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3 "Hyunseok Kang"
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Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort
Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung
Epidemiol Health. 2021;43:e2021093.   Published online November 2, 2021
  • 4,995 View
  • 149 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.
Medical use data of colorectal cancer patients were obtained from the Korean National Health Insurance Database from 2004 to 2018. We randomly selected 40% of all colorectal cancer patients (n=148,848). Cognitive impairment was defined as having 1 or more International Classification of Diseases, 10th revision diagnostic codes for dementia or mild cognitive impairment. Patients aged 18 years or younger, patients diagnosed with cognitive impairment before colorectal cancer diagnosis (n=8,225), and patients who did not receive primary resection (n=45,320) were excluded. The effects of individual chemotherapy regimens on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate the overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Landmark analyses with different lag times were conducted as sensitivity analyses.
Chemotherapy did not increase the risk of cognitive impairment in colorectal cancer patients (colon cancer: HR, 0.92; 95% confidence interval [CI], 0.83 to 1.03; rectal cancer: HR, 0.88; 95% CI, 0.75 to 1.04), while radiotherapy was negatively associated with cognitive impairment in rectal cancer patients (HR, 0.01; 95% CI, 0.84 to 0.99). Varying directions of the associations between regimens and cognitive impairment were detected. The adverse effect of certain chemotherapy regimens on cognition was more prominent in older adults.
Chemotherapy and radiotherapy did not increase the risk of cognitive impairment. Older patients with low cognitive reserve could be affected by the adverse cognitive effects of chemotherapy.
Korean summary
- 대장암 환자를 대상으로 한 항암화학요법 및 방사선요법은 인지기능저하의 위험을 높이지 않았다 - 일부 항암화학요법의 경우 고령의 대장암 환자에서 인지기능저하의 위험을 증가시킬 수 있다
Key Message
Results from nationwide cohort of Korea showed that chemotherapy and radiotherapy did not increase the risk of cognitive impairment in colorectal cancer patients.


Citations to this article as recorded by  
  • Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
    Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
    He-Ying Hu, Ya-Ru Zhang, Qiaolifan Aerqin, Ya-Nan Ou, Zuo-Teng Wang, Wei Cheng, Jian-Feng Feng, Lan Tan, Jin-Tai Yu
    Translational Psychiatry.2022;[Epub]     CrossRef
Androgen deprivation therapy is associated with decreased second primary lung cancer risk in the United States veterans with prostate cancer
Kyungsuk Jung, Jong Chul Park, Hyunseok Kang, Johann Christoph Brandes
Epidemiol Health. 2018;40:e2018040.   Published online August 11, 2018
  • 9,658 View
  • 197 Download
  • 3 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
We investigated whether androgen deprivation therapy (ADT) in prostate cancer patients was associated with a decreased risk for second primary lung cancer in US veterans.
Prostate cancer diagnoses in the US Veterans Affairs Cancer Registry between 1999 and 2008 were identified. Use of hormonal therapy and diagnoses of second primary lung cancer were determined from the registry. Synchronous prostate and lung cancers, defined as 2 diagnoses made within 1 year, were excluded from the analysis. Cancer-free survival was estimated using the Kaplan-Meier method and hazard ratios were estimated using Cox proportional hazard models.
Among the 63,141 identified patients with prostate cancer, 18,707 subjects were eligible for the study. Hormonal therapy was used in 38% of patients and the median follow-up period was 28 months. ADT use was associated with longer lung cancer-free survival in prostate cancer patients (log-rank p=0.01). After adjusting for age, race, smoking and prostate cancer stage, ADT use was associated with decreased lung cancer risk by 15, 21, and 24% after 1, 2, and 3 years, respectively.
ADT in prostate cancer patients may be associated with decreased second primary lung cancer risk among US veterans.
Korean summary
비소세포성 폐암이 호르몬 수용체에 의해 영향을 받을 수 있다는 기존의 연구 결과를 바탕으로, 이 연구는 미국 재향 군인 병원 암등록 자료를 분석하여 전립선암 환자 중, 안드로겐 박탈 요법으로 치료를 받은 경우와 그렇지 않은 경우의 비소세포성 폐암 발생율을 비교분석하였다. 분석 결과, 전립선암을 진단받은 미국 재향군인들 중 안드로겐 박탈 요법으로 치료를 받은 환자들이 그렇지 않은 환자들에 비해 비소세포성 폐암 발생율이 통계적으로 유의미하게 감소하는 것이 관찰되었다.
Key Message


