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Original Articles
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
DOI: https://doi.org/10.4178/epih.e2021093
  • 5,018 View
  • 149 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Summary
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

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
Real-world incidence of endopthalmitis after intravitreal anti-VEGF injections in Korea: findings from the Common Data Model in ophthalmology
Yongseok Mun, Seng Chan You, Da Yun Lee, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young Gun Park, Young Hoon Park, Young-Jung Roh, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park
Epidemiol Health. 2021;43:e2021097.   Published online November 9, 2021
DOI: https://doi.org/10.4178/epih.e2021097
  • 5,106 View
  • 213 Download
  • 4 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to evaluate the real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections using data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).
METHODS
Patients with endophthalmitis that developed within 6 weeks after intravitreal anti-VEGF injections were identified in 3 large OMOP CDM databases.
RESULTS
We identified 23,490 patients who received 128,123 intravitreal anti-VEGF injections. The incidence rates of endophthalmitis were 15.75 per 10,000 patients and 2.97 per 10,000 injections. The incidence rates of endophthalmitis for bevacizumab, ranibizumab, and aflibercept (per 10,000 injections) were 3.64, 1.39, and 0.76, respectively. The annual incidence has remained below 5.00 per 10,000 injections since 2011 despite the increasing number of intravitreal anti-VEGF injections. Bevacizumab presented a higher incidence rate for endophthalmitis than ranibizumab and aflibercept (incidence rate ratio, 3.17; p=0.021).
CONCLUSIONS
The incidence of endophthalmitis after intravitreal anti-VEGF injections has stabilized since 2011 despite the explosive increase in anti-VEGF injections. The off-label use of bevacizumab accounted for its disproportionately high incidence of endophthalmitis. The OMOP CDM, which includes off-label uses, laboratory data, and a scalable standardized database, could provide a novel strategy to reveal real-world evidence, especially in ophthalmology.
Summary
Korean summary
- 공통데이터모델 (Observational Medical Outcomes Partnership Common Data Model, OMOP CDM)을 통해 유리체강내 항혈관내피성장인자 주입술 후 발생한 안내염의 실세계 발생률 (Real-world incidence)은 1만명 당 15.75명, 주사 1만회 당 2.97회였음을 알 수 있었다. - 베바시주맙에서 다른 항혈관내피성장인자에 비해 유리체강내 주사 후 안내염 발생 비율이 높았으며, 이는 약제의 분주로 인한 오염과 관련이 있을 것이다. - 공통데이터모델은 건강보험 청구자료가 포함하지 않는 유리체강내 베바시주맙 사용과 같은 오프라벨 의약품 사용 자료까지 포함하기 때문에, 유리체강내 항혈관내피성장인자 주입 후 발생한 안내염의 인구기반 발생률 추정을 가능케 했다.
Key Message
- The real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections was 15.75 per 10,000 patients and 2.97 per 10,000 injections based on data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). - Patients treated with bevacizumab showed a significantly higher incidence rate of post-injection endophthalmitis, which might have resulted from contamination related to the division of bevacizumab. - OMOP CDM provides insights into the population-based incidence rate of endophthalmitis since it covers off-label prescriptions including intravitreal bevacizumab, which the national claims database does not cover.

