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1 J Korean Cancer Assoc 2001;33(2): Cancer Incidence in Daegu in : The First Results of the Daegu Cancer Registry Choong Won Lee, M.D. 1,4, Mi Young Lee, M.D. 1,4, Hyun Sook Lim, CTR 1,4, S oo Sang S ohn, M.D. 2 Jae Kyu Je on, M.D. 3 and Department of 1 Preventive Medicine, 2 Department of General Surgery, Department of 3 Anesthesia, and 4 Daegu Cancer Registry, Keimyung University College of Medicine, Daegu, Korea Purpose: A po pulatio n-bas ed cance r regis try was set up in January 1, 1997 to es timate the inc ide nce of cance r in Daeg u, So uth Ko rea. Materials and Methods : Data s o urces for cas e-finding and abs tracting we re hos pital inpatie nts, othe r s o urces in hos pitals othe r than inpatie nts, and private pathology labo rato ries. The reg is te red cas es we re matc hed agains t two exte rnal databas es, the death ce rtificate and medical ins urance c laims. Results : A total of 7,837 cases (4,203 males, 3,634 females ) we re regis te red in exc luding 2,718 cases of DCN. The c rude incide nce rates of all cance rs combined we re 170.7/100,000 (AS R 255.0) in males and (AS R 154.4) in fe males. In males, the most common cance r was s to mach (47.3, ASR 69.0), fo llowed by liver (28.0, ASR 37.6), lung (26.0, AS R 44.1), colo rectum (14.9, AS R 23.3), urinary bladder (4.5, AS R 7.0) and pros tate (3.5, AS R 7.0). The mos t common cance r in fe males was s to mach (25.8, AS R 26.9), fo llowed by breas t (21.7, ASR 20.4), ce rvix ute ri (21.1, ASR 20.4), co lo rectum (14.9, AS R 16.0), lung (9.9, AS R 11.0), live r (9.3, AS R 10.1), and thyro id (6.1, ASR 5.7). The ove rall pe rce ntage of mic ros co pically ve rified and the DCN% we re 80.3%, 27.7% in males and 88.7%, 20.7% in fe males, res pectively. Conclusion: These res ults s how that the incidence level of all cancers combined in both sexes in Daegu is approac hing that of othe r indus trialized regio ns in As ia as we ll as in the wo rld. (J Korean Cancer Assoc 2001;33: ) Key Words : Cancer reg istry, Daeg u (population-based cancer registry) (1) WHO (multi-hospital central cancer registry), , Tel: , Fax: , (2), (3) (4), (5 7). 8 (8,9) (Daegu Cancer Registry, DCR) (population-based can-

2 Choong Won Lee, et al Cancer Incidence in Daegu in Fig. 1. Age structure in Daegu, cer registry) (10)2,445,277 ( 1,231,602, 1,213,675 ) Fig. 1. ICD-O-2 /3(11,12). IARC. (12) ,,,,,,,,,,,, (morphology),, (PRN).,,. (Fig. 2). 8, (inpatients database). (,, CT/MRI,, ).,,,.,.,,. (matching), DCR (internal database). 2 2,. (, ) death certification notification (DCN). (suspense file). (prevalent cases)

3 138 J Korean Cancer Assoc 2001;33(2) Fig. 2. Data collection mechanism and input diagram., (13). (microscopic verification%, MV%), (death certificate notification, DCN)%, /(mortality/incidence ratios, MI ratios). MV% CI5 (14) (needle biopsy). 18 (1). CANREG-3 (15) ,837 4,203, 3, ,