Citations to this article as recorded by  
  • Endogenous sex hormones, aromatase activity and lung cancer risk in postmenopausal never‐smoking women
    Yingya Zhao, Yu‐Tang Gao, Xianglan Zhang, Alan L. Rockwood, Mark M. Kushnir, Qiuyin Cai, Jie Wu, Jiajun Shi, Qing Lan, Nathaniel Rothman, Yu Shyr, Xiao‐Ou Shu, Wei Zheng, Gong Yang
    International Journal of Cancer.2022; 151(5): 699.     CrossRef
  • Racial and ethnic differences in risk of second primary cancers among prostate cancer survivors
    Diana R. Withrow, Sara J. Schonfeld, Rochelle E. Curtis, Lindsay M. Morton, Michael B. Cook, Eboneé N. Butler, Amy Berrington de González
    Cancer Causes & Control.2020; 31(11): 1011.     CrossRef
  • Sex steroid metabolism and actions in non-small cell lung carcinoma
    Teeranut Asavasupreechar, Monica S.M. Chan, Ryoko Saito, Yasuhiro Miki, Viroj Boonyaratanakornkit, Hironobu Sasano
    The Journal of Steroid Biochemistry and Molecular Biology.2019; 193: 105440.     CrossRef
Green Tea Consumption and Stomach Cancer Risk: A Meta-Analysis
Hyunseok Kang, Sun Young Rha, Kyung Won Oh, Chung Mo Nam
Epidemiol Health. 2010;32:e2010001.   Published online April 26, 2010
  • 15,172 View
  • 121 Download
  • 27 Citations
AbstractAbstract PDF

Green tea has been suggested to have a chemopreventive effect against various cancers including stomach cancer. The aim of this study is to elucidate the relationship between green tea consumption and stomach cancer risk by meta-analysis.


Eighteen observational studies were identified using MEDLINE, THE COCHRANE LIBRARY, RISS, and a manual search. Summary relative risks/odds ratios (RR/ORs) for the highest versus non/lowest green tea consumption levels were calculated on the basis of fixed and random effect models. Subgroup analyses were used to examine heterogeneity across the studies.


The combined results indicate a reduced risk of stomach cancer with intake of green tea (RR/OR=0.86, 95% CI=0.74-1.00). Subgroup analysis with six studies that reported differences between the highest and lowest consumption levels equal to or greater than five cups/day revealed a statistically significant protective effect (RR/OR=0.68, 95% CI=0.53-0.87).


Green tea appears to play a protective role against the development of stomach cancer. The results also suggest that a higher level of green tea consumption might be needed for a clear preventive effect to appear. This conclusion, however, should be interpreted with caution because various biases can affect the results of a meta-analysis.

