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Gender differences in awareness and practices of cancer prevention recommendations in Korea:
a cross-sectional survey
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Yoonjoo Choi, Naeun Kim, Jin-Kyoung Oh, Yoon-Jung Choi, Bohyun Park, Byungmi Kim
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Epidemiol Health. 2025;47:e2025003. Published online January 15, 2025
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DOI: https://doi.org/10.4178/epih.e2025003
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Summary
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Abstract
OBJECTIVES
Gender is a major determinant of health behaviors that influences cancer prevention awareness and practices. This study investigated the relationship of the awareness and practice rates of cancer prevention recommendations with gender and socioeconomic status.
METHODS We used data from the Korean National Cancer Prevention Awareness and Practice Survey (2023). The sample included 4,000 men and women aged 20-74 years. We conducted multiple logistic regression analyses to evaluate associations with the awareness and practices of cancer prevention, and a joinpoint regression analysis using age-standardized rates to analyze trends in awareness and practice rates from 2007 to 2023.
RESULTS The awareness rates were 79.4% and 81.2% for men and women, respectively. The overall practice rates were substantially lower (43.1% for men and 48.9% for women). For men, awareness rates did not differ significantly by socio-demographic characteristics, but practice rates increased with age (20-29: 15.9%; 60-74: 53.8%). For women, both awareness (20-29: 73.0%; 60-74: 85.7%) and practice (20-29: 16.8%; 60-74: 67.5%) rates increased with age. The easiest recommendations to follow were “reducing salt intake and avoiding burnt or charred foods” (men: 29.9%; women: 28.4%), whereas the most difficult recommendation was “engaging in regular physical activity” (men: 32.5%; women: 34.4%).
CONCLUSIONS While awareness of cancer prevention recommendations was high, the practice of these recommendations was low. Gender influenced changes in awareness and practice rates over time, reflecting a large gap in practice. Future research should explore appropriate intervention points for cancer prevention practices and the development of more effective cancer prevention policies.
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Summary
Korean summary
암 예방에 대한 인식은 남녀 모두 높은 수준이었으나, 실천에서는 성별 차이가 크게 나타났다.
효과적인 암 예방 정책 수립을 위해 성별에 따른 실천 격차를 고려한 전략이 필요하다.
Key Message
Many factors influence cancer prevention awareness and practice, and gender is a crucial determinant of health behaviour in general. This study found that while awareness was reasonably high among both men and women, there was a signifi- cant gender gap in practice. Given the variation in health behaviours by gender, further evaluation of gender effects is nec- essary to inform future policy interventions aimed at improving cancer prevention practices.
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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
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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
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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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Summary
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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
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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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Summary
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Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021
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Jin-Kyoung Oh, Eunjung Park, Byungmi Kim, Yoon-Jung Choi, E Hwa Yun, Min Kyung Lim, Jeong-Soo Im, Eun Young Park
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Epidemiol Health. 2022;44:e2022068. Published online August 26, 2022
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DOI: https://doi.org/10.4178/epih.e2022068
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9,729
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159
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5
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6
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
This study reports data regarding the awareness and practice of cancer prevention among Koreans in 2021 and behavioral changes during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS We collected Cancer Prevention Awareness and Practice Survey data through face-to-face interview surveys using a structured questionnaire completed by 4,000 randomly selected men and women aged between 20 years and 74 years in 17 provinces. We examined the awareness and practice of 10 cancer prevention recommendations and evaluated their associations with potential risk factors through multiple logistic regression analysis adjusted for age, gender, residence, marital status, education, and income.
RESULTS Eighty percent of participants knew that cancer is preventable, while 45% practiced cancer prevention. Cancer prevention practice tended to be more common among older participants (adjusted odds ratio [aOR], 1.39 per 10-year increment; 95% confidence interval [CI], 1.29 to 1.49) and less common among rural inhabitants (aOR, 0.66; 95% CI, 0.51 to 0.86) than among urban residents and among single people (aOR, 0.55; 95% CI, 0.45 to 0.66) than among married people. Practices were the highest for avoiding burned or charred foods (87.6%) and lowest for vaccination against human papillomavirus (14.5%). Refusal to follow recommendations was most common for avoiding alcohol consumption (7.9%). The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).
CONCLUSIONS The awareness of cancer prevention was high, but the practice was low. Recommendations targeting awareness and practice need to be further promoted.
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Summary
Korean summary
2021년 국민 암예방 인식 및 실천행태 조사에 따르면, 국민의 80%는 암이 예방 가능하다는 사실을 알고 있으나, 45%만이 암예방을 위한 건강생활을 실천하고 있음. 암예방수칙 중 가장 지키기 어려운 항목으로는 ‘운동하기’(57.7%)를 꼽았고, 그 다음으로 ‘건강체중 유지하기’(46.1%)와 ‘소량음주도 피하기’(40.1%)순으로 나타났음. 코로나19 유행으로 인한 가장 흔한 변화는 운동 감소(32.5%)와 체중 증가(25.6%)로 나타났음.
