Epidemiological evidences on overdiagnosis of prostate and kidney cancers in Korean

Bae, Jong Myon

doi:10.4178/epih/e2015015

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…In Korea, the country with the highest TC incidence worldwide, SIRs for kidney cancer after TC increased with calendar period and paralleled TC increase in the general population 28 . For kidney cancer, the impact of enhanced screening (i.e., through abdominal ultrasound and imaging) has also been reported both in Korea 39 and elsewhere 40,41 …”

Section: Discussionmentioning

confidence: 98%

Risk of thyroid as a first or second primary cancer. A population‐based study in Italy, 1998–2012

et al. 2021

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Background The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. Methods We analyzed two population‐based cohorts of individuals with TC or other neoplasms diagnosed between 1998 and 2012, in 28 Italian areas covered by population‐based cancer registries. Standardized incidence ratios (SIRs) of SPC were stratified by sex, age, and time since first cancer. Results A total of 38,535 TC patients and 1,329,624 patients with other primary cancers were included. The overall SIR was 1.16 (95% CI: 1.12–1.21) for SPC in TC patients, though no increase was shown for people with follicular (1.06) and medullary (0.95) TC. SPC with significantly increased SIRs was bone/soft tissue (2.0), breast (1.2), prostate (1.4), kidney (2.2), and hemolymphopoietic (1.4) cancers. The overall SIR for TC as a SPC was 1.49 (95% CI: 1.42–1.55), similar for all TC subtypes, and it was significantly increased for people diagnosed with head and neck (2.1), colon–rectum (1.4), lung (1.8), melanoma (2.0), bone/soft tissue (2.8), breast (1.3), corpus uteri (1.4), prostate (1.5), kidney (3.2), central nervous system (2.3), and hemolymphopoietic (1.8) cancers. Conclusions The increased risk of TC after many other neoplasms and of few SPC after TC questions the best way to follow‐up cancer patients, avoiding overdiagnosis and overtreatment for TC and, possibly, for other malignancies.

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Section: Discussionmentioning

confidence: 98%

Risk of thyroid as a first or second primary cancer. A population‐based study in Italy, 1998–2012

et al. 2021

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“…Both criteria were stricter than contemporary Western studies, with relatively better outcomes in the rate of unfavorable disease and recurrence-free survival. However, applying an excessively strict protocol will unavoidably lead to the overtreatment of low-risk PCa, as shown in an epidemiological study in 2015 where mortality increased only by 3.3 deaths per 100,000 people (2.3 to 5.6) while the prevalence increased 6-fold (3.3 to 20.4) from 2000 to 2011 [ 22 ]. Thus, further assessment must be made to determine whether broader eligibility criteria can be applied to produce optimal outcomes.…”

Section: Discussionmentioning

confidence: 99%

A single-center long-term experience of active surveillance for prostate cancer: 15 years of follow-up

et al. 2021

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Purpose To describe a single-center 15-year experience of active surveillance (AS) for prostate cancer (PCa). Materials and Methods We retrospectively reviewed patients who underwent AS between 2003 and 2018. One hundred fifty-three patients were selected according to the following criteria: (1) biopsy Gleason pattern ≤3+4 with (2) ≤two positive core(s) and (3) ≤50% core involvement, clinical-stage ≤T2a, and prostate-specific antigen (PSA) ≤20 ng/mL. Follow-up included PSA measurement every six months, prostate biopsies at one year and then every 2–3 years, and MRI every year. Intervention was triggered by (1) Gleason score (GS) upgrading, (2) >two positive cores, or (3) PSA doubling-time in <3 years. Results Mean (±standard deviation) follow-up was 36.4 (±31.9) months. Ninety-three (60.8%) and 20 (13.1%) patients received second and third biopsies, respectively. Seventy-two patients (47.1%) discontinued AS for various reasons (59, intervention; 13, follow-up loss). Reasons for intervention consisted of GS upgrading (42.4%), >two positive cores (8.5%), abnormal PSA kinetics (11.9%), and patient preference (37.3%). Notably, 12 (25.5%) patients had pathologic GS ≥4+3 (unfavorable disease) and 3 (6.4%) patients had pathologic stage ≥T3a at radical prostatectomy. Median time to treatment-free survival was 19.5 months. Of the 59 patients who switched to intervention, biochemical recurrence was reported in only one (0.7%) patient. Conclusions AS is an available option for low-risk PCa in carefully selected patients. Further larger prospective studies are needed to determine the optimal criteria for AS, especially in Korean PCa patients.

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“…Among patients with dyslipidemia, those diagnosed with cancer before the dyslipidemia diagnosis were excluded. Moreover, individuals diagnosed with thyroid, breast, or prostate cancer were excluded from the analysis because of concerns about overdiagnosis in Korea 18 . Consequently, the final target population comprised 336,883 individuals with dyslipidemia.…”

Section: Methodsmentioning

confidence: 99%

What is the relationship between the local population change and cancer incidence in patients with dyslipidemia: Evidence of the impact of local extinction in Korea

Jeong,

Choi,

Kim

et al. 2024

Cancer Medicine

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BackgroundChanges in the local population are intricately linked to healthcare infrastructure, which subsequently impacts the healthcare sector. A decreasing local population can result in lagging health infrastructure, potentially leading to adverse health outcomes as patients may be at risk of not receiving optimal care and treatment. While some studies have explored the relationship between chronic diseases and local population decline, evidence regarding cancer is insufficient. In this study, we focused on how deteriorating management of chronic diseases such as dyslipidemia could influence the risk of cancer. We investigated the relationship between changes in the local population and cancer incidence among patients with dyslipidemia.MethodsThis cohort study was conducted using claims data. Data from adult patients with dyslipidemia from the National Health Insurance Service–National Sample Cohort conducted between 2002 and 2015 were included. Population changes in each region were obtained from the Korean Statistical Information Service and were used to link each individual's regional code. Cancer risk was the dependent variable, and Cox proportional hazards regression was used to estimate the target associations.ResultsData from 336,883 patients with dyslipidemia were analyzed. Individuals who resided in areas with a decreasing population had a higher risk of cancer than those living in areas with an increasing population (decrease: hazard ratio (HR) = 1.06, 95% CI = 1.03–1.10; normal: HR = 1.05, 95% CI = 1.02–1.09). Participants living in regions with a low number of hospitals had a higher risk of cancer than those in regions with a higher number of hospitals (HR = 1.20, 95% CI = 1.12–1.29).ConclusionPatients in regions where the population has declined are at a higher risk of cancer, highlighting the importance of managing medical problems caused by regional extinction. This could provide evidence for and useful insights into official policies on population decline and cancer risk.

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Epidemiological evidences on overdiagnosis of prostate and kidney cancers in Korean

Cited by 11 publications

References 19 publications

Risk of thyroid as a first or second primary cancer. A population‐based study in Italy, 1998–2012

Risk of thyroid as a first or second primary cancer. A population‐based study in Italy, 1998–2012

A single-center long-term experience of active surveillance for prostate cancer: 15 years of follow-up

What is the relationship between the local population change and cancer incidence in patients with dyslipidemia: Evidence of the impact of local extinction in Korea

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