Citations

Citations to this article as recorded by  
  • Real-World Treatment Intensity and Patterns in Patients With Myopic Choroidal Neovascularization: Common Data Model in Ophthalmology
    Manh-Hung Bui, Da Yun Lee, Sang Jun Park, Kyu Hyung Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Real-world treatment intensities and pathways of macular edema following retinal vein occlusion in Korea from Common Data Model in ophthalmology
    Yongseok Mun, ChulHyoung Park, Da Yun Lee, Tong Min Kim, Ki Won Jin, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young-Jung Roh, Donghyun Jee, Jin-Woo Kwon, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park
    Scientific Reports.2022;[Epub]     CrossRef
  • Blueprint for harmonising unstandardised disease registries to allow federated data analysis: prepare for the future
    Johannes A. Kroes, Aruna T. Bansal, Emmanuelle Berret, Nils Christian, Andreas Kremer, Anna Alloni, Matteo Gabetta, Chris Marshall, Scott Wagers, Ratko Djukanovic, Celeste Porsbjerg, Dominique Hamerlijnck, Olivia Fulton, Anneke ten Brinke, Elisabeth H. Be
    ERJ Open Research.2022; 8(4): 00168-2022.     CrossRef
  • Towards effective data sharing in ophthalmology: data standardization and data privacy
    William Halfpenny, Sally L. Baxter
    Current Opinion in Ophthalmology.2022; 33(5): 418.     CrossRef
Late eating, blood pressure control, and cardiometabolic risk factors among adults with hypertension: results from the Korea National Health and Nutrition Examination Survey 2010-2018
Jee-Seon Shim, Hyeon Chang Kim
Epidemiol Health. 2021;43:e2021101.   Published online November 24, 2021
DOI: https://doi.org/10.4178/epih.e2021101
  • 5,228 View
  • 130 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Despite growing concerns regarding the timing of eating, little is known about the association between late eating and health. This study aimed to investigate whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension.
METHODS
Data from the Korea National Health and Nutrition Examination Survey 2010-2018 were used. Adults with hypertension aged 30-79 years (n=13,361) were included in this study. Dietary intake and information on meal timing were assessed using 1-day 24-hour recall. Late eating was defined as after the median midpoint between the times of the first and the last eating episode during the recall day. Logistic and linear regression models were used to estimate the associations of late eating with BP control and cardiometabolic risk factors.
RESULTS
Among late eaters, there were more men than women. Compared to early eaters, late eaters were younger, had a higher body mass index (BMI) and unhealthier habits, and their overall dietary quality score was lower. A negative association between late eating and BP control was found in a univariate model (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.94 to 1.12), but this association disappeared after adjustment for confounders (OR, 1.03; 95% CI, 0.94 to 1.12). Late eating was independently associated with higher BMI (p=0.03) and blood triglyceride concentration (p<0.01).
CONCLUSIONS
Our results do not support a link between late eating and BP control among adults with hypertension, but suggest that late eating is associated with cardiometabolic risk factors.
Summary
Korean summary
식사시간이 건강에 미치는 영향에 대한 관심이 증가하고 있지만, 이에 대한 근거는 많지 않다. 이 연구는 국민건강영양조사 자료를 활용하여 고혈압이 있는 성인의 늦은 식사와 혈압 조절, 심장대사 위험인자의 연관성을 분석하였다. 늦은 식사와 혈압 조절의 독립적 연관성은 찾지 못했지만, 늦은 식사는 높은 체질량지수, 혈중 지질 농도와 연관성을 보여 식사 시간 조정이 고혈압 환자의 예후 개선을 위한 유용한 대책이 될 수 있으리라는 근거를 지지한다.
Key Message
This study investigated whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension using data from the Korea National Health and Nutrition Examination Survey 2010–2018. We did not find an independent association between late eating and BP control among Korean adults with hypertension, but found that late eating was significantly associated with higher BMI and a higher blood concentration of triglycerides, independent of potential confounders. Our findings support the suggestion that a time-based dietary approach can be used as a useful strategy to improve the prognosis of adults with hypertension.
Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis
Hwa Jeong Seo, Hyun Sook Oh
Epidemiol Health. 2021;43:e2021103.   Published online December 17, 2021
DOI: https://doi.org/10.4178/epih.e2021103
  • 4,431 View
  • 157 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients.
METHODS
Population-based cohort data were used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013. Patient-specific medication prescription status was defined by the landmark time (LMT; a fixed time after cohort entry), considering both pre- and post-LMT prescriptions to control methodological biases in observational research. The LMT was set to 2 years. Logistic regression analysis with multivariable adjustment was conducted to analyze cancer incidence by patient-specific medication prescription status.
RESULTS
Only 33.4% of the subjects were prescribed medication early (before the LMT) with compliance. Cancer incidence in individuals with early prescription and compliance was 25% lower (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.67 to 0.84) than in those without. As early-prescribed medications, metformin monotherapy and metformin combination therapy were associated with 34% (OR, 0.66; 95% CI, 0.51 to 0.83) and 25% (OR, 0.75; 95% CI, 0.64 to 0.88) lower cancer risk than non-use, respectively. Patients who were prescribed late (post-LMT) but did not comply with the prescription had a 24% (OR, 1.24; 95% CI, 0.97 to 1.58) higher cancer incidence than non-users. Among patients who started monotherapy early without changes throughout the entire follow-up period, those who started on metformin had a 37% (OR, 0.63; 95% CI, 0.41 to 0.99) lower risk of cancer than non-metformin users.
CONCLUSIONS
Doctors must prescribe antidiabetic medication early, and patient compliance is required, regardless of the prescription time, to prevent cancer. Metformin monotherapy or combination therapy is recommended as an early prescription.
Summary
Korean summary
당뇨 환자는 암 발병 위험이 높으며 암은 주요 사망 원인이다. 당뇨환자의 암발생 예방을 위한 관리로서, 당뇨병 진단 후 약물 치료 시기에 대한 연구는 부족하다. 또한, 전 세계적으로 가장 흔히 처방되는 당뇨병 치료제인 메트포민은 암 예방 효과가 있다고 알려져 왔으나 관측연구에서 발생하는 선택 편향의 문제가 제기되었고, 최근 일부 연구에서 기존의 암 예방 효과와 상충되는 결과가 나오고 있어 논쟁이 이어지고 있다. 본 연구는 선택 편향을 통제한 코호트 연구에서 조기 약물 치료와 메트포민 사용이 당뇨환자의 암 예방에 효과적임을 밝혔다. 따라서 의사들은 처음 당뇨 진단을 받은 환자에게 조기에 약물 처방을 하고, 환자들은 처방에 잘 따라야 한다. 조기 처방 약물로서 메트포민이 권장된다.
Key Message
Diabetic patients have a high risk of developing cancer, and cancer is the leading cause of death. There are few studies on the timing of medication treatment after diagnosis of diabetes. In addition, metformin, the most commonly prescribed diabetes treatment worldwide, is known to have cancer-preventive effects, but the problem of selection bias that occurs in observational studies has been raised, and some studies have recently been contradicting the existing cancer-preventing effects of metformin. This study, in a cohort study controlled for selection bias, demonstrated that early medication treatment and metformin use were effective in preventing cancer in diabetic patients.

