• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8423-8427
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• 2014

Background: Cancer is the most common cause of death in Thailand, where treatment outcomes and prognosis are poor and mortality rates remain high. This study reports new cancer cases and trends of all cancers registered in Srinagarind Hospital from 1993 to 2012 and also provides a picture of the cancer situation in Northeast Thailand. Materials and Methods: All new cases of cancer registered in the hospital-based cancer registry at Faculty of Medicine, Srinagarind Hospital, Khon Kaen University during 1993-2012 were included in the study. Results and Conclusions: The number of new cancer cases has gradually increased each year during the last 20 years. The three most common cancers at present in males are liver and bile duct cancer, lung cancer and colorectal cancer, respectively. In females, liver and bile duct, breast and thyroid cancers are now the most frequent. Interestingly, the number of cases of both liver and bile duct cancer and colorectal cancer in males noticeably increased during the second decade of the study. Additionally, breast cancer greatly increased in the same decade and lung cancer in females climbed into the top five most common cancers. Thyroid cancer has also risen steadily in the last decade. Trends of common cancers are similar to those throughout Thailand.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8525-8531
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• 2016

Background: Cancer has become a major health problem associated with high mortality worldwide, especially in developing countries. The aim of our study was to evaluate the incidence rates of different types of cancer in Sulaymaniyah from January-2006 to January-2014. The data were compared with those reported for other middle east countries. Materials and Methods: This retrospective study depended on data collected from Hiwa hospital cancer registry unit, death records and histopathology reports in all Sulaymaniyah teaching hospitals, using international classification of diseases. Results: A total of 8,031 cases were registered during the eight year period, the annual incidence rate in all age groups rose from 38 to 61.7 cases/100,000 population/year, with averages over 50 in males and 50.7 in females. The male to female ratio in all age groups were 0.98, while in the pediatric age group it was 1.33. The hematological malignancies in all age groups accounted for 20% but in the pediatric group around half of all cancer cases. Pediatric cancers were occluding 7% of total cancers with rates of 10.3 in boys and 8.7 in girls. The commonest malignancies by primary site were leukemia, lymphoma, brain, kidney and bone. In males in all age groups they were lung, leukaemia, lymphoma, colorectal, prostate, bladder, brain, stomach, carcinoma of unknown primary (CUP) and skin, while in females they were breast, leukaemia, lymphoma, colorectal, ovary, lung, brain, CUP, and stomach. Most cancers were increased with increasing age except breast cancer where decrease was noted in older ages. High mortality rates were found with leukemia, lung, lymphoma, colorectal, breast and stomach cancers. Conclusions: We here found an increase in annual cancer incidence rates across the period of study, because of increase of cancer with age and higher rates of hematological malignancies. Our study is valuable for Kurdistan and Iraq because it provides more accurate data about the exact patterns of cancer and mortality in our region.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8513-8517
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• 2016

Background: GLOBOCAN12 recently reported high cancer mortality in Malaysia suggesting its cancer health services are under-performing. Cancer survival is a key index of the overall effectiveness of health services in the management of patients. This report focuses on Subang Jaya Medical Centre (SJMC) care performance as measured by patient survival outcome for up to 5 years. Materials and Methods: All women with breast cancer treated at SJMC between 2008 and 2012 were enrolled for this observational cohort study. Mortality outcome was ascertained through record linkage with national death register, linkage with hospital registration system and finally through direct contact by phone or home visits. Results: A total of 675 patients treated between 2008 and 2012 were included in the present survival analysis, 65% with early breast cancer, 20% with locally advanced breast cancer (LABC) and 4% with metastatic breast cancer (MBC). The overall relative survival (RS) at 5 years was 88%. RS for stage I was 100% and for stage II, III and IV disease was 95%, 69% and 36% respectively. Conclusions: SJMC is among the first hospitals in Malaysia to embark on routine measurement of the performance of its cancer care services and its results are comparable to any leading centers in developed countries.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2125-2129
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• 2016

