Trend of Disease Burden of North Korean Defectors in South Korea Using Disability-adjusted Life Years from 2010 to 2018

BackgroundThis study aimed to examine the disease burden of North Korean defectors in South Korea by sex, age, and disease from 2000 to 2018 and to study the changes in the disease burden over time.MethodsBased on the incidence-based disability-adjusted life year (DALY) developed in a Korean National Burden of Disease (KNBD) study, we calculated the years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) for approximately 22,753 North Korean defectors in South Korea whose claims data were available from the National Health Insurance Service (NHIS).ResultsIn 2018, the rates of YLL, YLD, and DALY for North Korean defectors per 100,000 population was 3,763 (male 8,491; female 2,404), 37,683 (male 27,742; female 40,539), and 41,446 (male 36,233; female 42,943), respectively. Major depressive disorders constituted the highest DALY, followed by cirrhosis of the liver and low back pain. The disease burden of North Korean defectors consistently decreased from 2010 to 2018. The decrease in YLD contributed to the overall decline in DALY per 100,000 population in 2018, which decreased by 25.2% compared to that in 2010.ConclusionThis is the first study to measure the disease burden of North Korean defectors in South Korea. Given the decreasing or substantially increasing trends in disease burden, it is necessary to establish appropriate public health policies in a timely manner, and the results of this study provide a basis for the development of customized public health and healthcare policies for North Korean defectors in South Korea.     

Burden of cancer in Serbia

Aim

To provide a comprehensive assessment of burden of selected cancers in Serbia.

Method

We calculated disability adjusted life years (DALY) – the sum of the years of life lost (YLL) from premature mortality and the years lived with disability (YLD) – for cancers of stomach, colon and rectum, lung, breast, and cervical cancer for central Serbia and Vojvodina, Serbia and Montenegro. The obtained values were compared with the corresponding values for European region as estimated by the World Health Organization. The study was conducted between October 2002 and September 2003. The cancer burden was estimated for the year 2000.

Results

Observed cancers were responsible for 133 689 DALYs (73 197 for men and 60 482 for women). There were significantly more losses because of premature death than disease disability (95.2% vs 4.8% in men P<0.001, and 93.2% vs 6.8% in females, P<0.001). The cancer burden was dominated by lung cancer in men and breast cancer in women. The cancer burden was very small before the age of 35.

Conclusion

DALYs per 1000 population were higher in Serbia than in theEuropean region for all observed cancers except for stomach cancer. The participation of a burden caused by disability in the total burden of selected cancers was lower in Serbia than in other European countries, with the greatest differences in colorectal, breast, and cervical cancers.There is growing literature on the use of summary measures of population health, which combine the information on mortality and non-fatal health outcomes (1,2). One of them, called disability-adjusted life years (DALY) was introduced by the World Bank (3) and subsequently used by the World Health Organization and Harvard University for detailed assessment of global burden of disease and injuries (4). Afterwards, many investigators have performed and published studies on burden of diseases and injuries using DALY, which reflect both the years of life lost because of premature death and years lived with disability (5-7).Morbidity and mortality of cancers have a great impact on population of Serbia. During many decades, malignant neoplasms have occupied the second place as a cause of death, with mortality rates for some cancers showing a slow but steady increase (8,9). In 2000, cancer accounted for 19% of all causes of deaths (21% in men, and 17% in women) in the population of Serbia without Kosovo and Metohia. In 2000, stomach cancer (International Classification of Diseases, version 10 [ICD10], code C16), colorectal cancer (ICD10 codes C18 – C21), lung cancer (ICD10 codes C33 – C34), breast cancer (ICD10 code C50), and cervical cancer (ICD10 code C53) were responsible for 50% of all cancer incidence cases (45% in men and 54% in women) and for 65% of deaths caused by all malignant neoplasms (63% in men, and 66% in women) (10). Lung cancer, colorectal cancer, and stomach cancer were among ten leading causes of deaths in men, whereas breast cancer, colorectal cancer, lung cancer, stomach cancer, and cervical cancer were among twelve leading causes of death in women (11). We chose these cancers to provide a comprehensive assessment of premature mortality and disability attributable to cancers in Serbia by calculating disability adjusted life years (DALY).     