Citations

Citations to this article as recorded by  
  • Metformin and HER2-positive breast cancer: Mechanisms and therapeutic implications
    Sara S Bashraheel, Hadeel Kheraldine, Sarah Khalaf, Ala-Eddin Al Moustafa
    Biomedicine & Pharmacotherapy.2023; 162: 114676.     CrossRef
  • Effects of millimeter-wave for preventing joint stiffness in the immobilized knee rat model
    Xiao-ping Shui, Feng Ye, Chun-ying Li, Xin Zhang, Min-jia Wang, Bin Li, Ke Chen, Ying-ying Liao
    The Knee.2023; 42: 236.     CrossRef
Socio-demographic and lifestyle factors associated with multimorbidity in New Zealand
Nayyereh Aminisani, Christine Stephens, Joanne Allen, Fiona Alpass, Seyed Morteza Shamshirgaran
Epidemiol Health. 2020;42:e2020001.   Published online December 27, 2019
DOI: https://doi.org/10.4178/epih.e2020001
  • 11,483 View
  • 296 Download
  • 13 Citations
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The incidence of multimorbidity (MM) and its correlates among older adults remain poorly understood. This study aimed to examine the socio-demographic and lifestyle factors associated with MM in New Zealand.
METHODS
People aged 55-70 years were invited to participate in a population-based cohort study, the Health Work and Retirement Study, in 2006. Those who accepted the invitation and completed the baseline questionnaire were followed up on a biennial basis. Data on socio-demographic factors, health and lifestyle behaviours, and diagnoses of chronic diseases were obtained from baseline and 6 waves of follow-up. Generalised estimating equations (GEE) adjusted for both time-constant and time-varying factors were used to model factors associated with the onset of MM.
RESULTS
A total of 1,673 participants (with 0 or 1 chronic condition) contributed to an overall 8,616 person-years of observation. There were 590 new cases of MM over 10 years of follow-up, corresponding to an overall incidence of 68.5 per 1,000 person-years. The results of the age- and sex-adjusted GEE analysis showed that age, ethnicity, living alone, obesity, hypertension, and having 1 chronic condition at baseline were significant predictors of MM onset. Higher education, income, physical activity, and regular alcohol consumption were protective factors. In a fully adjusted model, marital status (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.01 to 1.37; p=0.039), hypertension (OR, 1.23; 95% CI, 1.02 to 1.48; p=0.032) and having 1 chronic condition at baseline (OR, 2.92; 95% CI, 2.33 to 3.67; p<0.001) remained significant.
CONCLUSIONS
The higher incidence of MM among Māori people, socioeconomically disadvantaged groups, those with low physical activity, and obese individuals highlights the importance of targeted prevention strategies.
Summary
Korean summary
Key Message