4 Choong Won Lee, et al Cancer Incidence in Daegu in (ASR 69.0) (ASR 37.6), 26.0 (ASR 44.1), 14.9 (ASR 23.3), 4.7 (ASR 8.0), 4.5 (ASR 7.0), 4.4 (ASR 7.3), 3.6 (ASR 5.1), 3.5 (ASR 7.0), Non-Hodgkin's lymphoma 3.4 (ASR 4.3), Kaposi's sarcoma Table 1. Average annual age-specific incidence rates, crude rates (all ages), ASR in Daegu by primary site and age in males All AGE Crude ASR ICD SITE ages UNK rate world (10th) Lip C00 Tongue C01-C02 Salivary gland C07-C08 Mouth C03-C06 Oropharynx C09-C10 Nasopharynx C11 Hypopharynx C12-C13 Pharynx unspec C14 Oesophagus C15 Stomach C16 Small intestine C17 Colon C18 Rectum C19-C21 Liver C22 Gallbladder etc C23-C24 Pancreas C25 Nose, sinuses etc C30-C31 Larynx C32 Bronchus, lung C33-C34 Other Thoracic organs C37-C38 Bone C40-C41 Connective tissue C47;C49 Mesothelioma C45 Kaposi's sarcoma C46 Melanoma of skin C43 Other skin C44 Breast C50 Prostate C61 Testis C62 Penis C60 Other male genital C63 Bladder C67 Kidney etc C64-C66; 5.1 C68 Eye C69 Brain, nervous system C70-C72 Thyroid C73 Other endocrine C74-C75 Hodgkin's disease C81 Non Hodgkin C82-C85; lymphoma C96 Multiple myeloma C88;C90 Lymphoid leukaemia C91 Myeloid leukaemia C92 Monocytic leukaemia C93 Other leukaemia C94 Leukaemia unspec C95 Other &unspecified All sites All sites but C

5 140 J Korean Cancer Assoc 2001;33(2) Table 2. Average annual age-specific incidence rates, crude rates (all ages), ASR in Daegu by primary site and age in females All AGE Crude ASR ICD SITE ages UNK rate world (10th) Lip C00 Tongue C01-C02 Salivary gland C07-C08 Mouth C03-C06 Oropharynx C09-C10 Nasopharynx C11 Hypopharynx C12-C13 Pharynx unspec C14 Oesophagus C15 Stomach C16 Small intestine C17 Colon C18 Rectum C19-C21 Liver C22 Gallbladder etc C23-C24 Pancreas C25 Nose, sinuses etc C30-C31 Larynx C32 Bronchus, lung C33-C34 Other thoracic organs C37-C38 Bone C40-C41 Connective tissue C47;C49 Mesothelioma C45 Kaposi's sarcoma C46 Melanoma of skin C43 Other skin C44 Breast C50 Uterus unspec C55 Cervix uteri C53 Placenta C58 Corpus uteri C54 Ovary etc C56 Other female genital C51-C52; C57 Bladder C67 Kidney etc C64-C66; C68 Eye C69 Brain, nervous system C70-C72 Thyroid C73 Other endocrine C74-C75 Hodgkin's disease C81 Non Hodgkin C82-C85; lymphoma C96 Multiple myeloma C88;C90 Lymphoid leukaemia C91 Myeloid leukaemia C92 Monocytic leukaemia C93 Other leukaemia C94 Leukaemia unspec C95 Other & unspecified All sites All sites but C

6 Choong Won Lee, et al Cancer Incidence in Daegu in (Table 1) , (ASR 26.9) (ASR 20.4) (ASR 20.4), 14.9 (ASR 16.0), 9.9 (ASR 11.0), 9.3 (ASR 10.1), 6.1 (ASR 5.7), 5.3 (ASR 5.9), 4.8 (ASR 4.8), Non-Hodgkin's lymphoma 2.8 (ASR 2.9) (Table 2) %. 80.3%, 88.7%. 100%, Hodgkin's disease,. 57.7%, 34.9%, Table 3. Percentage of cases registered with microscopic verification of diagnosis (MV%), and death certification notification (DCN (%)), mortality/incidence ratio percent by site and sex , Daegu Cancer Registry Sites MV %* DCN % M : I (%) Males Females Total Males Females Total Males Females Total Pharynx etc Oesophagus Stomach Small intestine Colon Rectum Liver Gallbladder Pancreas Larynx Bronchus, Lung Bone Connective tissue Melanoma of skin Other skin Breast Cervix uteri Uterus unspec Corpus uteri Ovary Prostate Bladder Kidney etc Brain, nervous system Thyroid Non Hodgkin lymphoma Hodgkin's disease Multiple myeloma Lymphoid leukaemia Myeloid leukaemia Leukaemia unspec All sites

