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      Survival of Korean Adult Cancer Patients by Stage at Diagnosis, 2006-2010: National Cancer Registry Study

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          Abstract

          Purpose

          Although the cancer stage at diagnosis is the most important prognostic factor for patients' survival, there are few population-based estimates of stage-specific survival outcome, especially in Asian countries. Our study aims to estimate stage-specific survival for Korean patients.

          Materials and Methods

          We analyzed the Korea National Cancer Incidence Database data on 626,506 adult patients aged ≥ 20 years, who were diagnosed between 2006 and 2010 with stomach, colorectal, liver, lung, breast, cervix, prostate, and thyroid cancers. Patients were followed up to December 2011, and the 5-year relative survival rates (RSRs) were calculated for gender and age group by Surveillance, Epidemiology, and End Results (SEER) stage at diagnosis.

          Results

          The 5-year RSRs for all localized-stage cancers, except for lung and liver, exceeded 90% with that for thyroid cancer being the highest at 100.4%. These values for distant stage liver, lung, and stomach cancers were very dismal at 2.5%, 4.8%, and 5.5%, respectively, while it was 69.1% for thyroid cancer, and was in the range of 18.3-36.4% for colorectal, cervix, breast and prostate cancers. Overall, the 5-year RSRs for all cancer types decreased with aging across all the disease stages with exception of prostate cancer, which suggests biologic difference in these cancer types in a young age group. When compared with US SEER data, Korean patients had better stage-specific survival rates for stomach, colorectal, liver, and cervical cancers.

          Conclusion

          Korean cancer patients showed relatively favorable stage distribution and 5-year RSRs, which suggests potential contribution of the national cancer screening program.

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          Most cited references23

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          Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010.

          This article gives an overview of nationwide cancer statistics, including incidence, mortality, survival and prevalence, and their trends in Korea based on 2010 cancer incidence data. Incidence data from 1993 to 2010 were obtained from the Korea National Cancer Incidence Database, and vital status was followed until 31 December 2011. Mortality data from 1983 to 2010 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, prevalence, and relative survival were calculated. In total, 202,053 cancer cases and 72,046 cancer deaths occurred during 2010, and 960,654 prevalent cancer cases were identified in Korea as of 1 January 2011. The incidence of all cancers combined showed an annual increase of 3.3% from 1999 to 2010. The incidences of liver and cervical cancers have decreased while those of thyroid, breast, prostate and colorectal cancers have increased. Notably, thyroid cancer, which is the most common cancer in Korea, increased by 24.2% per year rapidly in both sexes. The mortality of all cancers combined showed a decrease by 2.7% annually from 2002 to 2010. Five-year relative survival rates of patients who were diagnosed with cancer from 2006 to 2011 had improved by 22.9% compared with those from 1993 to 1995. While the overall cancer incidence in Korea has increased rapidly, age-standardized cancer mortality rates have declined since 2002 and survival has improved.
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            Nationwide cancer incidence in Korea, 1999~2001; first result using the national cancer incidence database.

            The first Korean national population-based cancer registry using nationwide hospital-based recording system and the regional cancer registries provided the source to obtain national cancer incidences for the period 1999~2001. The incidence of cancer in Korea was calculated based on the Korea Central Cancer Registry database, data from additional medical record review survey, the Regional Cancer Registry databases, site-specific cancer registry databases, and cancer mortality data from the Korea National Statistical Office. Crude and age-standardized rates were calculated by sex for 18 age groups. The overall crude incidence rates (CR) were 247.3 and 188.3 per 100,000 for men and women and the overall age-standardized incidence rates (ASR) were 281.2 and 160.3 per 100,000, respectively. Among men, five leading primary cancer sites were stomach (CR 58.6, ASR 65.6), lung (CR 42.1, ASR 50.9), liver (CR 41.9, ASR 44.9), colon and rectum (CR 24.2, ASR 27.3) and bladder (CR 7.7, ASR 9.2). Among women, the most common cancers were stomach (CR 30.8, ASR 25.8), breast (CR 25.7, ASR 21.7), colon and rectum (CR 19.6, ASR 16.7), uterine cervix (CR 18.4, ASR 15.5), and lung cancer (CR 15.1, ASR 12.4). In 0~14 age group, leukemia was most common for both sexes. For men, stomach cancer was most common in 15~64 age group, but lung cancer was more frequent for over 65 age group. For women, thyroid cancer in 15~34 age group, breast cancer in 35~64 age group, and stomach cancer in over 65 age group were most common for each age group. The proportions of death certificate only were 7.5% for men and 7.4% for women. This is the first attempt to determine the national cancer incidence and this data will be useful to plan for research and national cancer control in Korea.
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              Overview of the National Cancer screening programme and the cancer screening status in Korea.

              Organised cancer screening in Korea began in 1999. Operating system has been stabilised, target population have expanded and participation rate has been increased throughout its ten years. Here we present an overview of the organised cancer screening system in Korea and introduce the National Cancer Screening Programme including results from 2002 to 2008. Furthermore, we present the results of the Korea National Cancer Screening Survey, a survey that is representative of the population, from 2004 to 2009. Finally, we discuss our achievements and the future challenges.
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                Author and article information

                Journal
                Cancer Res Treat
                Cancer Res Treat
                CRT
                Cancer Research and Treatment : Official Journal of Korean Cancer Association
                Korean Cancer Association
                1598-2998
                2005-9256
                September 2013
                30 September 2013
                : 45
                : 3
                : 162-171
                Affiliations
                [1 ]The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea.
                [2 ]Molecular Epidemiology Branch, National Cancer Center, Goyang, Korea.
                Author notes
                Correspondence: Young-Joo Won, PhD. The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea. Tel: 82-31-920-2015, Fax: 82-31-920-2179, astra67@ 123456ncc.re.kr
                Article
                10.4143/crt.2013.45.3.162
                3804727
                24155674
                13c4dacf-ff97-4562-9eb0-48919c0bda87
                Copyright © 2013 by the Korean Cancer Association

                This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 July 2013
                : 13 August 2013
                Funding
                Funded by: National Cancer Center
                Award ID: No. 1310220
                Categories
                Original Article

                Oncology & Radiotherapy
                korea,neoplasms,survival,stage,cancer registry
                Oncology & Radiotherapy
                korea, neoplasms, survival, stage, cancer registry

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