Background: Stomach cancer is an aggressive malignancy that is difficult to detect at an early stage and therefore is characterized by poor survival rates. Over the last two decades, there has been no report of gastric cancer survival in Khon Kaen province, Thailand. The aim of this retrospective cohort study was to provide up-to-date information about the survival of gastric cancer patients in this province. Materials and Methods: Data from Khon Kaen population-based cancer registry, Faculty of Medicine, Khon Kaen University were newly obtained on 650 patients who were diagnosed with stomach cancer during the period 1 January, 2000 to 31 December, 2012. These were then followed up until death or the end of the study (31 December 2014). We calculated the observed survival with the actuarial life table method, and relative survival, defined as the ratio of observed survival in the group of the stomach cancer patients to the expected survival in the entire Thai population from the estimated generation life tables for Thailand of five-year birth cohorts from 1900 - 2000. Results: The 5 year observed and 5 year relative survival rates were 17.2 % (95% CI: 13.54-21.14) and 18.2 % (95% CI: 14.3-22.4), respectively. The highest 5 year relative survival rates were demonstrated among patients aged 45-65, with stage I or II lesions, with adenocarcinomas, with a body of stomach location, well differentiated and receiving surgery and/or chemotherapy. Conclusions: The observed and relative survival rates were close to each other. Our findings provide basic information beneficial to development of an effective treatment system and appropriately improved population-based cancer registration.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5367-5370
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• 2013

Background: Having knowledge or estimation of cancer incidence is necessary for planning and implementation of any cancer prevention and control programs. Population-based registries provide valuable information to achieve these objectives but require extra techniques to estimate the incidence rate. The present study aimed to estimate the esophageal cancer incidence using a log-linear method based on Tehran population-based cancer registry data. Materials and Methods: New cases of esophageal cancer reported by three sources of pathology reports, medical records, and death certificates to Tehran Metropolitan Area Cancer Registry Center during 2002-2006 were entered into the study and the incidence rate was estimated based on log-linear models. We used Akaike statistics to select the best-fit model. Results: During 2002-2006, 1,458 new cases of esophageal cancer were reported by the mentioned sources to the population-based cancer registry. Based on the reported cases, cancer incidence was 4.5 per 100,000 population and this was estimated to be 10.5 per 100,000 by the log-linear method. Conclusions: Based on the obtained results, it can be concluded that an estimated incidence for 2004 of 8.3 per 100,000 population could be a good benchmark for the incidence of esophageal cancer in the population of Tehran metropolis.

• 한국인구학
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• 제5권1호
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• pp.4-16
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• 1982

The Korean Population Control Program has been implementing under the jurisdiction of the Ministry of Health and Social Affairs through an existing network of health centers. This arrangement was successful in bringing population growth down to targeted level by the end of the Fourth Five Year Economic Planning, 1981. It is expected, however, that future goal will be harder to reach due to difficulty of reducing traditional family size norms further and to the projected increasing the number of eligible couples as the past Korean war baby boom generation enters the reproductive activity in the next few years. The recognition of the need for modification of population policy is increasing. The 1980 census shows that the total number of population reached approximately 38.5 million with 1.57 per cent of the growth rate. It was projected that the size of Korean Population will reach around 42 million and 51 million in 1986 and 2000 respectively. Furthermore, there is some argument as to whether decline in the birth rate in Korea is too slow to meet government target. Hence, a new development of population policy and greatly increased amount of effort will be needed in order to achieve Zero Population Growth Rate before the year 2050. The development of future national population policy and its related area are recommended as follow: 1. It is highly recommended that the population planning law governing both vital events of birth and death and population migration should be legislated. 2. The National Population Policy Council, Chaired by Deputy Prime Minister should be activated to implement and coordinate population program within ministries. 3. Responsible organization of population and family planning program should be established as a Bureau unit at central government level. 4. For the improvement of national vital registration, an existing system should be studied and developed.

• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.392-402
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• 2009

Objectives : The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). Methods : The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data. Results : The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies. Conclusions : The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.

