASR, 76.6 per 100,000), respectively. The overall cancer incidence rates increased annually by 3.5% from 1999 to 2011 and decreased by 2.7% annually thereafter. Cancer mortality rates have been decreasing since 2002, by 2.8% annually. The 5-year relative survival rate for all patients diagnosed with cancer between 2013 and 2017 was 70.4%, which contributed to a prevalence of approximately 1.87 million cases by the end of 2017. Conclusion The burden of cancer measured by incidence and mortality rates have improved in Korea, with the exception of a few particular cancers that are associated with increasing incidence or mortality rates. However, cancer prevalence is increasing rapidly, with the dramatic improvement in survival during the past several years. Comprehensive cancer control strategies and efforts should continue, based on the changes of cancer statistics.

Stimulus-responsible echogenic maltodextrin nanoplatform for peripheral arterial disease

홍세리,선세미,양준휘,박미란,이동원 한국고분자학회 2019 한국고분자학회 학술대회 연구논문 초록집 Vol.44 No.1

대학 이러닝 운영을 위한 개념체제

이혜정(李惠貞),최경애(崔京愛),김세리(金世利),홍성연(洪性蓮),홍영일(洪榮一) 서울대학교 교육연구소 2010 아시아교육연구 Vol.11 No.2

대학 이러닝의 양적 확대에 비해 교수자, 학습자, 개발자, 운영자, 기획자 등 대학의 이러닝 관련자들의 만족도 및 질적 체계화에 대한 인식은 여전히 미흡한 수준이다. 이러한 원인 중 하나는 이러닝 체제는 단순히 한 측면으로 이해해서는 안 되는, 총체적, 통합적인 사회적 체제로 이해되어야 함에도 불구하고, 교수자나 개발자, 운영자, 기관장 등 많은 이러닝 관련자들은 직간접적인 자신의 일부 경험만으로 이러닝 전체를 단언하는, 장님 코끼리 만지기의 우를 범하는 경우가 적지 않기 때문이다. 따라서 본 연구는 교수자, 콘텐츠 개발자, 시스템 개발자, 강좌 운영자, 혹은 이러닝 기관장 및 예산 기획을 해야 하는 보직자 등이 이러닝 체제를 이해하고 각 경우의 목적과 상황에 맞는 보다 적절한 기획과 설계를 할 수 있도록, 큰 그림으로서의 개념체제를 제공하고자 하는 목적에서 수행되었다. 먼저 "구조화"와 "대인 상호작용"이라는 두 축을 기준으로 대학 이러닝의 교수-학습 유형을 분류하기 위한 개념적 준거를 제안한 후, 이를 바탕으로 하여 콘텐츠 개발 및 강좌 운영 차원에서 접근한 대학 이러닝 운영을 위한 개념체제를 도출하였다. 콘텐츠 개발 유형은 재사용, 텍스트, 강의녹화(VOD), 멀티미디어 자료, 강의녹화와 멀티미디어 자료의 혼합, WBI, 비디오/오디오 강의, 비디오/오디오 강의와 멀티미디어 자료 등 8가지 유형으로, 강좌 운영 방식은 자율학습, 안내된 자율학습, 관리형 상호작용 학습, 학습촉진형 상호작용 학습 등 4가지 유형으로 분류되었다. 전 과정은 대학 이러닝 전문가들로 구성된 초점집단회의와 전문가 타당화 과정을 거쳤으며, 이렇게 도출된 개념체제를 현실에 보다 쉽게 적용할 수 있도록 강좌 목적에 따른 이러닝 개발 및 운영 유형의 예를 제시하였다. 본 연구는 대학의 이러닝 체제를 체계적으로 조직하고자 할 때, 이러닝 도입 목적에 따른 콘텐츠 개발 유형과 강좌 운영 방식을 가늠할 수 있도록 개념적 이해의 틀과 이를 기반으로 구체적인 실행 계획을 세울 수 있는 시사점을 제공할 것으로 기대된다. The purpose of this research is to develop a conceptual framework for e-Learning in higher education. First, on the theoretical basis of "structure" and "interpersonal interaction", the framework of "e-learning contents development types" and "course management types" were developed and verified. Then, according to the university"s goal from e-learning, certain e-learning contents types and course management types were suggested from this conceptual framework. Research methods were previous literature analysis, focus group interviews, and experts verification. As results, e-learning content development types include [reuse / text / VOD / multimedia / VOD & multimedia / WBI] for asynchronous mode and [video conference / video conference & multimedia] for synchronous mode. Course management types include [self free learning mode, admin (login only mode), managerial tutoring mode, and highly interactive academic tutoring mode]. Depending on the purpose of each institute to adopt e-learning, such as highly advanced expert re-education, or popular general education for lifelong learning, or credit courses within a university or for interuniversity exchange program, the university can choose their own e-learning contents development types and course management types upon the conceptual framework developed in this research.

