Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Trends in Colorectal Cancer Incidence in Daejeon and Chungcheongnam-do, South Korea (2000-2012)

대전광역시와 충청남도의 13년간(2000-2012) 대장암 발생 추세

  • Kim, Soon-Young (Department of Nursing, Health Institute of Technology) ;
  • Kweon, In-Sun (Clinical Trial Center, Chungnam National University Hospital) ;
  • Kim, Jung-A (Daejeon Regional Cancer Center, Chungnam National University Hospital) ;
  • Lee, Tae-Yong (Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine and Research Institute for Medical Sciences) ;
  • Nam, Hae-Sung (Daejeon Regional Cancer Center, Chungnam National University Hospital)
  • 김순영 (대전보건대 간호학과) ;
  • 권인선 (충남대학교병원 임상시험센터) ;
  • 김정아 (충남대학교병원 대전지역암센터) ;
  • 이태용 (충남대학교 의학전문대학원 예방의학교실 및 의학연구소) ;
  • 남해성 (충남대학교병원 대전지역암센터)
  • Received : 2015.05.26
  • Accepted : 2015.08.10
  • Published : 2015.09.30
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Abstract

Objectives: Colorectal cancer is one of the major cancers in South Korea. We described the time trends in colorectal cancer incidence in Daejeon, a metropolitan city, and Chungcheongnam-do (Chungnam), a rural province, South Korea. Methods: Using the databases from the Daejeon Cancer Registry (DCR) and the Chungnam Cancer Registry (CCR), age-standardized (to world standard population) rates for incidence (ASRW) were calculated. Average annual percent change (AAPC) was assessed as a trend indicator. The completeness (such as the mortality/incidence ratio) and validity (such as the death certificate only %, microscopic verification %, primary site uncertain %, and age unknown %) were analyzed to examine the data quality of DCR and CCR. Results: Incidence of colorectal cancer showed increasing trend in both sexes. Over the years 2000-2012 in Daejeon, ASRW was increased significantly from 37.2 to 51.7 per 100,000 person-years (AAPC, 3.9%) among men and from 17.1 to 28.4 (AAPC, 3.9%) among women, respectively. In Chungnam, ASRW was also increased from 29.8 to 50.1 per 100,000 person-years (AAPC, 5.1%) among men and from 15.9 to 26.6 (AAPC, 3.2%) among women, respectively. The AAPC for colon cancer was greater than rectal cancer in both Daejeon and Chungnam. The trend of rectal cancer incidence was differ by sex (AAPC in men vs women, 2.7% vs 1.7% in Daejeon; 3.5% vs 0.8% in Chungnam). Indices of completeness and validity showed that the quality control of DCR and CCR was adequate to describe the trends of ASRW. Conclusions: Both Daejeon and Chungnam have had a rapid increase in colorectal cancer incidence. Monitoring and intervention are required on the risk factors which may contribute to this trend.

대장암 발생에 관한 국내 역학연구는 매우 부족한 상황으로 국가단위 대장암 발생률의 추세는 보고되어 왔지만 광역 지역에서의 추세 연구는 미흡한 실정이다. 본 연구에서는 대전과 충남의 대장암 발생률 추세를 결장암과 직장암으로 구분하여 기술하고자 한다. 2000-2012년도 기간 동안 해당 지역암등록 자료를 이용하여 세계표준인구를 기준으로 연령표준화 대장암 발생률을 산출하였다. 발생률 추세는 Joinpoint Regression Program으로 분석하여 연평균 변화율(Average Annual Percent Change, AAPC)로 나타내었다. 연구 대상 암등록자료의 질적 수준 평가에서 충실도 지표(MI%)와 타당도 지표(DCO%, MV%, PSU%, AUK%)는 암 발생률의 추세를 기술하기에 전반적으로 적정한 수준이었다. 13년 동안 연령표준화 대장암 발생률은 남성과 여성 모두 지속적으로 증가하였다. 대전지역에서 남성의 경우 2000년 10만 명당 37.2건에서 2012년 51.7건으로 연평균 3.9%(AAPC) 증가하였고, 여성의 경우 2000년 10만 명당 17.1건에서 2012년 28.4건으로 연평균 3.9% 증가하였다. 충남지역에서 남성의 경우 2000년 10만 명당 29.8건에서 2012년 50.1건으로 연평균 5.1% 증가 하였고, 여성의 경우 2000년 10만 명당 15.9건에서 2012년 26.6건으로 연평균 3.2% 증가하였다. 이를 결장암과 직장암으로 분류하여 살펴보면 남녀 모두 결장암의 증가 추세가 직장암 증가보다 더 컸고, 직장암의 증가는 남성이 여성보다 더 빠른 추세였다. 결론적으로 대전과 충남의 대장암 발생은 2000년 이후 13년간 빠른 증가추세를 보였다. 이를 억제하기 위한 대장암 발생 감시와 예방에 지역사회의 관심을 더 높일 필요가 있다.

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