본문 바로가기
KERD
논문KCI 등재

Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015

강희연|Jung-Choi Kyunghee|박진욱|Khang Young-Ho
한국역학회 (Korean Society of Epidemiology)|2024.01|Epidemiology and Health|제46권 |pp. 74-74|DOI 10.4178/epih.e2024074

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

KoreaIncidenceMortalityBreast cancerHealth inequities

초록

OBJECTIVES: Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of women breast cancer from 2006 to 2015, using national data that covered all Korean women.METHODS: We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.RESULTS: When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based RD in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% confidence interval [CI], -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.CONCLUSIONS: This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.

Abstract

OBJECTIVES: Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of women breast cancer from 2006 to 2015, using national data that covered all Korean women.METHODS: We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.RESULTS: When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based RD in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% confidence interval [CI], -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.CONCLUSIONS: This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.

참고문헌 (50)

  1. Bray F, "Global cancer statistics 2022 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries", CA Cancer J Clin, 74, pp.229~263 (2024)[DOI]
  2. Kang MJ, "Cancer statistics in Korea : incidence, mortality, survival, and prevalence in 2020", Cancer Res Treat, 55, pp.385~399 (2023)[DOI]
  3. Lei S, "Global patterns of breast cancer incidence and mortality : a population-based cancer registry data analysis from 2000 to 2020", Cancer Commun(Lond), 41, pp.1183~1194 (2021)[DOI]
  4. Song SY, "Trends in breast cancer screening rates among Korean women : results from the Korean National Cancer Screening Survey, 2005-2020", Epidemiol Health, 44, pp.e2022111~ (2022)[DOI]
  5. Benitez Fuentes JD, "Global stage distribution of breast cancer at diagnosis : a systematic review and meta-analysis", JAMA Oncol, 10, pp.71~78 (2024)[DOI]
  6. Ong SK, "Feasibility of monitoring Global Breast Cancer Initiative Framework key performance indicators in 21 Asian National Cancer Centers Alliance member countries", EClinicalMedicine, 67, pp.102365~ (2023)[DOI]
  7. Rimpelä AH, "Cancers of affluence : positive social class gradient and rising incidence trend in some cancer forms", Soc Sci Med, 24, pp.601~606 (1987)[DOI]
  8. Lundqvist A, "Socioeconomic inequalities in breast cancer incidence and mortality in Europe-a systematic review and meta-analysis", Eur J Public Health, 26, pp.804~813 (2016)[DOI]
  9. Strand BH, "The reversed social gradient : higher breast cancer mortality in the higher educated compared to lower educated. A comparison of 11 European populations during the 1990s", Eur J Cancer, 43, pp.1200~1207 (2007)[DOI]
  10. Martikainen P, "Diminishing educational differences in breast cancer mortality among Finnish women : a register-based 25-year follow-up", Am J Public Health, 90, pp.277~280 (2000)[DOI]
  11. Albano JD, "Cancer mortality in the United States by education level and race", J Natl Cancer Inst, 99, pp.1384~1394 (2007)[DOI]
  12. Menvielle G, "Diverging trends in educational inequalities in cancer mortality between men and women in the 2000s in France", BMC Public Health, 13, pp.823~ (2013)[DOI]
  13. Kim MH, "Educational inequality in female cancer mortality in Korea", J Korean Med Sci, 30, pp.1~6 (2015)[DOI]
  14. Jung-Choi K, "Changes in contribution of causes of death to socioeconomic mortality inequalities in Korean adults", J Prev Med Public Health, 44, pp.249~259 (2011)[DOI]
  15. Bahk J, "Increased breast cancer mortality only in the lower education group : age-period-cohort effect in breast cancer mortality by educational level in South Korea, 1983-2012", Int J Equity Health, 16, pp.56~ (2017)[DOI]
  16. Seong SC, "Data resource profile : the National Health Information Database of the National Health Insurance Service in South Korea", Int J Epidemiol, 46, pp.799~800 (2017)[DOI]
  17. Yang MS, "Validation of cancer diagnosis based on the National Health Insurance Service Database versus the National Cancer Registry Database in Korea", Cancer Res Treat, 54, pp.352~361 (2022)[DOI]
  18. Bahk J, "Inequality in life expectancy in Korea according to various categorizations of the National Health Insurance premiums as a marker of income", Yonsei Med J, 61, pp.640~643 (2020)[DOI]
  19. Suh JS, "Menstrual and reproductive factors related to the risk of breast cancer in Korea. Ovarian hormone effect on breast cancer", J Korean Med Sci, 11, pp.501~508 (1996)[DOI]
  20. Lee EO, "Determining the main risk factors and high-risk groups of breast cancer using a predictive model for breast cancer risk assessment in South Korea", Cancer Nurs, 27, pp.400~406 (2004)[DOI]
