Trends in cancer incidence among people with human immunodeficiency virus in South Korea: a nationwide National Health Insurance Service data-based study.

Novel, Emerging Risk Factors for Colorectal Cancer Remain Understudied

Epidemic of Lung Cancer in Patients With HIV Infection

Utilizing the Veterans Aging Cohort Study, the largest HIV cohort in North America, we conducted one of the few comprehensive comparisons of cancer incidence time trends in HIV-infected (HIV+) versus uninfected persons during the antiretroviral therapy (ART) era. Prospective cohort study. We followed 44 787 HIV+ and 96 852 demographically matched uninfected persons during 1997-2012. We calculated age-, sex-, and race/ethnicity-standardized incidence rates and incidence rate ratios (IRR, HIV+ versus uninfected) over four calendar periods with incidence rate and IRR period trend P values for cancer groupings and specific cancer types. We observed 3714 incident cancer diagnoses in HIV+ and 5760 in uninfected persons. The HIV+ all-cancer crude incidence rate increased between 1997-2000 and 2009-2012 (P trend = 0.0019). However, after standardization, we observed highly significant HIV+ incidence rate declines for all cancer (25% decline; P trend <0.0001), AIDS-defining cancers (55% decline; P trend <0.0001), nonAIDS-defining cancers (NADC; 15% decline; P trend = 0.0003), and nonvirus-related NADC (20% decline; P trend <0.0001); significant IRR declines for all cancer (from 2.0 to 1.6; P trend <0.0001), AIDS-defining cancers (from 19 to 5.5; P trend <0.0001), and nonvirus-related NADC (from 1.4 to 1.2; P trend = 0.049); and borderline significant IRR declines for NADC (from 1.6 to 1.4; P trend = 0.078) and virus-related NADC (from 4.9 to 3.5; P trend = 0.071). Improved HIV care resulting in improved immune function most likely contributed to the HIV+ incidence rate and the IRR declines. Further promotion of early and sustained ART, improved ART regimens, reduction of traditional cancer risk factor (e.g. smoking) prevalence, and evidence-based screening could contribute to future cancer incidence declines among HIV+ persons.

Background The incidence of inflammatory bowel disease (IBD) is increasing in Asia. Numerous risk factors associated with IBD development have been investigated. This study aimed to demonstrate the risk factors of Crohn’s disease (CD) diagnosed in persons aged &amp;gt;40 years in South Korea and to specify any differences between age groups by using the National Health Insurance Service (NHIS) database. Methods Using the National Health Insurance Service (NHIS) database, a total of 14,060,821 persons aged &amp;gt;40 years who underwent national health screening in 2009 were followed up until December 2017. Patients with newly diagnosed CD were enrolled and compared with non-CD cohort. CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration programme codes from the NHIS database. The mean follow-up periods were 7.39 years. Age and sex were adjusted for in the multivariate analysis model. Results During the follow-up, 1337 (1.33/100,000) patients developed CD. Men in the middle-aged group (40–64 years) had a higher risk than women (adjusted HR [aHR] 1.46, 95% CI 1.29–1.66); however, this difference tended to disappear as the age of onset increases. In the middle-aged group, patients with a history of smoking (adjusted hazard ratio [aHR] 1.29, 95% confidence interval [CI] 1.06–1.58) and anemia (aHR 1.99, 95% CI 1.67–2.36) had a significantly higher CD risk. In the elderly group (age, ³65 years), ex-smoking and anemia also increased the CD risk (aHR 1.58 [95% CI 1.16–2.18] and 1.91 [95% CI 1.53–2.38], respectively). Especially in the middle-aged group, those with chronic kidney disease (CKD) had a statistically elevated CD risk (aHR 1.38, 95% CI 1.06–1.79). Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups. (Middle-aged: aHR 0.76 [95%CI 0.65–0.87] and aHR 0.38 [95%CI 0.27–0.53], respectively) (elderly-group: aHR 0.57 [95%CI 0.42–0.77] and aHR 0.52 [95%CI 0.32-.83], respectively) For regular physical activity and dyslipidemia, negative correlation between CD incidences was proved only in the middle-aged group (aHR 0.85 [95%CI 0.74–0.96] and aHR 0. [95%CI 0.75 [95% CI 0.63–0.89], respectively). Conclusion This study demonstrated four risk factors (ex-smoking, anemia, CKD, and lower BMI) and three possible protective factors (alcohol consumption, physical activity, and dyslipidemia) for CD in Asians age &amp;gt;40 years. Individuals with potential risk factors need more cautious monitoring for CD.

Recent information regarding the characteristics of people living with human immunodeficiency virus (HIV) (PLWH) is lacking. Therefore, we examined the incidence of HIV infection and epidemiologic characteristics of PLWH in South Korea using recent National Health Insurance Service database data. The HIV infection rate was 4.13 per 100,000 in 2017, 4.19 per 100,000 in 2018, 6.61 per 100,000 in 2019, 5.98 per 100,000 in 2020, 8.81 per 100,000 in 2021, and 4.14 per 100,000 in 2022. In 2016, the mean age of PLWH was 45.7 years (SD: 13.8 years), and it gradually increased to 49.0 years (standard deviation: 13.7 years) in 2022 over 7 years in South Korea. The proportion of male individuals among PLWH was 90.7% (19,970/22,026) in 2016, and it gradually increased to 92.3% (22,943/24,857) in 2022 over 7 years in South Korea. The proportion of anti-retroviral therapy (ART) users among PLWH in South Korea was 92.6% (20,388/22,026) in 2016, and it gradually increased to 97.9% (24,328/24,857) in 2022 over 7 years. In this population-based cohort analysis, we presented the HIV infection incidence and epidemiologic features of PLWH in South Korea. This study’s results may influence future infection prevention strategies and policies for PLWH.