Citations

Citations to this article as recorded by  
  • Epidemiology and predictors of multimorbidity in Kharameh cohort study: A population‐based cross‐sectional study in southern Iran
    Leila Moftakhar, Ramin Rezaeianzadeh, Masoumeh Ghoddusi Johari, Seyed Vahid Hosseini, Abbas Rezaianzadeh
    Health Science Reports.2023;[Epub]     CrossRef
  • Overweight, obesity and risk of multimorbidity: A systematic review and meta‐analysis of longitudinal studies
    Felipe Mendes Delpino, Ana Paula dos Santos Rodrigues, Glenda Blaser Petarli, Karla Pereira Machado, Thaynã Ramos Flores, Sandro Rodrigues Batista, Bruno Pereira Nunes
    Obesity Reviews.2023;[Epub]     CrossRef
  • Predictors of health‐related quality of life in older New Zealanders with cardiovascular health problems
    Jed Montayre, Mu‐Hsing Ho, Hui‐Chen (Rita) Chang, Megan F. Liu, Chia‐Chi Chang, Ritin Fernandez
    Australasian Journal on Ageing.2022; 41(2): 274.     CrossRef
  • Physical Activity and Multimorbidity Among Community-Dwelling Older Adults: A Systematic Review With Meta-Analysis
    Felipe Mendes Delpino, Ana Paula Maciel de Lima, Bruna Gonçalves Cordeiro da Silva, Bruno Pereira Nunes, Eduardo Lucia Caputo, Renata Moraes Bielemann
    American Journal of Health Promotion.2022; 36(8): 1371.     CrossRef
  • Incidence and predictors of multimorbidity among older adults in Korea: a 10-year cohort study
    Tae Wha Lee, Jane Chung, Kijun Song, Eunkyung Kim
    BMC Geriatrics.2022;[Epub]     CrossRef
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    Age and Ageing.2022;[Epub]     CrossRef
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    Hejian Xie, Jinchen Li, Xuanmeng Zhu, Jing Li, Jinghua Yin, Tianqi Ma, Yi Luo, Lingfang He, Yongping Bai, Guogang Zhang, Xunjie Cheng, Chuanchang Li
    Cardiovascular Diabetology.2022;[Epub]     CrossRef
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    Mee-Ri Lee, Sung Min Jung
    Medicine.2021; 100(1): e23994.     CrossRef
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    Prtha Kudesia, Banafsheh Salimarouny, Meagan Stanley, Martin Fortin, Moira Stewart, Amanda Terry, Bridget L Ryan
    Journal of Multimorbidity and Comorbidity.2021; 11: 263355652110328.     CrossRef
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    Mikk Jürisson, Heti Pisarev, Anneli Uusküla, Katrin Lang, M Oona, Ruth Kalda
    BMJ Open.2021; 11(10): e049045.     CrossRef
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    Yifan Zhang, Ranjita Misra, Usha Sambamoorthi
    International Journal of Environmental Research and Public Health.2020; 17(9): 3336.     CrossRef

  • Lifestyle Behaviors and Socio-Demographic Factors Associated with Overweight or Obesity Among Saudi Females Attending Fitness Centers