• Journal of Trauma and Injury
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• 제34권2호
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• pp.87-97
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• 2021

Purpose: This study examined emergency medical service (EMS) transportation patterns for adult trauma patients before and after establishing a level 1 regional trauma center (RTC) and to evaluate the transportation approach after prehospital severity screening. Methods: This was a retrospective observational study of trauma patients aged ≥18 years admitted via EMS to the emergency department or a level 1 RTC, 1 year before to 3 years after RTC establishment. Patients with an Injury Severity Score (ISS) in the patient registration system were selected. Analyses were performed to determine transportation pattern changes by comparing patients pre- and post-RTC establishment and by yearly comparisons over the 4-year study period using the Mann-Whitney U test and chi-square test. Results: Overall, 3,587 patients were included. The mean ISS was higher in the post-RTC group (n=2,693; 10.63±8.90, median 9.00) than in the pre-RTC group (n=894; 9.44±8.20, median 8.00; p<0.001). The mean transportation distance (9.84±13.71, median 5.80 vs. 13.12±16.15 km, median 6.00; p<0.001) was longer in the post-RTC group than in the pre-RTC group. Furthermore, proportionally fewer patients were transported from an area in the same city as the RTC after establishment (86.1% vs. 78.3%; p<0.001). Yearly comparisons revealed a gradually increasing trend in the hospital death rate (ptrend=0.031). Conclusions: After establishing a level 1 RTC, the EMS transportation of severe trauma patients increased gradually along with the long-distance transportation of minor trauma patients. Therefore, improved prehospital EMS trauma severity assessments and level 1 RTC involvement in patient classification in the prehospital phase are necessary.

• Journal of Preventive Medicine and Public Health
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• 제4권1호
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• pp.77-87
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• 1971

연세지역 아파트 주민의 모자보건과 가족계획에 대한 지식, 태도와 실천을 파악하기 위하여 1970년 11 월24일부터 12월 30일까지 305명의 유배우가임부인을 대상으로 조사 하였다. 본 연구를 통해 얻어진 결과를 요약하면 다음과 같다. A. 임신과 출산 1. 현 임신율 16.4% 2. 분만장소 출산경험이 있는 281명에 대한 최종아의 분만중 48.0%가 의사 또는 조사원이 개조 하였고 그 나머지 52.0%는 가정분만이었다. 교육정도, 매스메디아 접촉정도가 높을수록, 그리고 도시출생성장일수록 병원 또는 조산원 분만이 높았다. 9. 분만시 방포 사용 종류 가정분만 141예중 세멘트 포대와 비닐을 깐 경우가 합해서 50%이었고 아무것도 깔지 않고 분만한 경우도 4예가 있었다. 4. 제대 절단 용구와 소독 가정 분만 141예중 70.2%가 가위를 사용했고, 소독해서 사용한 예는 불과 24.1%이었다. 5. 산후 휴식기간 산후 1달 혹은 1달이상 휴식한 예가 47.3%이었고 교육정도가 높아짐에 따라 길어지고 있다. 6. 초유처리 초유를 애기에게 먹인 예가 52.4%이있고 교육정도에 따라 유의한 차이가 없었다. 7. 산전 산후의 금기 음식 42.9%가 산전 산후에 먹어서는 안될 음식이 있다는 그릇된 지식을 갖고 있다. B. 아동 보건 1. 예방접종에 관한 지식과 실천 어린이 예방접종 6가지 모두 알고있는 부인은 20.3%이며 93.2%가 1가지 이상 알고있었다. 1가지 이상 실시한 경우는 85.2%이었고 교육정도별 유의한 차이는 없었다. 2. 최종아의 이환과 치료 48.1%가 아픈 일이 있었으며 그중 병원 이용은 41.5%이었다. 3. 육아 상담 76.5%가 상담한 일이 없었으며 세브란스 병원 육아 지도회 이용율은 13.2%의 저율을 보였고 앞으로의 육아지도회 이용할 생각은 54.1%가 생각 없다고 하였다. 4. 수 유 최종아의 이유기간은 6개월${\sim}$1년미만이 33.9%로 수위이며 젖뗀 이유는 모자 보건을 위해서가 수위였다. 5. 출생 및 사망신고장소에 대한 지식과 실천구청으로 답한 옳은 답은 64.6%였고 14일 이내 출생 신고한 비율은 29.2%에 한 하였다. C. 가족계획에 대한 지식, 태도, 실천정도 가족계획 찬성율은 95.0%의 고율을 보이고 있고, 97.7%가 1가지 이상의 방법을 알고 있었으나 가족계획 실천율은 35.4%이었다. 첫아이갖는 이상적인 연령은 $24{\sim}25$세가 수위였다. D. 자녀수 이상적인 평균 자녀수는 3.1명이며 인공유산 경험자는 31.1%이다. 본 논문을 완성함에 있어서 간곡하신 지도와 교열의 수고를 베풀어 주신 연세의대 예방의학교실 김일순 선생님과 연세간호대학 김모임 선생님께 충심으로 감사를 드린다.