7 142 J Korean Cancer Assoc 2001;33(2) 32.3%. DCN 25.5%, 27.7%, 20.7%. 3.7% 4.2%, 4.6%. 10%,,. 75.9%, 67.2%. 30% (52.4%), (40.1%), (33.9%), (33.1%). 18.5%, 3.6%. / 70.6%, 50.9%. 100% 345.1%, 191.4%, 117.0%, 106.1%, 102.8% %, 140.8%, 131.8%, 114.3%, Fig. 3. Age-specific curves for all sites, lung, and selected female cancers, , Daegu Cancer Registry. Table 4. Number of cases registered by other sources and local laboratories alone by site and sex Other sources Local laboratories Sites Males Females Total Males Females Total Stomach 111 (31.5) 48 (15.0) 159 (23.6) 57 (74.0) 35 (29.7) 92 (47.2) Colorectum 41 (11.6) 44 (14.4) 85 (12.6) 12 (15.5) 13 (11.0) 25 (12.8) Liver 23 (6.5) 5 (1.5) 28 (4.1) Gallbladder 10 (2.8) 7 (2.1) 17 (2.5) Larynx 13 (3.6) 3 (0.9) 16 (2.3) Lung 41 (11.6) 21 (6.5) 62 (9.2) 1 (1.3) 1 (0.8) 2 (1.0) Other skin 14 (3.9) 15 (4.6) 29 (4.3) 2 (2.6) 9 (7.6) 11 (5.6) Breast 43 (13.4) 43 (6.3) 23 (19.5) 23 (11.7) Cervix uteri 59 (18.4) 59 (8.7) 35 (29.7) 35 (17.0) Prostate 12 (3.4) 12 (1.7) Bladder 18 (5.1) 5 (1.5) 23 (3.4) 1 (0.8) 1 (0.5) Thyroid 4 (1.1) 17 (5.3) 21 (3.1) Non Hodgkin lymphoma 9 (2.5) 6 (1.8) 15 (2.2) Leukaemia 11 (3.1) 7 (2.1) 18 (2.6) Others 45 (12.7) 40 (12.5) 85 (12.6) 5 (6.5) 1 (0.8) 6 (3.1) All sites 352 (100.0) 320 (100.0) 672 (100.0) 77 (100.0) 118 (100.0) 195 (100.0)

8 Choong Won Lee, et al Cancer Incidence in Daegu in % 78.5% 100%. 13.5%, 6.1%. 61.5% (Table 3) , 75 79, , , (Fig. 3). 672, %, 2.5%. (31.5%) (11.6%), (11.6%), (18.4%), (15.0%), (14.4%), (13.4%). Table 5. Comparisons of major cancers among cancer registries by sex (ASR world) Sites LA Korean DCR* Kangwha Japan Shanghai migrants (97 98) (86 92) (1995) (88 92) (88 92) Males All sites Oesopahgus Stomach Colon Rectum Liver Gallbladder etc Pancreas Larynx Bronchus, lung Prostate Bladder Kidney etc Females All sites Stomach Colon Rectum Liver Gallbladder etc Pancreas Bronchus, lung Breast Cervix uteri Ovary etc Thyroid

9 144 J Korean Cancer Assoc 2001;33(2) 54.8%, 60.6% , %, 15.5% 89.6%. 29.7%, 29.7%, 19.5%, 11.0%89.8% (Table 4) , 110.7, LA 188.8, LA 69.0, LA 35.5, 37.6, LA , 21.4,, , , (Table 5).,, (13).. CI5 6 (14),..,, (16) (14).,,., (13). (death certificate method) (13). DCN% (23.8%), 953 (19.8%) 2718 DCN (56.4%). DCN% 25.5% ( 27.7%, 20.7%). Spain Torragona %, 39% 10 13%, 11%(13).. DCO%5% (8), 1995(16) 17.2%, 16.9%. / (M I ratio) 47.5%. 300%, (13). (13) 55.0%, 37.4%. 70.6%, 50.9%, CI5 7 (8) Osaka67%, 59%, SEER 42%, 43%. -

10 Choong Won Lee, et al Cancer Incidence in Daegu in (13). 5 9 (17).,,, (13). -, 50, 45 50, ,.,., (C26, C42, C48, C76, C77, C80) 88, %, 1.8% , 3.0. CI5 7 (8) Osaka4.2, 2.9, Khon Kaen 23.3, 14.0, SEER 9.2, 7.1, 12.5, ,, 54.8%,,,, 60.6%,, 89.6%,,,, 89.8%.,,,, , , , , , ,,, (17)., 1995 (18) 55, , CI5 7 (8) 163 New Mexico 255.0, 253.8, Shanghai 154.3, Yamagata, Osaka 153.8, , , 1995(16) 265.8, , (19). ( ) LA ( )

11 146 J Korean Cancer Assoc 2001;33(2).,,,,,. LA., %1 (20) (acculturation).,,,,,.., , LA 21.4, 26.5, ( over-diagnosis bias ). 66.5, ( pseudo-disease ) (21) (22) %,. 2,, LA. (23),.,,, (13)..,.,... 10% (23).,,.,.,,, 2...,,,,,,..