Key Message
According to the data collected from the Cancer Prevention Awareness and Practice Survey in 2021, 80% of participants knew that cancer is preventable, while 45% practiced cancer prevention. The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).
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Citations
Citations to this article as recorded by  - A comparative study of health behaviors in adult male cancer survivors and the general male population in Korea: from the Korea national health and nutrition examination survey VII-VIII (2016–2021)
Hyein Jung, Yoonjoo Choi, Byungmi Kim
Supportive Care in Cancer.2025;[Epub] CrossRef - Gender differences in awareness and practices of cancer prevention recommendations in Korea:
a cross-sectional survey
Yoonjoo Choi, Naeun Kim, Jin-Kyoung Oh, Yoon-Jung Choi, Bohyun Park, Byungmi Kim
Epidemiology and Health.2025; 47: e2025003. CrossRef - Risk Factors of Gastric Cancer and Lifestyle Modification for Prevention
Kwang-Pil Ko
Journal of Gastric Cancer.2024; 24(1): 99. CrossRef - Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef - Imposing stragies for health promotion fund for alcohol
Kwang Wook Koh, Hye Sook Kim, Seong Hyun Koh
Korean Journal of Health Education and Promotion.2023; 40(4): 45. CrossRef - Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
Epidemiology and Health.2023; 45: e2023092. CrossRef
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Association between weekly fruit and vegetable consumption and depressive symptoms: results from the Korean Elderly Environmental Panel study
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Youjeong Yuk, Chae-Rin Han, Yoonyoung Jang, Yun-Chul Hong, Yoon-Jung Choi
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Epidemiol Health. 2021;43:e2021029. Published online April 20, 2021
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DOI: https://doi.org/10.4178/epih.e2021029
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15,937
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393
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6
Web of Science
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6
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
Although previous studies have investigated the correlation between fruit and vegetable consumption and depression, the results remain inconclusive. The present study aimed to investigate the association between weekly fruit and vegetable consumption and depressive symptoms in elderly Koreans.
METHODS A multiple covariate linear regression analysis was performed using the data of 1,226 elderly individuals ≥ 60 years of age who participated in the Korean Elderly Environmental Panel II study from 2012 to 2014. Depressive symptoms were evaluated using the Korean version of the Short form Geriatric Depression Scale (SGDS-K). Generalized linear mixed-effects models were constructed to analyze the repeated measurements of 305 people who participated in the survey every year.
RESULTS After adjusting for confounders, SGDS-K scores were negatively associated with the frequency of weekly fruit consumption as follows (β [95% confidence interval; CI]: -0.17 [-0.28 to -0.05], -0.17 [-0.27 to -0.07], -0.42 [-0.54 to 0.29], and -0.33 [-0.44 to -0.21]) for less than 1 time/wk, 1-3 times/wk, 4-6 times/wk, and daily, respectively, compared to no consumption. The SGDS-K scores were also negatively associated with the frequency of vegetable consumption (β [95% CI]: -0.86 [-1.18 to -0.55], -0.18 [-0.35 to -0.01], -0.36 [-0.53 to -0.18], and -0.15 [-0.29 to 0.00]) in the above order, respectively.
CONCLUSIONS Fruit consumption was inversely associated with depression levels in a dose-dependent manner. Although there was no dose-response relationship between vegetable consumption and the level of depression, it was negatively associated with SGDS-K scores.
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Summary
Korean summary
KEEP-II 데이터를 활용하여 한국 노년층의 주간 과일 및 채소 섭취 빈도와 우울증상 간의 상관관계를 알아보았다. 주중 과일을 섭취하는 빈도와 우울증상의 정도 및 우울증 이환 간에서 음의 상관관계가 있었으며 양반응관계가 나타났다. 채소 섭취 빈도의 경우에는 양반응관계가 나타나지 않았으나 채소 섭취 빈도와 우울증상의 정도 간에 음의 상관관계가 있었다.
Key Message
Weekly fruit consumption frequency was inversely associated with the level of depression in a dose-dependent manner in Korean elderly population who participated in KEEP-II study. Although there was no dose-response relationship between vegetable consumption and the level of depression, vegetable consumption frequency was negatively associated with the level of depression.