  21. Kim CW, "Inequalities in cancer incidence and mortality across income groups and policy implications in South Korea", Public Health, 122, pp.229~236 (2008)[DOI]
  22. Choe SA, "Income disparity in breast cancer incidence and stage at presentation : a national population study of South Korea", J Breast Cancer, 25, pp.415~424 (2022)[DOI]
  23. Carlsen K, "Social inequality and incidence of and survival from breast cancer in a population-based study in Denmark, 1994-2003", Eur J Cancer, 44, pp.1996~2002 (2008)[DOI]
  24. Fujino Y, "A prospective study of educational background and breast cancer among Japanese women", Cancer Causes Control, 19, pp.931~937 (2008)[DOI]
  25. Fei X, "Urban-rural disparity of breast cancer and socioeconomic risk factors in China", PLoS One, 10, pp.e0117572~ (2015)[DOI]
  26. Goldberg M, "Socioeconomic disparities in breast cancer incidence and survival among parous women : findings from a population-based cohort, 1964-2008", BMC Cancer, 15, pp.921~ (2015)[DOI]
  27. Akinyemiju TF, "Socioeconomic status and incidence of breast cancer by hormone receptor subtype", Springerplus, 4, pp.508~ (2015)[DOI]
  28. Trewin CB, "Changing patterns of breast cancer incidence and mortality by education level over four decades in Norway, 1971-2009", Eur J Public Health, 27, pp.160~166 (2017)[DOI]
  29. Tweel M, "Trends in socioeconomic inequalities in breast cancer incidence among women in Canada", Cancer Control, 30, pp.10732748231197580~ (2023)[DOI]
  30. Youn HJ, "A review of the epidemiology of breast cancer in Asia : focus on risk factors", Asian Pac J Cancer Prev, 21, pp.867~880 (2020)[DOI]
  31. Park B, "Korean risk assessment model for breast cancer risk prediction", PLoS One, 8, pp.e76736~ (2013)[DOI]
  32. A study of fertility changes in Korea : based on National Fertility and Family Health Survey(1974-2012), "Oh Y", Korea Institute for Health and Social Affairs, ~ (2016)
  33. Strand BH, "Is birth history the key to highly educated women’s higher breast cancer mortality? a follow-up study of 500,000 women aged 35-54", Int J Cancer, 117, pp.1002~1006 (2005)[DOI]
  34. Menvielle G, "The contribution of risk factors to the higher incidence of invasive and in situ breast cancers in women with higher levels of education in the European prospective investigation into cancer and nutrition", Am J Epidemiol, 173, pp.26~37 (2011)[DOI]
  35. Cho GJ, "Age at menarche in a Korean population : secular trends and influencing factors", Eur J Pediatr, 169, pp.89~94 (2010)[DOI]
  36. Park CY, "Age at natural menopause in Koreans : secular trends and influences thereon", Menopause, 25, pp.423~429 (2018)[DOI]
  37. Hong J, "The current status of prolonged breastfeeding and its related factors in Korean infants and their mothers : a nationwide cross-sectional study", J Korean Med Sci, 38, pp.e261~ (2023)[DOI]
  38. Hwang J, "Measuring socioeconomic inequalities in obesity among Korean adults, 1998-2015", Int J Environ Res Public Health, 16, pp.1617~ (2019)[DOI]
  39. Park H, "Trends and factors associated with oral contraceptive use among Korean women", Healthcare(Basel), 9, pp.1386~ (2021)[DOI]
  40. Chang Y, "Long-term trends in smoking prevalence and its socioeconomic inequalities in Korea, 1992-2016", Int J Equity Health, 18, pp.148~ (2019)[DOI]
  41. Harding C, "Breast cancer screening, incidence, and mortality across US counties", JAMA Intern Med, 175, pp.1483~1489 (2015)[DOI]
  42. Choi SW, "Higher breast cancer prevalence associated with higher socioeconomic status in the South Korean population; has it resulted from overdiagnosis?", PLoS One, 13, pp.e0200484~ (2018)[DOI]
  43. Park EC, "The present and challenges of National Cancer Screening Program", J Korea Assoc Health Promot, 3, pp.280~287 (2005)
  44. Choi E, "Socioeconomic inequalities in cervical and breast cancer screening among women in Korea, 2005-2015", Yonsei Med J, 59, pp.1026~1033 (2018)[DOI]
  45. Riba LA, "Association between socioeconomic factors and outcomes in breast cancer", Breast J, 25, pp.488~492 (2019)[DOI]
  46. Woods LM, "Origins of socio-economic inequalities in cancer survival : a review", Ann Oncol, 17, pp.5~19 (2006)[DOI]
  47. Choi KH, "Quality assessment and trend for breast cancer treatment practice across South Korea based on nationwide analysis of Korean health insurance data during 2013-2017", Cancer Res Treat, 55, pp.570~579 (2023)[DOI]
  48. Lee HE, "Occupational disparities in survival in Korean women with cancer : a nationwide registry linkage study", BMJ Open, 10, pp.e039259~ (2020)[DOI]
  49. Jung KW, "Cancer statistics in Korea : incidence, mortality, survival, and prevalence in 2015", Cancer Res Treat, 50, pp.303~316 (2018)[DOI]
  50. Khang YH, "A publicly well-accepted measure versus an academically desirable measure of health inequality : cross-sectional comparison of the difference between income quintiles with the slope index of inequality", BMJ Open, 9, pp.e028687~ (2019)[DOI]

