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Preventable cancer cases and deaths attributable to tobacco smoking in Korea from 2015 to 2030
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Soseul Sung, Jihye An, Jeehi Jung, Hyeon Sook Lee, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seung-Ho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Daehee Kang, Keun-Young Yoo, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Hai-Rim Shin, Kwang-Pil Ko, Sue K. Park
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Epidemiol Health. 2025;e2025008. Published online February 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025008
[Accepted]
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Abstract
OBJECTIVES
Tobacco smoking is a major public health concern worldwide. This study aimed to assess its impact on cancer incidence and mortality by estimating the population attributable fraction (PAF) in the Korean population for 2015 and 2020 and by projecting future trends until 2030.
METHODS The Korean relative risk (RR) was calculated via a meta–analysis of RRs for individual cancers attributed to tobacco smoking, based on primary data analysis from the Korean Cohort Consortium. The PAF was estimated using the Levin formula with past and current prevalence rates and the number of cancer cases and deaths, assuming a 15–year latency period.
RESULTS The proportions of cancer cases and deaths in Korea attributable to tobacco smoking were similar to those calculated using Asian and global RRs for both men and women. In 2015 and 2020, tobacco smoking contributed to 14.32% and 13.17% of cancer cases and 21.70% and 20.69% of cancer deaths in adults, respectively. Among Koreans, smoking was responsible for 25.83% of new cancer cases in men in 2015, 23.49% in men in 2020, 1.46% in women in 2015, and 1.68% in women in 2020. In both years, smoking impacted mortality more strongly than incidence in Korean men and women (incidence in men: 25.83% and 23.49%; mortality in men: 32.09% and 30.41%; incidence in women: 1.46% and 1.68%; and mortality in women: 4.70% and 4.96%, respectively).
CONCLUSIONS Tobacco smoking causes cancers and deaths in Korea, however, it is preventable. Effective control policies that consider trends and vulnerabilities among women are required.
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Summary
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Preventable cancer cases and deaths attributable to alcohol consumption in Korea from 2015 to 2030
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Soseul Sung, Jihye An, Jeehi Jung, Hyeon Sook Lee, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seung-Ho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Kwang-Pil Ko, Sue K. Park
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Epidemiol Health. 2025;e2025009. Published online February 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025009
[Accepted]
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Abstract
OBJECTIVES
Alcohol consumption is causally linked to several cancers, and major health organizations classify it as a carcinogen. This study assessed the impact of alcohol consumption on cancer incidence and mortality in Korea in 2015 and 2020, projected trends up to 2030, and compared results based on different criteria.
METHODS The relative risk of cancer associated with alcohol consumption in Korea was determined through a meta–analysis of alcohol–related relative risks for specific cancers, using primary data from the Korean Cohort Study within the Korean Cohort Consortium. The population–attributable fraction (PAF) was calculated using Levin's formula, incorporating drinking prevalence and the number of cancer cases and deaths, with a 15–year latency period assumed.
RESULTS In Korea, the PAF for alcohol consumption, based on ever/never drinking criteria, was higher than that calculated using other criteria, except for the PAF based on past and current/never drinking criteria. Alcohol consumption contributed to 3.58% of all cancer cases and 3.28% of cancer deaths in 2015. It accounted for 4.58% of new cancer cases in men and 2.08% in women, with a higher contribution to incidence than mortality (4.00% and 2.25% of cancer deaths in men and women, respectively). Projections indicate that alcohol–related cancer PAF will decrease by 17.2% in men but increase by 70.2% in women by 2030.
CONCLUSIONS This study highlights the impact of alcohol consumption on cancer in Korea, emphasizing the need for sex–specific regulations to address sex differences.
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Preventable cancer cases and deaths attributable to deficit of physical activity in Korea from 2015 to 2030
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Soseul Sung, Sungji Moon, Jihye An, Jeehi Jung, Hyeon Sook Lee, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Inah Kim, Jung Eun Lee, Sun Ha Jee, Aesun Shin, Ji-Yeob Choi, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seung-Ho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Jeong-Soo Im, Hong Gwan Seo, Sohee Park, Kwang-Pil Ko, Sue K. Park
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Epidemiol Health. 2025;e2025010. Published online February 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025010
[Accepted]
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Abstract
OBJECTIVES
This study aimed to determine the population–attributable fractions (PAFs) of cancers using various calculation methods and to estimate the PAFs of cancer incidence and mortality resulting from deficit in physical activity (DPA) from 2015 to 2030, based on data on prevalence rates.
METHODS The PAF of cancer was estimated using a cohort study–based meta–analysis of relative risk (RR), national prevalence rates of DPA from 2000 to 2015, and national cancer statistics from 2015 to 2030, with a latency of 15 years.