비소세포폐암 환자의 재발 예측을 위한 흉부 CT 영상 패치 기반 CNN 분류 및 시각화

마세리,안가희,홍헬렌 (사)한국컴퓨터그래픽스학회 2022 컴퓨터그래픽스학회논문지 Vol.28 No.1

Non-small cell lung cancer (NSCLC) accounts for a high proportion of 85% among all lung cancer and has a significantly higher mortality rate (22.7%) compared to other cancers. Therefore, it is very important to predict the prognosis after surgery in patients with non-small cell lung cancer. In this study, the types of preoperative chest CT image patches for non-small cell lung cancer patients with tumor as a region of interest are diversified into five types according to tumor-related information, and performance of single classifier model, ensemble classifier model with soft-voting method, and ensemble classifier model using 3 input channels for combination of three different patches using pre-trained ResNet and EfficientNet CNN networks are analyzed through misclassification cases and Grad-CAM visualization. As a result of the experiment, the ResNet152 single model and the EfficientNet-b7 single model trained on the peritumoral patch showed accuracy of 87.93% and 81.03%, respectively. In addition, ResNet152 ensemble model using the image, peritumoral, and shape-focused intratumoral patches which were placed in each input channels showed stable performance with an accuracy of 87.93%. Also, EfficientNet-b7 ensemble classifier model with soft-voting method using the image and peritumoral patches showed accuracy of 84.48%. 비소세포폐암(NSCLC)은 전체 폐암 중 85%의 높은 비중을 차지하며 사망률(22.7%)이 다른 암에 비해 현저히 높은 암으로비소세포폐암 환자의 수술 후 예후에 대한 예측은 매우 중요하다. 본 연구에서는 종양을 관심영역으로 갖는 비소세포폐암환자의 수술 전 흉부 CT 영상 패치의 종류를 종양 관련 정보에 따라 총 다섯 가지로 다양화하고, 이를 입력데이터로 갖는사전 학습 된 ResNet 과 EfficientNet CNN 네트워크를 사용하여 단일 모델과 간접 투표 방식을 이용한 앙상블 모델, 그리고3 개의 입력 채널을 활용한 앙상블 모델에서의 실험 결과 및 성능을 오분류의 사례와 Grad-CAM 시각화를 통해 비교분석한다. 실험 결과, 종양 주변부 패치를 학습한 ResNet152 단일 모델과 EfficientNet-b7 단일 모델은 각각 87.93%와81.03%의 정확도를 보였다. 또한 ResNet152 에서 총 3 개의 입력 채널에 각각 영상 패치, 종양 주변부 패치, 형상 집중 종양내부 패치를 넣어 앙상블 모델을 구성한 경우에는 정확도 87.93%를, EfficientNet-b7 에서 간접 투표 방식으로 영상 패치와종양 주변부 패치 학습 모델을 앙상블 한 경우에는 정확도 84.48%를 도출하며 안정적인 성능을 보였다.