    Abeer A AlTamimi, Nada M Albawardi, Mezna A AlMarzooqi, Mohanad Aljubairi, Hazzaa M Al-Hazzaa
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 2613.     CrossRef
  • Video Consultations for Older Adults With Multimorbidity During the COVID-19 Pandemic: Protocol for an Exploratory Qualitative Study
    Eng Sing Lee, Poay Sian Sabrina Lee, Evelyn Ai Ling Chew, Gayathri Muthulingam, Hui Li Koh, Shu Yun Tan, Yew Yoong Ding
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Geographical distribution of at fault drivers involved in fatal traffic collisions in Tehran, Iran
Amir Kavousi, Ali Moradi, Khaled Rahmani, Salahdin Zeini, Pegah Ameri
Epidemiol Health. 2020;42:e2020002.   Published online January 13, 2020
DOI: https://doi.org/10.4178/epih.e2020002
  • 8,977 View
  • 167 Download
  • 2 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
According to Traffic Police, about 35% of deaths and more than 50% of injuries caused by traffic collision in the roads of Tehran are among drivers and car occupants. This study was conducted to determine areas with the highest number of traffic collisions and perform spatial analysis of traffic collisions involving drivers in Tehran during April 2014 to March 2017.
METHODS
The present study was a cross-sectional and descriptive-analytic research. In this study, all traffic collision that driver was accounted (100 percent or less) for crash occurrence which resulted in the death of at least one person (driver, pedestrian or passenger) were included in the analyses. Geographic information system software was used to show spatial distribution of events from zoning maps. Moran index was used in the mathematical analysis in order to determine the distribution pattern of the events from and Getis-Ord G statistics was applied to analyze the hot spots (high risk points).
RESULTS
A total number of 519 traffic collisions were investigated in this study. Moreover, 283 cases (54.5%) of the incidents took place in direct routes and 236 cases (45.5%) occurred at intersections. The most frequent events were in the region 4 (57 cases) and the least frequent events were reported in the region 10 (6 cases). Moran statistics show that the distribution of the studied events significantly follows the cluster pattern (p<0.001).
CONCLUSIONS
The northeastern and northwest margins of Tehran are the most prone areas for drivers involved with traffic collisions leading to death. Most traffic collisions leading to death take place at highways located at the entrance and exit points of Tehran and highways in regions 2 and 5.
Summary
Korean summary
Key Message

Citations

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  • GIS-based risk mapping of cutaneous leishmaniasis: a survey in an endemic area of Central Iran
    Mohammad Reza Maracy, Fariba Jaffary, Afshin Ebrahimi, Fatemeh Sokhanvari, Asieh Heidari, Hanieh Sharifian-Koupaiee, Reza Fadaei, Javad Ramazanpour, Malihe Moazeni
    Environmental Science and Pollution Research.2021; 28(41): 57470.     CrossRef
  • Identifying and prioritizing risk factors involved in motorcyclists' traffic accidents in Tehran
    Ali Moradi, Amir Kavousi, Pegah Ameri, Mohyeddin Amjadian, MohammadHossein Vaziri
    Archives of Trauma Research.2021; 10(3): 153.     CrossRef
Systematic Review
Risk factors for stomach cancer: a systematic review and meta-analysis
Jalal Poorolajal, Leila Moradi, Younes Mohammadi, Zahra Cheraghi, Fatemeh Gohari-Ensaf
Epidemiol Health. 2020;42:e2020004.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020004
  • 21,109 View
  • 782 Download
  • 95 Citations
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.
METHODS
PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.
RESULTS
Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.
CONCLUSIONS
This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.
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COVID-19: Special Article
Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea
Moran Ki
Epidemiol Health. 2020;42:e2020007.   Published online February 9, 2020
DOI: https://doi.org/10.4178/epih.e2020007
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.
Summary
Korean summary
2020년 1월 20일 한국의 신종코로나바이러스 감염자가 확진된 이후 약 20일만에 28명이 확진되었다. 확진자중 지표환자가 16명(57.2%), 1세대환자 9명(32.1%), 2세대환자가 3명(10.7%)이다. 지표환자 16명중 15명은 1월 19일-24일에, 1명은 1월 31일에 국내에 입국하였다. 환자들의 잠복기는 평균 3.9일 (중위값 3일), 감염재생산수(R)는 0.48로 추정되었다. 확진자 중 3명은 증상이 없는 상태에서 확진이 되었다. 향후 새로운 정보가 나오면 역학 지표들이 수정될 것이다.
Key Message