Serious fungal infections in Korea

Information on the incidence and prevalence of fungal infections is of critical value in public health policy. However, nationwide epidemiological data on fungal infections are scarce, due to a lack of surveillance and funding. The objective of this study was to estimate the disease burden of fungal infections in the Republic of Korea. An actuarial approach using a deterministic model was used for the estimation. Data on the number of populations at risk and the frequencies of fungal infections in those populations were obtained from national statistics reports and epidemiology papers. Approximately 1 million people were estimated to be affected by fungal infections every year. The burdens of candidemia (4.12 per 100,000), cryptococcal meningitis (0.09 per 100,000), and Pneumocystis pneumonia (0.51 per 100,000) in South Korea were estimated to be comparable to those in other countries. The prevalence of chronic pulmonary aspergillosis (22.4 per 100,000) was markedly high, probably due to the high burden of tuberculosis in Korea. The low burdens of allergic bronchopulmonary aspergillosis (56.9 per 100,000) and severe asthma with fungal sensitization (75.1 per 100,000) warrant further study. Oral candidiasis (539 per 100,000) was estimated to affect a much larger population than noted in previous studies. Our work provides valuable insight on the epidemiology of fungal infections; however, additional studies are needed.     

Trend Analysis and Prediction of Hepatobiliary Pancreatic Cancer Incidence and Mortality in Korea

BackgroundThis study aimed to analyze the current trends and predict the epidemiologic features of hepatobiliary and pancreatic (HBP) cancers according to the Korea Central Cancer Registry to provide insights into health policy.MethodsIncidence data from 1999 to 2017 and mortality data from 2002 to 2018 were obtained from the Korea National Cancer Incidence Database and Statistics Korea, respectively. The future incidence rate from 2018 to 2040 and mortality rate from 2019 to 2040 of each HBP cancer were predicted using an age-period-cohort model. All analyses, including incidence and mortality, were stratified by sex.ResultsFrom 1999 to 2017, the age-standardized incidence rate (ASIR) of HBP cancers per 100,000 population had changed (liver, 25.8 to 13.5; gallbladder [GB], 2.9 to 2.6; bile ducts, 5.1 to 5.9; ampulla of Vater [AoV], 0.9 to 0.9; and pancreatic, 5.6 to 7.3). The age-standardized mortality rate (ASMR) per 100,000 population from 2002 to 2018 of each cancer had declined, excluding pancreatic cancer (5.5 to 5.6). The predicted ASIR of pancreatic cancer per 100,000 population from 2018 to 2040 increased (7.5 to 8.2), but that of other cancers decreased. Furthermore, the predicted ASMR per 100,000 population from 2019 to 2040 decreased in all types of cancers: liver (6.5 to 3.2), GB (1.4 to 0.9), bile ducts (4.3 to 2.9), AoV (0.3 to 0.2), and pancreas (5.4 to 4.7). However, in terms of sex, the predicted ASMR of pancreatic cancer per 100,000 population in females increased (3.8 to 4.9).ConclusionThe annual incidence and mortality cases of HBP cancers are generally predicted to increase. Especially, pancreatic cancer has an increasing incidence and will be the leading cause of cancer-related death among HBP cancers.     

广州市居民恶性肿瘤疾病负担研究

目的综合分析恶性肿瘤疾病负担,为确定疾病防治重点,合理配置卫生资源提供依据。方法利用广州市2008年恶性肿瘤死亡资料,统计分析恶性肿瘤死亡率和伤残调整寿命年（DALY）等,评价恶性肿瘤疾病负担。结果广州市恶性肿瘤标化死亡率为116.74/10万,恶性肿瘤每千人造成的DALYs损失为17.77,男女性分别为22.16和13.22;早死所致寿命损失年（YLLs）和残疾所致寿命损失年（YLDs）分别占DALYs的84.40%和15.60%;每千人DALYs随年龄增加而上升,70～79岁组最高。恶性肿瘤疾病负担前3位为气管、支气管和肺,肝脏,鼻咽,DALYs/千人分别是4.62、3.25和0.99,男性排位基本与之一致,女性前3位为气管、支气管和肺,乳房,肝脏。结论广州市居民气管、支气管、肺,肝胆,鼻咽,乳房恶性肿瘤疾病负担较重。应加强早诊早治,采取有效的干预措施,降低广州市恶性肿瘤的疾病负担。     