Korean summary
Key Message


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    International Journal of Biological Macromolecules.2023; 237: 123991.     CrossRef
  • Pancreatic cancer risk: alcoholic and non-alcoholic beverages
    Irina N. Grigor’eva
    Terapevticheskii arkhiv.2022; 94(2): 265.     CrossRef
  • Diet and gastric cancer risk: an umbrella review of systematic reviews and meta-analyses of prospective cohort studies
    Shu-Jun Liu, Pi-Di Huang, Jia-Min Xu, Qian Li, Jian-Hui Xie, Wen-Zhen Wu, Chen-Tong Wang, Xiao-Bo Yang
    Journal of Cancer Research and Clinical Oncology.2022; 148(8): 1855.     CrossRef
  • Anticarcinogenic potentials of tea catechins
    Xiao-Xiang Li, Chang Liu, Shu-Ling Dong, Can-Song Ou, Jian-Liang Lu, Jian-Hui Ye, Yue-Rong Liang, Xin-Qiang Zheng
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Green tea and cancer and cardiometabolic diseases: a review of the current epidemiological evidence
    Sarah Krull Abe, Manami Inoue
    European Journal of Clinical Nutrition.2021; 75(6): 865.     CrossRef
  • Antimetastatic Properties of Tea Polyphenols
    Niladri Bag, Arundhati Bag
    Nutrition and Cancer.2020; 72(3): 365.     CrossRef
  • Nanoencapsulated dietary polyphenols for cancer prevention and treatment: successes and challenges
    Shams Tabrez, Nasimudeen R Jabir, Vaqar Mustafa Adhami, Mohammad Imran Khan, Mohammed Moulay, Mohammad Amjad Kamal, Hasan Mukhtar
    Nanomedicine.2020; 15(11): 1147.     CrossRef
  • In Search of Panacea—Review of Recent Studies Concerning Nature-Derived Anticancer Agents
    Dawid Przystupski, Magdalena J. Niemczura, Agata Górska, Stanisław Supplitt, Krzysztof Kotowski, Piotr Wawryka, Paulina Rozborska, Kinga Woźniak, Olga Michel, Aleksander Kiełbik, Weronika Bartosik, Jolanta Saczko, Julita Kulbacka
    Nutrients.2019; 11(6): 1426.     CrossRef
  • The Cytoprotective Role of Antioxidants in Mammalian Cells Under Rapidly Varying UV Conditions During Stratospheric Balloon Campaign
    Dawid Przystupski, Agata Górska, Paulina Rozborska, Weronika Bartosik, Olga Michel, Joanna Rossowska, Anna Szewczyk, Małgorzata Drąg-Zalesińska, Paulina Kasperkiewicz, Jędrzej Górski, Julita Kulbacka
    Frontiers in Pharmacology.2019;[Epub]     CrossRef
  • Mechanisms of Phytonutrient Modulation of Cyclooxygenase-2 (COX-2) and Inflammation Related to Cancer
    Shreena J. Desai, Ben Prickril, Avraham Rasooly
    Nutrition and Cancer.2018; 70(3): 350.     CrossRef
  • Green Tea Consumption and the Risk of Liver Cancer: A Meta-Analysis
    Chen-Xu Ni, Hong Gong, Ying Liu, Yang Qi, Chun-Lei Jiang, Jun-Ping Zhang
    Nutrition and Cancer.2017; 69(2): 211.     CrossRef
  • An inverse association between tea consumption and colorectal cancer risk
    Yuetong Chen, Yuan Wu, Mulong Du, Haiyan Chu, Lingjun Zhu, Na Tong, Zhengdong Zhang, Meilin Wang, Dongying Gu, Jinfei Chen
    Oncotarget.2017; 8(23): 37367.     CrossRef
  • Epigallocatechin Gallate Nanodelivery Systems for Cancer Therapy
    Andreia Granja, Marina Pinheiro, Salette Reis
    Nutrients.2016; 8(5): 307.     CrossRef
  • Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study
    Harinakshi Sanikini, Vincent K. Dik, Peter D. Siersema, Nirmala Bhoo-Pathy, Cuno S.P.M. Uiterwaal, Petra H.M. Peeters, Carlos A. González, Raul Zamora-Ros, Kim Overvad, Anne Tjønneland, Nina Roswall, Marie-Christine Boutron-Ruault, Guy Fagherazzi, Antoine
    International Journal of Cancer.2015; 136(6): E720.     CrossRef