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Original Articles
Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis
Yongho Jee, Gyuyoung Lee
Epidemiol Health. 2020;42:e2020008.   Published online March 3, 2020
DOI: https://doi.org/10.4178/epih.e2020008
  • 9,913 View
  • 193 Download
  • 5 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents.
METHODS
We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed.
RESULTS
The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years.
CONCLUSIONS
In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.
Summary
Korean summary
성경험 유병률은 일반적으로 남녀 공히 모든 시기에서 연령대에 따라 증가했다. 공통적으로 최근 연도에서 12-13세 연령군의 성 경험 유병률이 증가한 반면 16-17세 연령군에서 성경험 유병률이 감소했다. 전반적으로 2006 년부터 2017 년까지 청소년들의 성경험률은 소폭 감소했지만, 조기 성경험의 빈도는 증가하고 있다. 따라서 피임이나 순결 교육뿐만 아니라 성적자기결정능력같은 보다 실질적인 성교육이 어릴 때부터 강화되어야 할 것으로 보인다.
Key Message

Citations

Citations to this article as recorded by  
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Estimating the reproductive number and the outbreak size of COVID-19 in Korea
Sunhwa Choi, Moran Ki
Epidemiol Health. 2020;42:e2020011.   Published online March 12, 2020
DOI: https://doi.org/10.4178/epih.e2020011
  • 36,880 View
  • 3,249 Download
  • 131 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Since the first novel coronavirus disease 2019 (COVID-19) patient in Korea was diagnosed on January 20, 2020, 30 patients were diagnosed until February 17, 2020. However, 5,298 additional patients were confirmed until March 4, 2020. Therefore, our objective was to estimate the reproduction number (R) and evaluate the effectiveness of preventive measures.
METHODS
A COVID-19 transmission model (SEIHR) was established to suit the Korean outbreak. The number of daily confirmed cases in Daegu and North Gyeongsang Province (NGP), the main area of outbreak, was used. The first patient’ symptom onset date in the Daegu/NGP outbreak was assumed as January 22, 2020. The R according to the start date of the effect of preventive measures was estimated.
RESULTS
The estimated R in Hubei Province, China, was 4.0281, whereas the estimated initial R in Korea was 0.555, but later in Daegu/NGP, the value was between 3.472 and 3.543. When the transmission period decreases from 4-day to 2-day, the outbreak ends early, but the peak of the epidemic increases, and the total number of patients does not change greatly. It was found that, if transmission rate decreases, the outbreak ends early, and the size of the peak and the total number of patients also decreases.
CONCLUSIONS
To end the COVID-19 epidemic, efforts to reduce the spread of the virus, such as social distancing and wearing masks, are absolutely crucial with the participation of the public, along with the policy of reducing the transmission period by finding and isolating patients as quickly as possible through the efforts of the quarantine authorities.
Summary
Korean summary
수학적 모델링을 통하여 코로나-19 감염재생산수( R )와 대구, 경북의 유행 규모와 유행 종료 시점 등을 예측해보았다. 그 결과 중국 후베이성의 R=4, 한국 초기 30일간의 유행은 R=0.5, 대구/경북의 3월 4일까지의 유행은 R=3.5 수준으로 나타났다. 하지만 방역당국의 적극적인 코로나-19검사로 환자들의 감염전파기간이 짧아지고, 국민들의 마스크 쓰기, 사회적 거리두기 등의 감염 예방조치 적극 참여로 전파율이 낮아져 5월 1일경에 하루 환자 1명 수준으로 예측되었다.
Key Message