Cancer burden in China from 2006 to 2010

Objective: To investigate the incidence, mortality, and disease burden of cancer in China to provide a reference for cancer prevention and control. Methods: Cancer registry data (2006-2010) were collected from the Chinese Cancer Registry Annual Report by the National Center for Cancer Registries. Cancer incidence and mortality, potential years of life lost (PYLL), and disability-adjusted life years (DALYs) were calculated. Results: The cancer incidence rate was 267.13/100,000 overall, 299.13/100,000 in men, and 234.06/100,000 in women (1.2 times higher in men than in women). The cancer mortality rate was 176.32/100,000 overall, 220.54/100,000 in men, and 130.60/100,000 in women (1.6 times higher in men than in women). The incidence rate was higher in urban areas (285.97/100,000) than in rural areas (250.91/100,000), whereas the mortality rate was higher in rural areas (179.25/100,000) than in urban areas (172.91/100,000). The rural: urban incidence ratio decreased from 0.89 in 2006 to 0.69 in 2010, and the rural: urban mortality ratio decreased from 1.10 to 0.91 in the same years. PYLL rates and DALY rates were higher in men (16.45 and 22.19, respectively) than in women (11.22 and 13.87, respectively) and in rural areas (17.6 and 22.17, respectively) than in urban areas (12.6 and 17.09, respectively). The male: female ratios for PYLL and DALY rates were 1.46 and 1.6, respectively. The rural: urban ratios for PYLL and DALY rates decreased from 1.63 in 2006 to 1.22 in 2010 and from 1.51 in 2006 to 1.08 in 2010, respectively. Conclusion: The disease burden of cancer in China in 2006-2010 was substantial, particularly for men and residents of rural districts.     

Incidence estimation of stomach cancer among Koreans

A series of incidence estimation studies of cancers among Koreans through a nationwide survey has been undertaken by authors since 1988. The medical records were studied of inpatients with diagnoses of either ICD-9 151 (malignant neoplasm of the stomach), or 197 (secondary malignant neoplasm of the respiratory and digestive systems), or 211 (benign neoplasm of other parts of the digestive system) in claims sent in by medical care institutions throughout the country to the Korea Medical Insurance Corporation (KMIC) during the period from January 1, 1986 to December 31, 1987. These records were abstracted in order to identify and confirm the new cases of stomach cancer among the beneficiaries of the KMIC, which covers about 10% of whole Korean population. Using these data from the KMIC, the incidence patterns of stomach cancer among Koreans were estimated as of July 1, 1986 to June 30, 1987. The crude incidence rates of stomach cancer among Koreans are estimated to be 36.2 (95% tonfidence interval; 35.3-36.9) and 21.0 (95% CI; 20.3-21.6) per 100,000 in males and females, respectively. The cumulative rates for age spans 0-64 and 0-74 are 3.8% and 7.3% in males, respectively. In females they are 1.8% and 3.0%. The adjusted rates for the world population are 57.9 in males and 25.1 in females, which are similar to those of Shanghai, China '78-'82 but lower than those of Osaka, Japan. The truncated rates for ages 35-64 years, however, are 108.3 in males and 49.1 in females, which may be the highest in the world. Among Koreans in Korea, an increased risk of stomach cancer in this age group is the notable finding. Incidence patterns of stomach cancer by age, sex, and area, which are the first report in Korea, are analyzed and presented.     

Disability Weights for Cancers in Korea

This study renewed the estimation of disability weights for cancers in Korea, reflecting the nation''s economic and medical-technological development during the past 10 yr. Thirty-two medical doctors evaluated disability weights for 24 major cancers based on the visual analogue scale (VAS) method. To check the intra-rater reliability, a correlation was calculated between 2011 and 2012 medians. To assess the inter-rater reliability, a correlation was estimated between oncologist and non-oncologist medians. To assess the inter-method reliability, a correlation was calculated between medians on VAS and Person-Trade-Off approaches. Moreover, findings in this study were compared to those in 2003 research. Spearman correlation was used and the 1% significance level was applied. Disability weights were relatively high for pancreas cancer (0.90), gallbladder cancer (0.81), mouth and oropharynx cancer (0.80), and esophagus cancer (0.80). Conversely, they were relatively low for breast cancer (0.37), prostate cancer (0.33) and thyroid cancer (0.10). All the inter-rater reliabilities were higher than 0.7. Indeed, the intra-rater and inter-method reliabilities were 0.752 and 0.927, respectively. Above all, disability weights for major cancers went down in Korea during 2003-2012, reflecting the progress of medical technology and the growth of cancer survival.     