국가암검진사업에서 디지털 유방촬영술의 현황과 과제

송수연,홍세리,전재관 대한영상의학회 2021 대한영상의학회지 Vol.82 No.1

국가암검진사업에서 매년 400만 명 이상의 여성이 유방촬영술을 이용한 유방암 검진을 받고있다. 2000년 디지털 유방촬영술의 도입 이후, 선행 연구들에 의하면 디지털 유방촬영술은치밀유방을 가진 여성에서 제한적으로 기존의 필름 방식 또는 computed radiography (이하 CR)보다 높은 진단 정확도를 보고하였다. 최근 국가암검진사업에서 수행된 자료를 분석한 결과에 따르면 디지털 유방촬영술의 진단 정확도가 필름 또는 CR 방식에 비해서 치밀유방을 가진 여성뿐만 아니라 모든 연령대의 여성에서 검진 횟수와 상관없이 보다 정확하였다. 우리나라는 OECD 국가 중에서도 높은 유방촬영기기 보급률에도 불구하고 현재 디지털 유방촬영기기의 보급은 전체 유방촬영기기 중, 35% 정도 수준으로 더디기만 하다. 디지털 유방촬영기기로의 신속한 전환을 위하여 수가제도의 개선, 유방 영상 판독 교육 지원 등 관련법과 제도의 정비가 필요할 것이다. 아울러 국가암검진사업에서 보다 많은 여성이 디지털 유방촬영기기를 이용한 유방암 검진을 받을 수 있도록 장비 보급의 지역 간 격차 해소를 위해노력해야 할 것이다. More than 4 million women undergo breast cancer (BC) screening with mammography each year in Korea. Digital mammography (DM) was introduced in 2000, and it has been reported to have a higher diagnostic accuracy than screen-film mammography (SFM) or computed radiography (CR) in women with dense breasts. According to a study using data from the National Cancer Screening Program for BC, the diagnostic accuracy of DM was higher than those of SFM and CR, regardless of age, breast density, and screening round. Currently, despite high supply rate among OECD countries, the distribution of DM equipment is approximately 35% in Korea. For quick replacement with DM, it will be necessary to improve its fee for the National Health Insurance and support an educational program for radiologists. In addition, efforts should be made to increase the accessibility of DM.

Comparison of Digital and Screen-Film Mammography for Breast-Cancer Screening: A Systematic Review and Meta-Analysis

송수연,박보영,홍세리,김민정,이은혜,전재관 한국유방암학회 2019 Journal of breast cancer Vol.22 No.2

Purpose: Digital mammography (DM) has replaced screen-film mammography (SFM). However, findings of comparisons between the performance indicators of DM and SFM for breast-cancer screening have been inconsistent. Moreover, the summarized results from studies comparing the performance of screening mammography according to device type vary over time. Therefore, this study aimed to compare the performance of DM and SFM using recently published data. Methods: The MEDLINE, Embase, and Cochrane Library databases were searched for paired studies, cohorts, and randomized controlled trials published through 2018 that compared the performance of DM and SFM. All studies comparing the diagnostic accuracy of DM and SFM in asymptomatic, average-risk women aged 40 years and older were included. Two reviewers independently assessed the study quality and extracted the data. Results: Thirteen studies were included in the meta-analysis. The pooled sensitivity (DM, 0.76 [95% confidence interval {CI}, 0.70–0.81]; SFM, 0.76 [95% CI, 0.70–0.81]), specificity (DM, 0.96 [95% CI, 0.94–0.97]; SFM, 0.97 [95% CI, 0.94–0.98]), and area under the receiver-operating characteristic curve (DM, 0.94 [95% CI, 0.92–0.96]; SFM, 0.92 [95% CI, 0.89–0.94]) were similar for both DM and SFM. The pooled screening performance indicators reinforced superior accuracy of full-field DM, which is a more advanced type of mammography, than SFM. The advantage of DM appeared greater among women aged 50 years or older. There was high heterogeneity among studies in the pooled sensitivity, specificity, and overall diagnostic accuracy estimates. Stratifying by study design (prospective or retrospective) and removing studies with a 2-year or greater follow-up period resulted in homogeneous overall diagnostic accuracy estimates. Conclusion: The breast-cancer screening performance of DM is similar to that of SFM. The diagnostic performance of DM depends on the study design, and, in terms of performance, full-field DM is superior to SFM, unlike computed radiography systems.