  • Methylenetetrahydrofolate reductase (MTHFR) polymorphism susceptibility to schizophrenia and bipolar disorder: an updated meta-analysis
    Cai-Yun Hu, Zhen-Zhong Qian, Feng-Feng Gong, Shan-Shan Lu, Fang Feng, Yi-Le Wu, Hui-Yun Yang, Ye-Huan Sun
    Journal of Neural Transmission.2014;[Epub]     CrossRef
  • Association of Risk of Gastric Cancer and Consumption of Tobacco, Alcohol and Tea in the Chinese Population
    Gui-Xian Tong, Han Liang, Jing Chai, Jing Cheng, Rui Feng, Peng-Lai Chen, Qing-Qing Geng, Xing-Rong Shen, De-Bin Wang
    Asian Pacific Journal of Cancer Prevention.2014; 15(20): 8765.     CrossRef
  • Green Tea Consumption and Risk of Pancreatic Cancer: A Meta-analysis
    Jin-Long Zeng, Zhi-Hua Li, Zhi-Chao Wang, Hai-Liang Zhang
    Nutrients.2014; 6(11): 4640.     CrossRef
  • Tea consumption and the risk of five major cancers: a dose–response meta-analysis of prospective studies
    Feifei Yu, Zhichao Jin, Hong Jiang, Chun Xiang, Jianyuan Tang, Tuo Li, Jia He
    BMC Cancer.2014;[Epub]     CrossRef
  • Evidence-based assessment of proton-pump inhibitors inHelicobacter pylorieradication: A systematic review
    Vinayak Nagaraja
    World Journal of Gastroenterology.2014; 20(40): 14527.     CrossRef
  • Coffee and beverages are the major contributors to polyphenol consumption from food and beverages in Japanese middle-aged women
    Yoichi Fukushima, Takeshi Tashiro, Akiko Kumagai, Hiroyuki Ohyanagi, Takumi Horiuchi, Kazuhiro Takizawa, Norie Sugihara, Yoshimi Kishimoto, Chie Taguchi, Mariko Tani, Kazuo Kondo
    Journal of Nutritional Science.2014;[Epub]     CrossRef
  • Tea consumption and prostate cancer: an updated meta-analysis
    Yi-wei Lin, Zheng-hui Hu, Xiao Wang, Qi-qi Mao, Jie Qin, Xiang-yi Zheng, Li-ping Xie
    World Journal of Surgical Oncology.2014;[Epub]     CrossRef
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    Proceedings of the Japan Academy, Series B.2012; 88(3): 88.     CrossRef
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    Donato F. Romagnolo, Ornella I. Selmin
    Journal of Nutrition in Gerontology and Geriatrics.2012; 31(3): 206.     CrossRef
  • Overview of Methodological Quality of Systematic Reviews about Gastric Cancer Risk and Protective Factors
    Lun Li, Xiang-Ji Ying, Tian-Tian Sun, Kang Yi, Hong-Liang Tian, Rao Sun, Jin-Hui Tian, Ke-Hu Yang
    Asian Pacific Journal of Cancer Prevention.2012; 13(5): 2069.     CrossRef
  • Growth inhibition of Walker carcinosarcoma 256 with alcoholic extract of green tea leaves (Camellia sinensis)
    Mauriclécio Franco Ponte, Thiago Sousa e Silva Targino, Matheus Alves de Lima Mota, José Saul Peixoto Landim, Thyciana Rodrigues Ribeiro, Fabiana Pereira Soares, Márcio Roberto Pinho Pereira, Sônia Leite da Silva, Silvia Fernandes Ribeiro da Silva
    Acta Cirurgica Brasileira.2012; 27(9): 634.     CrossRef
  • Prospective cohort study of tea consumption and risk of digestive system cancers: results from the Shanghai Women's Health Study
    Sarah Nechuta, Xiao-Ou Shu, Hong-Lan Li, Gong Yang, Bu-Tian Ji, Yong-Bing Xiang, Hui Cai, Wong-Ho Chow, Yu-Tang Gao, Wei Zheng
    The American Journal of Clinical Nutrition.2012; 96(5): 1056.     CrossRef
  • What Should be Taken into Consideration for a Meta-Analysis of Green Tea Consumption and Stomach Cancer Risk?
    Jeongseon Kim
    Epidemiology and Health.2010; 32: e2010012.     CrossRef

Epidemiol Health : Epidemiology and Health