Estimating and validating disability-adjusted life years at the global level: a methodological framework for cancer

ABSTRACT: BACKGROUND: Disability-adjusted life years (DALYs) link data on disease occurrence to health outcomes, and they are a useful aid in establishing country-specific agendas regarding cancer control. The variables required to compute DALYs are however multiple and not readily available in many countries. We propose a methodology that derives global DALYs and validate variables and DALYs based on data from various cancer registries. METHODS: We estimated DALYs for four countries (Norway, Bulgaria, India and Uganda) within each category of the human development index (HDI). The following sources (indicators) were used: Globocan2008 (incidence and mortality), various cancer registries (proportion cured, proportion treated and duration of disease), treatment guidelines (duration of treatment), specific burden of disease studies (sequelae and disability weights), alongside expert opinion. We obtained country-specific population estimates and identified resource levels using the HDI, DALYs are computed as the sum of years of life lost and years lived with disabilities. RESULTS: Using mortality:incidence ratios to estimate country-specific survival, and by applying the human development index we derived country-specific estimates of the proportion cured and the proportion treated. The fit between the estimates and observed data from the cancer registries was relatively good. The final DALY estimates were similar to those computed using observed values in Norway, and in WHOs earlier global burden of disease study. Marked cross-country differences in the patterns of DALYs by cancer sites were observed. In Norway and Bulgaria, breast, colorectal, prostate and lung cancer were the main contributors to DALYs, representing 54 % and 45 %, respectively, of the totals. These cancers contributed only 27 % and 18 %, respectively, of total DALYs in India and Uganda. CONCLUSIONS: Our approach resulted in a series of variables that can be used to estimate country-specific DALYs, enabling global estimates of DALYs and international comparisons that support priorities in cancer control.     

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007

Introduction:

Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition.

Aim:

To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007.

Methods:

Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi''s world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1.

Results:

We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively.

Conclusion:

Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs.     

1991 cancer incidence in Seoul,Korea: results of the Implementation Study of the Seoul Cancer Registry.

This article presents the results of the Implementation Study of the Seoul Cancer Registry, which started in July, 1991 as a population based cancer registry in Seoul, Korea. The completeness and validity of the registered data were evaluated using Mortality/Incidence ratio (M/I ratio), Histologically Verified Cases (HV%), Primary Site Uncertain (PSU%), and Age Unknown (Age UNK%). Owing to the additional active surveillance, the completeness of the data turned out to be fairly acceptable, except for the aged over 75(Mortality/Incidence ratio was over 100%). Eventhough the Seoul cancer registry(SCR) has further way to go in the completeness especially among elderly persons, the validity of SCR data was also acceptable in terms of HV%, PSU%, and Age UNK%. However, PSU% and Age UNK% might need to be further reduced to be comparable with other well established cancer registries. The age standardized incidence rates(ASR) of all cancers between July 1, 1991 and June 30, 1992 were 232.4/100,000 in males and 147.9/100,000 in females. The top five major sites of cancers in Seoul were the stomach, liver, lung, colo-rectum, and bladder in order in males, and the uterine cervix, stomach, breast, colo-rectum, and liver in females. Those 5 cancer sites comprised 68.9% and 64.7% of the total cancer incidence in males and females, respectively.     

Incidence and survival of cancer in Kangwha County (1983-1987)

To measure incidence and survival rates of cancer in Kangwha County, 663 cancer patients registered in the Kangwha County Cancer Registry Program for the past 5 years (1983-1987) were analyzed. The average annual cancer incidence rate per 100,000 population was 183.0 in males and 99.5 in females. The common cancers were stomach (37.3%), lung (14.8%), and liver cancer (11.1%) in males and stomach (25.6%), cervix uteri (20.9%), and liver cancer (9.7%) in females. The median survival times of all cancer patients after diagnosis and onset of the first symptom were 8.4 +/- 0.8 months and 15.0 +/- 1.1 months respectively. Female cancer patients survived significantly longer than male cancer patients. The median survival times of the stomach, lung, and liver cancer in males were 7.7 +/- 0.9, 4.9 +/- 0.9, and 2.3 +/- 0.4 months respectively. In females, the median survival times of the stomach and liver cancer patients were 9.2 +/- 1.5 and 2.5 +/- 0.5 months. The 5 year survival rate of cervical cancer was 67.1%. Those cancer patients who received anticancer therapy survived significantly longer than cancer patients without treatment.     

