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Current Status of Multicenter Cancer Cohort Study with Biological Materials Bank in Korea.
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Keun Young Yoo, Hai Rim Shin, Song Hun Chang, Jung Myung Choi, Chang Yup Kim, Kun Sei Lee, Won Jin Lee, Dae Hee Kang, Bu Ok Lee, Duck Hee Lee, Sue Kyung Park, Joo Hon Sung, Yeong Su Ju, Dae Sung Kim, Jong Won Kang, Soo Hun Cho
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Korean J Epidemiol. 1998;20(2):275-278.
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Abstract
This cohort study is a collaborative effort of 8 institutions. The goal is to establish a large scale cohort that can be followed for 10 or more years to assess the relationship between life-styles and cancer occurrence, and to evaluate the role of environmental exposures in the development of six major sites of cancers(stomach, liver, lung, colorectum, uterine cervix and female breast) in the rural population. Since 1993, 11,304 men and women aged over 35 living in four areas have been recruited. The number of target population is 30,000 persons, which is expected to be successfully recruited until 1999. Each subject has completed a detailed questionnaire on general life-styles, reproductive factors, and agricultural chemical exposures through the interview. Anthropometric measurements with body fat composition and the routine clinical laboratories were examined. For the cancer-free cohort, physical examination by the physicians and serologic tests for hepatitis markers, some tumor markers, and lipid profile have been done, but not all. In order to provide an opportunity to incorporate barious biomarkers of exposure and effect as well as genetic susceptibility, a biologic tissue bank has been established from blood and urine sample(plasma, WBC buffy-coat, RBC clots, and urine supernatant) stored at-70degrees C.
Re-examination of changes in exposere to risk factors will be done periodically. Disease occurrence will be ascertained by the active(mainly through diagnosis by physicians) and the passive surveillance(through both death certificate and screening of medical utilization records).
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Years of Life Lost(YLL) and Health Priority in Korea.
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Joo Hon Sung
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Korean J Epidemiol. 1997;19(2):200-209.
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Abstract
BACKGROUND
A national burden of disease estimation enables priority setting in health policy, baseline and post hoc evaluation of public health service. But, lack of elementary statistics had kept it from having been fully appraised in Korea. Years of life lost(YLL) due to premature death of 1995 was estimated from National Death Certificate data.
This study was launched as necessary step for assessing global burden of disease(GBD)which will include years lived with disability (YLD) and disabillity-adjusted life year(DALY).METHODS National Death Certificate data in 1995 and 1991 were available with individual information. Diseases classification system suggested by GBD researchers were modified into 60 entities, reflecting death pattern in Korea. Some tropical, infectious, non-fatal conditions were combined and occupational injury category was newly defined.
Potential years of life lost (PYLL) to 60-85 years by 5 years, death rate, standard expected years of life lost(SEYLL) were calculated according to new disease categories.RESULTS Cancer followed by traffic accident and Cardiovascular disease was the most important cause of PYLL and SEYLL by 24 categories classification, and traffic accident (TA) contributes by far the largest part of PYLL and SEYLL by 60 categories classification. SEYLL is thought to be a better single index for YLL, and 20 leading causes of SEYLL were calculated (by 60 categories). Such entities as self injury, leukemia, congenital anomaly, occupational injury among 20 leading causes showed discrepancy between relatively low death rate and larger YLLs.CONCLUSION TA, stomach, liver, lung cancers, cerebrovascular attacks, chronic liver diseases, cardiovascular diseases still shows high death rate and enormous YLLs. The importance of controling them cannot be over-emphasized. Diseases with larger YLLs and lower death rate should be reassessed and attentioned in view of public health promotion. This study could be a basis for health policy making and reference of further studies.
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The Relationship Between Cholesterol Level and Mortality in Korean Women.
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Yun Mi Song, Joo Hon Sung, Jai Jun Byeon, Joung Soon Kim, Oh Young Park
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Korean J Epidemiol. 1997;19(2):131-146.
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Abstract
BACKGROUND
There were many efforts to evaluate the relationship between cholesterol and mortality. But almost all of them have been performed on male western people who have higher mean cholesterol concentration than oriental people and have different disease pattern from women's. So, upto now, the relationship of cholesterol to mortality in women with low cholesterol concentration was not well known.
We carried out this study to investigate the relationship in Korea women whose mean cholesterol level was lower than that of western people and men.METHOD Study subjects included in were 100,363 Korean women aged 30-65 years. They undertook multiphasic health examination provided by Korea Medical Insurance Corporation between March 1990 and July 1990, and had no history of cancer and no significant medical illnesses which could change blood cholesterol level. Study subjects were followed for 5.5 years until December 1995 and it was determined whether each subject was dead or alive using the mortality data from the Korea National Statistical office and the Korea Medical Insurance Corporation. Nonlinear ralationship between serum total cholesterol and mortality was investigated with the use of quadratic regression and with dummy variables using the 158-180mg/dl group as the comparison group. To analyzing the relationship between cholesterol concentra-tion and mortality with controlling for age, smoking, alcohol drinking, exercise, diastolic blood pressure, body mass index, pay level, Cox propor-tional hazard model was used.RESULT During the follow-up period, there were 369 deaths.
Mean cholesterol concentration of study subjects was 182.8mg/dl There was no significant association between serum cholesterol and total mortality, but women with cholesterol concentrations below 130mg/dl showed slightly increased risk of death(RR=1.20). Cholesterol had an inverse relationship with mortality from stroke, and women with cholesterol concentrations below 130mg/dl had higher risk of death from stroke(RR=3.28). Although there was no statistical significance,risk of mortality from hemorrhagic stroke in women with very low cholesterol concentration was markedly higher than in women with cholesterol concentrations above 130mg/dl. Mortality relationship with cholesterol. And women with cholesterol concentrations higher than 203mg/dl had abruply increased risk for death from ischemic heart disease.CONCLUSION Through this study, we could observe an inverse J shaped relationship between cholesterol concentration and mortality in Korean women. The increased risk of mortality from hemorrhagic stroke in people with very low cholesterol concentration supports the previous report which proposed low cholesterol level as a significant risk factor of hemorrhagic stroke. In spite of the lack of statistical signi-ficance, greately increased risk of mortality from ischemic heart disease in people with cholesterol higher than 203mg/dl suggests that cholesterol concentration at the upper end of distribution can be a significant risk factor of ischemic heart disease in women.
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