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Aim: To estimate the risk of cancer incidence and mortality among patients with alcoholic liver disease in South Korea. Methods: A matched cohort study was conducted, including 1,042,185 men (alcoholic liver disease cases: 208,437; controls: 833,748) and 100,400 women (alcoholic liver disease cases: 20,080; controls: 80,320), matched for sex, age, smoking, alcohol consumption, and body mass index at a 1:4 ratio. The risk of cancer incidence and mortality in the alcoholic liver disease group was assessed using Cox proportional hazards regression models. Results: Both men and women with alcoholic liver disease had an elevated risk of all‐cancer and liver cancer incidence and mortality in comparison with the control group. In men, alcoholic liver disease was associated with a significantly higher risk of development of 10 cancer types, including lip, oral cavity, and pharynx; esophagus; liver; gallbladder and biliary tract; pancreas; larynx; lung; kidney; thyroid gland; and leukemia. Subgroup analysis by hepatitis B and C infection showed increased hazard ratios of all cancer incidences and mortality in the alcoholic liver disease group, regardless of hepatitis B or C infection status. In both sexes, a higher number and more years of hospital or clinic visits for alcoholic liver disease were associated with an increased risk of incidence and mortality from all cancers and liver cancer. A more profound dose–response relationship between alcoholic liver disease and alcohol consumption was observed in women than in men. Conclusions: Our findings emphasize the need for a clinical surveillance program and the early detection of cancer in patients with alcoholic liver disease. [ABSTRACT FROM AUTHOR]

Identification of high-risk areas of cancer, referred to as spatial clusters, can inform targeted policies for cancer control. Although cancer cluster detection could be affected by various geographic characteristics including sociodemographic and environmental factors which impacts could also vary over time, studies accounting for such influence remain limited. This study aims to assess the role of geographic characteristics in the spatial cluster detection for lung and stomach cancer over an extended period. We obtained sex-specific age-standardized incidence and mortality rates of lung and stomach cancer as well as geographic characteristics across 233 districts in South Korea for three five-year periods between 1999 and 2013. We classified geographic characteristics of each district into four categories: demography, socioeconomic status, behaviors, and physical environments. Specifically, we quantified physical environments using measures of greenness, concentrations of particulate matter and nitrogen dioxide, and air pollution emissions. Finally, we conducted cluster detection analyses using weighted normal spatial scan statistics with the residuals from multiple regression analyses performed with the four progressive sets of geographic attributes. We found that the size of clusters reduced as we progressively adjusted for geographic covariates. Among the four categories, physical environments had the greatest impact on the reduction or disappearance of clusters particularly for lung cancer consistently over time. Whereas older population affected a decrease of lung cancer clusters in the early period, the contribution of education was large in the recent period. The impact was less clear in stomach cancer than lung cancer. Our findings highlight the importance of geographic characteristics in explaining the existing cancer clusters and identifying new clusters, which jointly provides practical guidance to cancer control. • Spatial cluster detection of cancer by accounting for geographic characteristics. • Reduction or disappearance of lung cancer clusters by physical environments. • Large impact of greenness and air pollution emissions in recent periods. • Less impacts of geographic characteristics on stomach cancer than lung cancer. [ABSTRACT FROM AUTHOR]

Background: We hypothesized that lower socioeconomic status (SES) was associated with higher all‐cause mortality in patients newly diagnosed with cancer, particularly in the elderly population. Methods: We collected study patients from the stratified random sample of Korean National Health Insurance Elderly Cohort (2002‐2015). The Cox's proportional hazards model was used to investigate the risk factors for mortality. Income level and composite deprivation index (CDI) 2010 were used to define the SES: low, intermediate, and high SES groups. The comorbidities were measured using Charlson Comorbidity Index score. After a wash‐out period (2002), the final study population was 108 626 (2003‐2015). Results: In multivariate analysis, low SES was associated with poor overall survival (OS) (HR = 1.08, 95% CI: 1.05‐1.12, P < 0.001) and cancer‐specific survival (CSS) (HR = 1.11, 95% CI: 1.06‐1.16, P < 0.001) particularly for patients aged 70‐79 years. High SES was favorable prognostic factor of OS in patients aged 60‐69 years (HR = 0.85, 95% CI: 0.81‐0.89, P < 0.001), 70‐79 years (HR = 0.90, 95% CI: 0.87‐0.93, P < 0.001), and ≥80 years (HR = 0.91, 95% CI: 0.87‐0.96, P < 0.001). However, SES was not associated with CSS in advanced age patients (≥80 years). Patients with low SES manifesting colorectal, urinary, liver, gastric, melanoma, and esophageal cancers demonstrated worse OS, compared to patients with intermediate SES. Also, low SES patients with urinary, liver, or colorectal cancers or melanoma demonstrated worse CSS compared to those with intermediate SES. Conclusion: Low SES at the time of cancer diagnosis is associated with increased risk of OS and CSS in elderly patients. Depending on cancer sites, different patterns of OS and CSS were observed according to SES. Further elucidation of the causes underlying these phenomena is needed along with appropriate support for elderly cancer patients with low SES. [ABSTRACT FROM AUTHOR]

Abstract: We sought to explore a possible association between higher parental socioeconomic position and lower child cancer mortality. We examined total cancer mortality as well as site-specific cancer mortality. We constructed a retrospective birth cohort by linking South Korean birth records to death records from 1995 to 2004. Parental socioeconomic position and birth characteristics were identified from the birth records. Parental education and occupation were examined as socioeconomic variables while sex, parental age, gestational age, birth weight, multiple birth, birth order, and the death of previous children were included as birth characteristics. Cancer deaths were identified from the death records. In total, 5711,337 births were analyzed, including 30,844,015 total person-years. The total number of deaths was 21,217, including 1102 children who died of cancer. Hazard ratios of cancer mortality according to parental socioeconomic position were calculated using a Cox proportional hazard analysis with adjustment for the birth characteristics. All socioeconomic measures except maternal occupation showed a significant inverse association with cancer mortality after adjusting for the birth characteristics. For paternal education, high school and middle school graduation or lower was associated with an increased hazard ratio of cancer mortality compared to university education or higher: 1.14 (1.00–1.29) and 1.29 (1.02–1.62), respectively. For maternal education, middle school graduation or lower was associated with a hazard ratio of 1.54 (1.21–1.95). For paternal occupation, manual work and economic inactivity were associated with increased hazard ratios as compared to non-manual work: 1.17 (1.02–1.34) and 1.34 (1.04–1.73), respectively. Inequalities were also found for leukemia and central nervous system tumors. The extent of the inequalities decreased after age 5, and only the 1-4-year-old group showed significant associations with parental socioeconomic position. We conclude that there is an inverse relationship between childhood cancer mortality and parental socioeconomic position in Korea. [Copyright &y& Elsevier]