Serious fungal infections in Pakistan

The true burden of fungal infection in Pakistan is unknown. High-risk populations for fungal infections [tuberculosis (TB), diabetes, chronic respiratory diseases, asthma, cancer, transplant and human immunodeficiency virus (HIV) infection] are numerous. Here, we estimate the burden of fungal infections to highlight their public health significance. Whole and at-risk population estimates were obtained from the WHO (TB), BREATHE study (COPD), UNAIDS (HIV), GLOBOCAN (cancer) and Heartfile (diabetes). Published data from Pakistan reporting fungal infections rates in general and specific populations were reviewed and used when applicable. Estimates were made for the whole population or specific populations at risk, as previously described in the LIFE methodology. Of the 184,500,000 people in Pakistan, an estimated 3,280,549 (1.78%) are affected by a serious fungal infection, omitting all cutaneous infection, oral candidiasis and allergic fungal sinusitis, which we could not estimate. Compared with other countries, the rates of candidaemia (21/100,000) and mucormycosis (14/100,000) are estimated to be very high, and are based on data from India. Chronic pulmonary aspergillosis rates are estimated to be high (39/100,000) because of the high TB burden. Invasive aspergillosis was estimated to be around 5.9/100,000. Fungal keratitis is also problematic in Pakistan, with an estimated rate of 44/100,000. Pakistan probably has a high rate of certain life- or sight-threatening fungal infections.     

Incidence estimation of genitourinary cancer in Korea.

A nation-wide study was performed to estimate the incidence of bladder, kidney, renal pelvis and ureter, prostate, testicular and other genitourinary cancer among Koreans in Korea using medical records of the inpatients of the beneficiaries of the Korea Medical Insurance Corporation (KMIC) from Jan. 1, 1989 to Dec. 31, 1989. The crude incidence rate of bladder cancer (ICD-9 188) is estimated to be 4.43 and 0.98 per 100,000 in males and females, respectively. Around 1,093 new cases of bladder cancer (895 male and 198 female) are estimated to occur in a year. The adjusted rate for the world population is 7.76 in males and 1.19 in females which is similar to that of Japanese in Osaka and Chinese in Shanghai, but lower than in American whites and blacks. The crude incidence of kidney, renal pelvis and ureteral cancer (ICD-9 189) is estimated to be 1.61 and 0.87 in males and females, respectively. Around 507 new cases of kidney, renal pelvis and ureteral cancer (332 male and 175 female) are estimated to occur in a year. The adjusted rate for the world population is 2.69 in males and 1.04 in females. In the prostate (ICD-9 185), the crude incidence rate of cancer is estimated to be 1.36. Around 274 new cases of prostate cancer are occurring in a year. The adjusted rate for the world population is 2.98 which is similar to the Chinese rate. The incidence of genitourinary cancer continuously increases with age.     

Incidence estimation of thyroid cancer among Koreans

The medical records of inpatients with diagnoses of either ICD-9 193(malignant neoplasm of the thyroid gland) or 226(benign neoplasm of the thyroid gland) in the claims sent in by medical care institutions throughout the country, to the Korea Medical Insurance Corporation (KMIC) during the period from January 1, 1986 to December 31, 1987 were abstracted. These records were abstracted in order to identify and confirm new cases of thyroid cancer among the beneficiaries of the KMIC. Using these data, the incidence rate of thyroid cancer among Koreans was estimated as of July 1, 1986 through June 30, 1987. The crude rates were estimated to be 0.76(95% Cl: 0.63-0.87) and 3.87(95% Cl: 3.60-4.14) per 100,000 in males and females, respectively, and the cumulative rates for the age spans 0-64 and 0-74 in males were 0.06% and 1.10%, respectively. In females, those were equally 0.35%. The age-adjusted rate for the world population was 0.93 per 100,000 in males, which is one of the lowest levels in the world. However, the adjusted rate in females was 3.96 per 100,000, which is an average level and very similar to that of the Chinese in Singapore and Shanghai. A similar tendency was shown in the case of the truncated rates for the age group of 35-64, which was 1.91 per 100,000 in males and 8.82 per 100,000 in females.     

Prevention of cancer through immunization: Prospects and challenges for the 21st century

Persistent infection by several microbial agents is responsible for at least 15% of cancer globally, including most cancers of the liver, stomach, and cervix. The recent development of vaccines that can prevent infection and premalignant disease caused by human papillomaviruses (HPV), which cause virtually all cases of cervical cancer as well as some other cancers, has focused renewed attention on infection control as a means of reducing the global cancer burden. For vaccines to prevent cancer-causing infection with hepatitis C virus, Helicobacter pylori, or Epstein Barr virus, new vaccine technologies to induce more effective protective responses are required. For the two available cancer control vaccines, designed to prevent infection with HPV and hepatitis B virus, the major challenge is to promote effective vaccine deployment through education programs and increased affordability/accessibility for underserved populations, particularly in the developing world, where the cancer burden attributable to infection by these two viruses is greatest.     

