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. 2023:45:e2023089.
doi: 10.4178/epih.e2023089. Epub 2023 Oct 12.

Regional disparities in major cancer incidence in Korea, 1999-2018

Affiliations

Regional disparities in major cancer incidence in Korea, 1999-2018

Eun Hye Park et al. Epidemiol Health. 2023.

Abstract

Objectives: This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018.

Methods: The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran's I with a spatial weight matrix based on adjacency or distance.

Results: Regional disparities varied depending on cancer type and gender during the 20-year study period. For men, the regional disparities of stomach, colon and rectum, lung, and liver cancer declined, and those of thyroid and prostate cancer recently decreased, despite an overall increasing incidence. For women, regional disparities in stomach, colon and rectum, lung, liver, and cervical cancer declined, that of thyroid cancer recently decreased, despite an overall increasing incidence, and that of breast cancer steadily increased. In 2014-2018, breast cancer (I, 0.61; 95% confidence interval [CI], 0.53 to 0.70) showed a high probability of cancer clusters in women, and liver cancer (I, 0.48; 95% CI, 0.40 to 0.56) showed a high probability of cancer clusters in men.

Conclusions: Disparities in cancer incidence that were not seen at the national level were discovered at the municipal level. These results could provide important directions for planning and implementing local cancer policies.

Keywords: Epidemiology; Incidence; Korea; Neoplasms; Small-area analysis.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflicts of interest to declare for this study.

Figures

Figure 1.
Figure 1.
National and regional incidence of major cancers (A) stomach, (B) colon and rectum, (C) lung, (D) thyroid, (E) liver, (F) breast, (G) prostate, and (H) cervix uteri among Koreans, 1999-2018. The national incidence is represented by a diamond shape, while the regional incidence is depicted as a boxplot. The median of the regional incidence is marked by a line within the box. The box representing the interquartile range illustrates the middle 50% of regions, demonstrating the distance between the first and third quartiles (Q3-Q1). The numbers displayed in the graph represent age-standardized incidence rates per 100,000.
Figure 2.
Figure 2.
Municipal-level incidence of major cancers (A) stomach, (B) colon and rectum, (C) lung, (D) thyroid, (E) liver, (F) breast, (G) prostate, and (H) cervix uteri among Koreans in 2014-2018.
Figure 3.
Figure 3.
Distance-based global Moran’s I of major cancers (A) stomach, (B) colon and rectum, (C) lung, (D) thyroid, (E) liver, (F) breast, (G) prostate, and (H) cervix uteri incidence among Koreans in 2014-2018. All values are statistically significant, except for those shaded in black. I>0 indicates a clustering of areas with similar high or low values. I=0 denotes no spatial autocorrelation or complete spatial randomness. I<0 indicates neighboring areas that have dissimilar values, like a chessboard pattern.

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