Citations

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Prediction of COVID-19 transmission dynamics using a mathematical model considering behavior changes in Korea
Soyoung Kim, Yu Bin Seo, Eunok Jung
Epidemiol Health. 2020;42:e2020026.   Published online April 13, 2020
DOI: https://doi.org/10.4178/epih.e2020026
  • 17,661 View
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  • 44 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Since the report of the first confirmed case in Daegu on February 18, 2020, local transmission of coronavirus disease 2019 (COVID-19) in Korea has continued. In this study, we aimed to identify the pattern of local transmission of COVID-19 using mathematical modeling and predict the epidemic size and the timing of the end of the spread.
METHODS
We modeled the COVID-19 outbreak in Korea by applying a mathematical model of transmission that factors in behavioral changes. We used the Korea Centers for Disease Control and Prevention data of daily confirmed cases in the country to estimate the nationwide and Daegu/Gyeongbuk area-specific transmission rates as well as behavioral change parameters using a least-squares method.
RESULTS
The number of transmissions per infected patient was estimated to be about 10 times higher in the Daegu/Gyeongbuk area than the average of nationwide. Using these estimated parameters, our models predicts that about 13,800 cases will occur nationwide and 11,400 cases in the Daegu/Gyeongbuk area until mid-June.
CONCLUSIONS
We mathematically demonstrate that the relatively high per-capita rate of transmission and the low rate of changes in behavior have caused a large-scale transmission of COVID-19 in the Daegu/Gyeongbuk area in Korea. Since the outbreak is expected to continue until May, non-pharmaceutical interventions that can be sustained over the long term are required.
Summary
Korean summary
본 논문은 행동변화를 고려한 수학적 모델을 이용하여 코로나바이러스병-19의 유행 양상을 분석하고 총 환자수와 유행기간을 예측하고자 한다. 질병관리본부 확진자 데이터를 이용하여 전국과 대구·경북 지역의 감염전파율과 행동변화율을 추정하였다. 3월 10일까지의 데이터를 기준으로 전국적으로 6월 중순까지 약 13,000명, 대구·경북지역의 경우 5월 말까지 약 11,000명의 환자가 발생할 것으로 예측된다.
Key Message

Citations

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Review
Freshwater snails as the intermediate host of trematodes in Iran: a systematic review
Samira Dodangeh, Ahmad Daryani, Mehdi Sharif, Shirzad Gholami, Elham Kialashaki, Mahmood Moosazadeh, Shahabeddin Sarvi
Epidemiol Health. 2019;41:e2019001.   Published online January 7, 2019
DOI: https://doi.org/10.4178/epih.e2019001
  • 14,790 View
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  • 12 Citations
AbstractAbstract PDFSupplementary Material
Abstract
Freshwater snails, as the first intermediate hosts of trematodes, can cause health hazards in animals and humans. Recently, the World Health Organization has included Iran in a list of 6 countries known to have serious problems with fascioliasis. In addition, cercarial dermatitis is a job-related disease that is seen often in paddy workers, agricultural labourers, and fishermen in Iran, particularly in Mazandaran Province. Many studies have been conducted in Iran to survey larval trematodes in freshwater snails. However, to the best of our knowledge, no comprehensive data exist regarding infections in gastropods. Therefore, the aim of the present study was to estimate the types and prevalence of cercarial infections in snails in Iran. Electronic English-language and Persian-language databases were searched to identify 24 published articles reporting the prevalence of trematode infections in snails (9 species from 6 families) in various provinces of Iran. In total, 4.4% of gastropods were infected with the larval stages of trematodes. According to the studies reviewed in this meta-analysis‚ the highest infection prevalence was found in Radix auricularia (9.9%). Twelve larval species of trematodes were identified, and the highest prevalence of cercariae was found for Echinostomatidae cercariae (4.3%). Among the provinces explored, West Azerbaijan had the highest prevalence of infected snails (16.9%). The presence of trematodes in snails could pose a serious health problem in Iran. Thus, further studies are necessary to characterize these infections in other provinces.
Summary
Korean summary
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Perspective
Health effects of exposure to radon: implications of the radon bed mattress incident in Korea
Songwon Seo, Wi-Ho Ha, Jin-Kyu Kang, Dalnim Lee, Soojin Park, Tae-Eun Kwon, Young Woo Jin
Epidemiol Health. 2019;41:e2019004.   Published online February 12, 2019
DOI: https://doi.org/10.4178/epih.e2019004
  • 13,234 View
  • 355 Download
  • 18 Citations
AbstractAbstract AbstractSummary PDF
Abstract
Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth’s crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.
Summary
Korean summary
라돈은 세계보건기구에서 지정한 발암물질로, 흡연 다음으로 폐암을 유발한다. 지난 2018년 5월에 D사 침대 매트리스에서 라돈 및 토론에 의한 일반인의 선량한도 기준치(1 mSv/yr) 이상의 방사선이 검출되었다. 이로 인해 침대 사용자의 방사선 피폭으로 인한 건강영향 우려가 대두되고 있다. 이번 연구에서는 라돈 침대 노출 사고와 관련하여 그 동안 잘 알려지지 않은 라돈 및 토론의 노출평가 및 역학 연구 결과들을 살펴보고, 그 시사점을 고찰한다.
Key Message