RESULTS In 2015, DPA contributed to 909 cancer cases and 548 deaths, accounting for 0.42% and 0.68% of new cancer cases and deaths, respectively. By 2030, the PAF values are expected to increase to 1.31% of incidence and 1.80% of mortality, with a continual increase from 2015 to 2030. When the low metabolic equivalent of task (MET) criteria were selected, the PAF values decreased for both incidence and mortality. The PAF calculated with <900 MET–min/week for the sex–specific MET criterion was higher than that calculated with <900 MET–min/week for both incidence and mortality.
CONCLUSIONS The risk of cancer associated with DPA is expected to rise in both men and women. Future research and strategies should emphasize the promotion of physical activity for cancer prevention, considering its significant implications for public health.
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Regional disparities in major cancer incidence in Korea, 1999-2018
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Eun Hye Park, Mee Joo Kang, Kyu-Won Jung, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Hyun-Joo Kong, Chang Kyun Choi, Jeong-Soo Im, Hong Gwan Seo, The Community of Population-Based Regional Cancer Registries
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Epidemiol Health. 2023;45:e2023089. Published online October 12, 2023
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DOI: https://doi.org/10.4178/epih.e2023089
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Abstract
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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.
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Summary
Korean summary
이 연구는 한국 시군구 단위에서 지난 20년(1999-2018)간 주요 8개 암 발생률의 지역 간 격차를 조사하고, 최근 5년(2014-2018)의 암 발생 군집 가능성을 평가했습니다.
지역 간 격차는 여성에서 갑상선암, 남성에서는 폐암이 가장 큰 격차를 보였습니다. 군집 가능성은 여성의 경우 유방암, 남성의 경우 간암에서 가장 높았습니다.
전국 단위에서는 볼 수 없었던 지역 간 격차 및 군집 발생 가능성이 시군구 단위에서 발견되었고, 이러한 결과는 지역에 맞는 암 정책을 기획하고 실행하는 데 중요한 방향을 제시할 수 있을 것입니다.
Key Message
This study investigated regional disparities in the incidence of eight major cancers in Korea at the municipal level during 1999-2018 and assessed the possibility of cancer clusters during 2014-2018.
Thyroid cancer in women and lung cancer in men showed the most significant regional disparities. Breast cancer in women and liver cancer in men displayed the highest possibility of clustering.
Regional disparities and cancer clusters were identified locally, which were not detected nationally. These findings could provide valuable guidance for developing and implementing cancer policies that are tailored to local needs.
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Citations
Citations to this article as recorded by  - Hormone Replacement Therapy and Risks of Various Cancers in Postmenopausal Women with De Novo or a History of Endometriosis
Hee Joong Lee, Banghyun Lee, Hangseok Choi, Minkyung Lee, Kyungjin Lee, Tae Kyoung Lee, Sung Ook Hwang, Yong Beom Kim
Cancers.2024; 16(4): 809. CrossRef - What is the relationship between the local population change and cancer incidence in patients with dyslipidemia: Evidence of the impact of local extinction in Korea
Wonjeong Jeong, Dong‐Woo Choi, Woorim Kim, Kyu‐Tae Han
Cancer Medicine.2024;[Epub] CrossRef
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Application of Epidemiology to the Tobacco Lawsuit Cases in KOREA.
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Hong Gwan Seo, Hyung Joon Jhun
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Korean J Epidemiol. 2005;27(2):20-27.
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Over the half of last century, epidemiology has witnessed that tobacco causes lung cancer. Therefore, lung cancer lawsuits against tobacco companies have been raised in many countries. However, a discrepancy between epidemiology dealing with population-based causal association and lawsuit dealing with individual-based evidence has happened. This article discusses application of epidemiology to the tobacco lawsuit cases in Korea. Epidemiological studies such as double blind randomized controlled clinical trials and cohort studies give clinicians important information on decision-making for the treatment of an individual patient and predicting prognosis. Epidemiological data have also been applied to the diagnosis of a worker's claim on occupational disease or work-related disorder. Illegality is generally recognized in the court when direct causal relationship between offending action(s) and damage(s) is proved and the damaged must prove illegality of the offender(s). The probability theory was emerged to reduce the responsibility especially when a plaintiff has a difficulty in proving causal relationship and illegality due to long-term duration or complexity or poor condition of the plaintiff such as environmental lawsuit cases. In relation to the probability theory, a theory was raised that a causal relationship is proved legally if an epidemiological causal relationship between offending action(s) and damage(s) is proved. Based on these evidences and theories, we show our opinion that epidemiological data are applicable to the individuals such as tobacco lawsuit cases in Korea.
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