• 농촌의학ㆍ지역보건
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• 제30권2호
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• pp.127-135
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• 2005

본 연구는 결핵관리사업의 중요한 지표인 결핵사망률의 증가와 감소를 전국, 지역(대도시, 일반시, 군지역)별로 연도별 결핵 표준화사망률의 변화 양상을 확인하고자 시행되었으며, 1995년부터 2002년까지의 결핵사망자를 사망신고상 주소지를 기준으로 기초자치단체별로 분류하였고 2000년 현재 236개의 기초자치단체 중 도농통합시로 통합개편되었거나 분리되어 분석이 어려운 기초자치단체 4곳을 제외한 232개 시군구의 결핵사망자를 최종 분석 대상으로 선정하였다. 분석 대상은 연령보정 직접 표준화법을 사용하여 결핵 표준화사망률을 산출하였고, 각 지역별 연도별 결핵 표준화사망률의 변화를 그래프와 표로 관찰해보았다. 전국, 지역(대도시, 일반시, 군지역)별로 연도별 결핵 표준화사망률의 증감 추이를 모형적 정성 검정을 이용하여 연도별 결핵 표준화사망률의 변화 곡석의 양상을 확인하였고, 1995-1998년의 결핵 표준화사망률과 1999-2002년의 결핵 표준화사망률을 4년씩 묶어 이 두 기간 사이의 변화량을 알아보기 위해 분산분석 및 사후검정을 실시하였다. 수집된 자료는 SPSS 100판을 이용하였다. 1. 전국 결핵사망률의 변화를 추이해 보면 조율과 표준화율 모두에서 꾸준하게 감소하는 양상을 보이다가, 1999년을 정점으로 그 감소폭이 둔화되고 있는 양상을 보였다. 2. 지역을 대도시, 일반시, 군지역으로 분류하고 1995-1998년과 1999-2002년으로 4년씩 묶어 이 두 기간의 결핵 표준화사망률 변화를 살펴보면, 분산분석을 실시하였을 때 1995-1998년의 군지역의 사망률은 다른 지역들에 비해 유이하게 높게 나타났으나 1999-2002년의 군지역의 사망률도 여전히 높게 나타났다. 3. 지역별 결핵 표준화사망률의 모형적정성 검정 결과를 살펴보면, 대도시지역의 경우 일차함수적으로 꾸준히 감소하고, 일반시의 경우 일차함수적으로 감소하고 있기는 하지만 그 감소폭이 다소 둔화되는 양상을 보였다. 군지역의 경우 이차함수 모형에서 유의하게 나타났다. 연도별 결핵 표준화사망률의 감소경향이 지역별로 다른 양상을 나타내는 것을 알 수 있었다. 각 지역별로 꾸준히 감소하고는 있었지만 1999년을 정점으로 대부분의 지역에서 그 감소가 둔화되는 모습을 보여주었다. 이러한 현상은 군지역에서 더욱 뚜렷하게 볼 수 있었는데 이에 대한 추가 연구가 필요하며 지역별로 차별화된 결핵사업 전략이 필요함을 시사하였다.