12 Choong Won Lee, et al Cancer Incidence in Daegu in ( ) 1. Jensen OM, Parkin DM, Maclennan R, Muir CS, Skeet RG. Cancer Registration: Principles and Methods. Lyon; IARC Scientific Publications No. 95, Park CH. Central Multi-hospital Cancer Registry in Korea. Proceedings of the 4 th Cancer Registry Symposium; 2000 Oct 24; Ilsan, Korea: Korean Association for Cancer Registry and Korean Association of Medical Records, Kim J, Park I, Ahn Y, Shin M, Ahn D, Kang T, Ko U, Ku P, Kim K, Kim K, Kim N, Kim D, Kim D, Kim B, Kim S, Park C, Min J, Park T, Woo B, Yoo H, Lee S, Lee S, Cho K, Joo H, Ham E cancer incidence in Seoul, Korea: Results of the implementation study of the Seoul Cancer Registry. J Korean Med Sci 1995;10: Group for Seoul Regional Cancer Registration. Cancer facts and estimates, Seoul, Korea, Shin H, Lee D, Park T, Ahn D, Ahn Y, Jeung D. Development of procedures of cancer ascertainment in Pusan city area. J Korean Cancer Assoc 1996;28: Choi J, Sohn S, Na B, Sun B, Park K, Kweon S, Im J, Kim Y, Hwang T. A feasibility study for the implementation of Kwangju Cancer Registry (KCR). J Korean Cancer Assoc 1999;31: Lee D, Shin H, Ahn D, Chun B, Kam S, Ahn Y. Accuracy of cancer death certificates in Korea. J Korean Cancer Assoc 2000;32: Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer Incidence in Five Continents Vol. VII. Lyon; IARC Scientific Publications No. 143, Kim SY, Ohrr H, Kang HG, Kim SI, Yi SW. Cancer incidence in Kangwha County ( ). Korean J Prevent Med 1999;32: Korea National Statistical Office Population Census Report, Vol II, City and Provinces, Daegu Percy C, Van Holten V, Muir C. International Classification of Diseases for Oncology. 2 n d ed., Geneva; World Health Organization, Esteban D, Whelan S, Laudico A, Parkin DM. Manual for Cancer Registry Personnel. Lyon; IARC Technical Report No. 10, Parkin DM, Chen WW, Ferlay J, Galceran J, Storm HH, Whelan SL. Comparability and Quality Control in Cancer Registration. Lyon; IARC Technical Report No. 19, Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J. Cancer Incidence in Five Continents Vol VI. Lyon; IARC Scientific Publications No. 120, Olivier S, Parkin DM. CANREG. Cancer Registration Software for Microcomputers. Lyon; IARC Internal Report No. 92/004, 1992.

13 148 J Korean Cancer Assoc 2001;33(2) 16. The Research Group for Population-based Cancer Registration in Japan. Cancer incidence and incidence rates in Japan in 1995: Estimates based on data from nine population-based cancer registries. Jpn J Clin Oncol 2000;30: Aitio A, Day NE, Heseltine E, Kaldor J, Miller AB, Parkin DM, Riboli E. Cancer: Causes, occurrence and control. Lyon; IARC Scientific Publications No. 100, Korean National Statistical Office. Districts/sex/no. of foreigners by age (Population Census), Average age of first marriage, divorce and remarriage. Available from: URL: Hong Kong Cancer Registry. Cancer incidence and mortality in Hong Kong , West DW, Le GM, Lin SS. Ethnicity and cancer: Asian migrant data and directions for future research. Proceedings of the 22 n d Annual Meeting of the International Association of Cancer Registries; 2000 Nov 10-12; Khon Kaen, Thailand: International Association of Cancer Registry, Everett SM, Axon ATR. Early gastric cancer: Disease or pseudo-disease? Lancet 1998;351: Korean National Statistical Office Annual Report on the cause of death statistics Schottenfeld D, Fraumeni JF, eds. Cancer Epidemiology and Prevention. 2 n d ed. New York: Oxford University Press, 1996: ,

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