Measuring the burden of disease in Korea

This paper provides an overview of the Korean Burden of Disease (KBoD) study, which was the first such study to assess the national burden of disease using disability-adjusted life years (DALYs) in an advanced Asian country. The KBoD study generally followed the approach utilized in the original Global Burden of Disease study (GBD), with the exception of the disease classification and epidemiological data estimation methods used, and the relative weightings of disabilities. The results of the present study reveal that the burden of disease per 100,000 of the Korean population originates primarily from; cancer (1,525 Person Years, PYs), cardiovascular disease (1,492 PYs), digestive disease (1,140 PYs), diabetes mellitus (990 PYs), and certain neuro-psychiatric conditions (883 PYs). These results are largely consistent with those of developed countries, but also represent uniquely Korean characteristics.     

Epidemiology of hypertensive heart disease in Poland: findings from the Global Burden of Disease Study 2016

IntroductionHypertension may cause target organ damage leading to hypertensive heart disease (HHD). The burden caused by HHD in Poland has not been studied systematically. The purpose of this study was to describe the burden of HHD in Poland in terms of prevalence, mortality, disability-adjusted life years lost (DALY) and key risk factors.Material and methodsData were obtained from the Global Burden of Diseases, Injuries and Risk Factors (GBD) Study database. The GBD uses a wide range of data sources and complex statistical methods to estimate disease burden for all countries by age, sex, and year. HHD was defined by ICD-9 codes 402-402.91 and ICD-10 codes I11-I11.9. From the GBD 2016 estimates, we extracted data for Poland between 1990 and 2016.ResultsHypertensive heart disease is the fourth most important cause of cardio- and cerebrovascular death, after ischemic heart disease, stroke and cardiomyopathy. In 2016, there were about 180 000 people diagnosed with HHD in Poland and close to 5000 HHD-related deaths. HHD prevalence increased from 0.29% in 1990 to 0.47% in 2016 and was higher in women, while mortality increased from 11.2 to 12.7 per 100 000, largely due to population aging. Age-standardized death and DALY rates declined between 1990 and 2016 and were lower than in Central Europe but higher than in Western Europe.ConclusionsOur data suggest a need for national initiatives to improve the diagnosis and treatment of hypertension, slow the progression of HHD, and reduce the related risks and premature deaths.     

Estimates of Radiation Doses and Cancer Risk from Food Intake in Korea

The aim of this study was to estimate internal radiation doses and lifetime cancer risk from food ingestion. Radiation doses from food intake were calculated using the Korea National Health and Nutrition Examination Survey and the measured radioactivity of ¹³⁴Cs, ¹³⁷Cs, and ¹³¹I from the Ministry of Food and Drug Safety in Korea. Total number of measured data was 8,496 (3,643 for agricultural products, 644 for livestock products, 43 for milk products, 3,193 for marine products, and 973 for processed food). Cancer risk was calculated by multiplying the estimated committed effective dose and the detriment adjusted nominal risk coefficients recommended by the International Commission on Radiation Protection. The lifetime committed effective doses from the daily diet are ranged 2.957-3.710 mSv. Excess lifetime cancer risks are 14.4-18.1, 0.4-0.5, and 1.8-2.3 per 100,000 for all solid cancers combined, thyroid cancer, and leukemia, respectively.     

The current status of asthma in Korea

A systematic review of English and Korean articles published between 1990 and 2004 and a search of database and various online resources was conducted to determine the prevalences, mortality rates, socioeconomic burden, quality of life, and treatment pattern of asthma in Korean adults and children. Asthma morbidity and mortality in Korea are steadily increasing. The prevalence of asthma in Korea is estimated to be 3.9% and its severity is often underestimated by both physicians and patients. Mortality resulting from chronic lower respiratory diseases including asthma increased from 12.9 to 22.6 deaths per 100,000 of the population between 1992 and 2002. Disease severity, level of control, and symptom state were all found to negatively impact the quality of life of asthmatics. Although international and Korean asthma management guidelines are available, familiarity with and implementation of these guidelines by primary care physicians remain poor.