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Citations
Citations to this article as recorded by - Digital village construction and depressive symptoms in rural middle-aged and older adults: Evidence from China
Shenwei Wan, Pengfei Zhang, Song Chen, Yue Yang
Journal of Affective Disorders.2025; 372: 200. CrossRef - Bidirectional associations between dietary diversity and depressive symptoms in Chinese adult women: A retrospective cohort study
Xiaoqian Dong, Ying Li, Xingxing Wang, Yinglong Duan, Min Liu, Sha Wang, Xue He, Pingting Yang, Yaqin Wang, Jianfei Xie, Andy S.K. Cheng
Journal of Affective Disorders.2024; 351: 683. CrossRef - Regional differences in the effects of healthy aging on depressive symptoms: a Korean longitudinal study of aging (2006–2020)
Soo Jin Kang, Jinseub Hwang, Dohyang Kim, Bongjeong Kim
Frontiers in Public Health.2024;[Epub] CrossRef - Anti-Inflammatory, Antioxidant, and Neuroprotective Effects of Polyphenols—Polyphenols as an Element of Diet Therapy in Depressive Disorders
Anna Winiarska-Mieczan, Małgorzata Kwiecień, Karolina Jachimowicz-Rogowska, Janine Donaldson, Ewa Tomaszewska, Ewa Baranowska-Wójcik
International Journal of Molecular Sciences.2023; 24(3): 2258. CrossRef - Genetic and environmental influences on fruit and vegetable consumption and depression in older adults
Annabel P. Matison, Anbupalam Thalamuthu, Victoria M. Flood, Julian N. Trollor, Vibeke S. Catts, Margaret J. Wright, David Ames, Henry Brodaty, Perminder S. Sachdev, Simone Reppermund, Karen A. Mather
BMC Geriatrics.2023;[Epub] CrossRef - Longitudinal correlates of fruit and vegetable consumption with depressive symptoms among middle-aged and older adults in South Africa
Supa Pengpid, Karl Peltzer
BMC Psychology.2022;[Epub] CrossRef
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The age-standardized incidence, mortality, and case fatality rates of COVID-19 in 79 countries: a cross-sectional comparison and their correlations with associated factors
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Dongui Hong, Sohyae Lee, Yoon-Jung Choi, Sungji Moon, Yoonyoung Jang, Yoon-Min Cho, Hyojung Lee, Sukhong Min, Hyeree Park, Seokyung Hahn, Ji-Yeob Choi, Aesun Shin, Daehee Kang
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Epidemiol Health. 2021;43:e2021061. Published online September 8, 2021
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DOI: https://doi.org/10.4178/epih.e2021061
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26,370
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population.
METHODS The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R<sup>2</sup>). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated.
RESULTS The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R<sup>2</sup> between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly.
CONCLUSIONS Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.
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Summary
Korean summary
국가별 발생률, 사망률, 치명률을 WHO 표준 인구로 연령표준화하였고, 의료자원과 관계된 지표와의 상관관계를 파악하였다. 2021년 4월 6일 기준, 연령표준화 발생률, 사망률, 치명률이 가장 높은 나라는 각각 체코 (10만명당 14,253명), 멕시코 (10만명당 182명), 멕시코 (6.7%)이며, 60세 이상 노인은 사망률과 치명률이 더 높은 것으로 나타났다. 1인당GDP, 인구당 의사 수, 인구당 병상 수는 발생률과 양의 상관관계가, 치명률과는 음의 상관관계가 있었고 노인에게서는 상관관계가 약하게 나타났다. 코로나바이러스감염증-19로 인한 피해를 최소화하기 위해서 의료자원의 투입과 더불어 노인의 감염예방이 중요할 것이다.
Key Message
The incidence, mortality, and case fatality rates of 79 countries were age-standardized using the WHO standard population. The correlations between the rates and the healthcare resource-related factors were investigated. As of April 6, 2021, the countries with the highest age-standardized incidence, mortality, and case fatality rates were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively; the mortality and case fatality rates were higher among the elderly. GDP per capita, number of hospital beds per population, and number of doctors per population were associated positively with incidence rate, and negatively with case fatality rates: the correlations were weaker among the elderly. To minimize the burden caused by COVID-19, preventing the elderly from infection is important as well as supply of medical resources.
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Citations
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Uwe Riedmann, Alena Chalupka, Lukas Richter, Martin Sprenger, Wolfgang Rauch, Robert Krause, Peter Willeit, Harald Schennach, Bernhard Benka, Dirk Werber, Tracy Beth Høeg, John PA Ioannidis, Stefan Pilz
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Anna K. Porter, Sarah E. Kleinschmidt, Kara L. Andres, Courtney N. Reusch, Ryan M. Krisko, Oyebode A. Taiwo, Geary W. Olsen, Matthew P. Longnecker
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Dongui Hong, Sohyae Lee, Kyu-Won Jung, Aesun Shin
Journal of Health Informatics and Statistics.2023; 48(Suppl 1): S15. CrossRef - Topic and Trend Analysis of Weibo Discussions About COVID-19 Medications Before and After China’s Exit from the Zero-COVID Policy: Retrospective Infoveillance Study
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Journal of Medical Internet Research.2023; 25: e48789. CrossRef - Rapid establishment of a dedicated COVID-19 hospital in Mexico city during a public health crisis
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BMC Infectious Diseases.2022;[Epub] CrossRef - Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019
Jiaye Yu, Zhuo Wang, Qinyi Bao, Shuxin Lei, Yayu You, Zhehui Yin, Xiaojie Xie
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