관련 논문AI추천

Socioeconomic Inequalities in Cervical and Breast Cancer Screening among Women in Korea, 2005–2015김열, 기모란, 박보영, 서미나, 오진경, 이윤영, 이은영, 전재관, 조현순, 최귀선, 최은지, Tran Thi Xuan Mai연세대학교의과대학 · Yonsei Medical Journal2018 · 제59권 제9호Socioeconomic inequality in organized and opportunistic screening for breast cancer: results from the Korean National Cancer Screening Survey, 2009-2021Choi Kui Son, Ha Yejin, Jun Jae Kwan, Kim Woorim, Luu Xuan Quy, Suh Mina한국역학회 · Epidemiology and Health2025 · 제47권 사회경제적 위치와 유방암 수술 후 총 사망위험과의 관련성박미진, 박종혁, 이선미, 장후선, 정우진대한예방의학회 · 예방의학회지2010 · 제43권 제4호Regional disparities in major cancer incidence in Korea, 1999-2018서홍관, Choi Chang Kyun, Jeong-Soo Im, Jung Kyu-Won, Kang Mee Joo, Kim Hye-Jin, Kong Hyun-Joo, Park Eun Hye, Yun E Hwa한국역학회 · Epidemiology and Health2023 · 제45권 Health Inequities in Cancer Incidence According to Economic Status and Regions Are Still Existed even under Universal Health Coverage System in Korea: A Nationwide Population Based Study using National Health Insurance Database이진용, 이혜진, 장영수, 조상아, 조은별, 황수희대한암학회 · Cancer Research and Treatment2024 · 제56권 제2호Trends in Breast Cancer Screening Rates among Korean Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2005-2020송수연, 신혜영, 최귀선, Jun Jae Kwan, Lee Yun Yeong, Park Bomi, Suh Mina한국역학회 · Epidemiology and Health2022 · 제44권

이 간행물의 다른 논문 (96건)

Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in KoreaLee Hyeok-Hee, 김현창, Kim Min, Park Sohee, Lee Seung-Jun, Cho Minsung, Baek Jang-Hyun, Yum Kyu Sun, Kim Kyung Won, Kim Young Dae, Yang JiHyun, Kim Yung Ah, 박해용, 김병극, 김동욱, 유승찬, 이호규, 배장환pp. 1-1Incidence and case fatality of acute myocardial infarction in Korea, 2011-2020배장환, Kim Eunji, Lee Hyeok-Hee, Lee Hokyou, Kaneko Fumie, Shin Sojung, Kim Byeong-Keuk, Moon Jenny, Kim Hyeon Chang, Lee Seung-Jun, 김민, Seo Yeeunpp. 2-2Incidence and case fatality rates of stroke in Korea, 2011-2020Kim Eunji, Moon Jenny, Seo Yeeun, Kim Young Dae, Yum Kyu Sun, Baek Jang-Hyun, Shin Sojung, Kaneko Fumie, Lee Hokyou, Kim Hyeon Chang, Lee Hyeok-Heepp. 3-3Decomposition of socioeconomic inequalities in glaucoma knowledge in TaiwanHou Chiun-Ho, Pu Christypp. 4-4The mediating role of atrial fibrillation in causal associations between risk factors and stroke: a Mendelian randomization studyLiu Xinfeng, Gill Dipender, Wang Mengmeng, Qin Shanmei, Zhang Zhizhongpp. 5-5
원문 보기