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Original Articles
Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women’s Health-Related Issues
Eunji Choi, Ha Na Cho, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee
Epidemiol Health. 2019;41:e2019005.   Published online February 13, 2019
DOI: https://doi.org/10.4178/epih.e2019005
  • 12,018 View
  • 270 Download
  • 5 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.
METHODS
Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.
RESULTS
Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.
CONCLUSIONS
Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.
Summary
Korean summary
한국 성인 여성의 과체중 및 비만유병률은 서구여성에 비해 낮으며 2005년 이후 큰 변화 없이 약40%대로 일정하게 유지되어왔으나, 사회경제적불평등에 대한 연구는 체계적으로 이루어지지 않음. 경사불평등(Slope index of inequality)과 상대불평등(Relative index of inequality) 지표를 사용하여 비만유병률에서 발견되는 사회경제적불평등을 조사한 결과, 교육수준별 불평등이 유의하게 나타남. 19-44세의 젊은 여성층에서는 소득수준이 낮은 집단에, 65-79세의 노년기 여성층에서는 도시화된 지역에 사는 집단에 비만유병률이 치중되어있음.
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  • Disparities in Obesity Rates among Adults: Analysis of 514 Districts in Indonesia
    Dumilah Ayuningtyas, Dian Kusuma, Vilda Amir, Dwi Hapsari Tjandrarini, Pramita Andarwati
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    Chi-Young Lee, Eun-Ok Im
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    Jin-Sung Yuk, Banghyun Lee, Kidong Kim, Myoung Hwan Kim, Yong-Soo Seo, Sung Ook Hwang, Sang-Hee Yoon, Yong Beom Kim, Wen-Chi Chou
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Geospatial analysis and epidemiological aspects of human infections with Blastocystis hominis in Mazandaran Province, northern Iran
Shabnam Asfaram, Ahmad Daryani, Shahabeddin Sarvi, Abdol Sattar Pagheh, Seyed Abdollah Hosseini, Reza Saberi, Seyede Mahboobeh Hoseiny, Masoud Soosaraei, Mehdi Sharif
Epidemiol Health. 2019;41:e2019009.   Published online March 28, 2019
DOI: https://doi.org/10.4178/epih.e2019009
  • 11,533 View
  • 266 Download
  • 8 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
Blastocystis hominis is a very common large intestinal protozoan with global prevalence in humans and non-human hosts. No precise statistics exist regarding the geographical distribution of Blastocystis that would enable the identification of high-risk communities. Therefore, the current research aimed to characterize the spatial patterns and demographic factors associated with B. hominis occurrence in northern Iran.
METHODS
The current study was performed among 4,788 individuals referred to health centers in Mazandaran Province, from whom stool samples were obtained. Socio-demographic data were gathered using a questionnaire. Samples were examined by a direct wet mount, the formalin-ethyl acetate concentration technique, and trichrome staining. Moran local indicators of spatial association and a geographically weighted regression model were utilized to analyze the results.
RESULTS
Generally, the infection rate of Blastocystis parasites was 5.2%, and was considerably higher in the age group of 10-14 years (10.6%) than in other age groups (p=0.005). Our data showed important associations between the occurrence of B. hominis and age, residence, job, contact with domestic animals, anti-parasitic drug consumption, and elevation above sea level (p<0.001).
CONCLUSIONS
The current study characterized for the first time the infection rate and risk of B. hominis in the north of Iran, and produced a prediction map. It is expected that this map will help policymakers to plan and implement preventive measures in high-risk areas and to manage already-infected patients.
Summary
Korean summary
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    Sara Soleimani Jevinani, Hanieh Mohammad Rahimi, Nastaran Asri, Mohammad Rostami-Nejad, Shokoufeh Ahmadipour, Hamed Mirjalali
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