BackgroundThe burden of rare diseases on society and patients’ families has increased in Korea. However, because of the infrequency of rare diseases, there is a lack of resources and information to address these cases and inadequate funding for the management of these patients. We investigated the average annual cumulative incidence of rare diseases and the trends in annual cumulative incidence from 2011 to 2015 in Korea by using nationwide administrative data from the Korean National Health Insurance Service (NHIS) database for patients registered with the co-payment assistance policy for rare and incurable diseases. Annual cumulative incidence per 10,000,000 was calculated as the total number of newly enrolled patients with the Korean Standard Classification of Diseases (KCD)-7 code in the register, divided by the number of residents with health insurance coverage during each year. We employed simple linear regression analysis to evaluate the trends in annual cumulative incidence/10,000,000 population per year for each rare disease.ResultsOverall, national support was provided for patients with 415 KCD codes listed among the targeted rare diseases. The total number of newly enrolled patients with rare diseases was 53,831 in 2011, 52,658 in 2012, 52,955 in 2013, 71,530 in 2014, and 70,559 in 2015. The number of rare diseases with an average annual cumulative incidence of 100/10,000,000 and above was 22 (5.30%), while there were 227 (54.70%) and 148 (35.66%) with an average cumulative incidence between 1/10,000,000 and 100/10,000,000 and less than 1/10,000,000, respectively. The trends in the annual cumulative incidence for 43 rare diseases were statistically significant (p-value < 0.05). The rare diseases for which the incremental trend per year was statistically significant were sarcoidosis (D86, D86.0, D86.1, D86.2, D86.3, D86.8, D86.9), Parkinson’s disease (G20), Guillain-Barré syndrome (G61.0), primary biliary cirrhosis (K74.3) and Sjogren’s syndrome (M35.0).ConclusionsThe number of rare diseases showing an increasing trend in annual cumulative incidence was higher than the number of diseases showing a decreasing trend in annual cumulative incidence. Given that the definition and diagnosis vary based on country and that there is difficulty in identifying valid cases, further detection strategies are needed to establish the incidence of each rare disease considering the importance of establishing a health policy based on the actual incidence of the targeted diseases.

Mapping overdiagnosis of thyroid cancer in China

ObjectivesIn Japan, prostate cancer constitutes the fourth common cancer and the sixth major cause of cancer death in men. Despite the rising incidence, it remains unclear whether Prostate Specific Antigen...

To investigate the population-based incidence of uveitis and the differences between anterior and non-anterior uveitis using the comprehensive Korean National Health Insurance Service (NHIS) database. We extracted data of patients who visited the clinic and were diagnosed with uveitis (based on Korean Classification of Diseases) from 2010 to 2021. The incidence of uveitis, differences between the demographics, and the underlying co-morbidities of anterior uveitis, non-anterior uveitis, and control groups were investigated. We identified 919,370 cases with uveitis (anterior: 800,132; non-anterior: 119,238). The average incidences (per 10,000 persons) of anterior and non-anterior uveitis were 13.0 (95% confidence interval [CI], 12.9-13.0), and 1.9 (95% CI, 1.9-1.9), respectively. The incidence increased (2010: 13.0; 2019: 16.5) but decreased during the coronavirus disease (COVID-19) pandemic (2020: 15.5; 2021: 15.4). The non-anterior group was significantly associated with sex (female, odds ratio [OR]: 1.09, p < 0.0001), specific age range (40-69 years, p < 0.0001), high Charlson Comorbidity Index (p < 0.0001), high household income (p < 0.0001), and various immunologic diseases (antiphospholipid antibody syndrome, OR: 1.79, p < 0.0001; systemic lupus erythematosus, OR: 1.22, p < 0.0001; psoriasis, OR: 1.13, p < 0.0001; ulcerative colitis, OR: 1.11, p = 0.0013; tuberculosis, OR: 1.09, p < 0.0001; rheumatoid arthritis, OR: 1.05, p < 0.0001) compared with the anterior group. Using the NHIS database, we conducted the largest population-based epidemiological study on uveitis in South Korea to estimate its increasing incidence in the past decade (including changes during COVID-19 pandemic) as well as its anatomical distribution. Our results may be beneficial for estimating the national burden of uveitis.

HIV and sickle cell disease (SCD) are significant causes of morbidity and mortality in sub-Saharan Africa. Given their separate roles in immune dysregulation, our objective was to characterise the impact that SCD has on the presentation and progression of paediatric HIV. The study was a retrospective cohort study (study period 2004-2018). Cases of HIV+and SCD-afflicted patients (HIV+/SCD+) were obtained via electronic chart review from a paediatric HIV clinic in Kampala, Uganda and matched 1:3 with HIV+controls without SCD (HIV+/SCD-). Thirty-five HIV+/SCD+subjects and 95 HIV+/SCD- controls were analysed (39% female (51/130), age 3.6years (SD3.9)). At baseline, WHO clinical stage (64% total cohort Stage III/IV) and nutritional status (9.4% severe acute malnutrition) were similar for both groups, whereas HIV+/SCD+had higher though non-significant baseline CD4 count (1036 (SD713) vs 849 (SD638) cells/microlitre, P=0.20, two-tailed t-test). There were 19 deaths, 6 (17%) HIV+/SCD+and 13 (14%) HIV+/SCD-, with unadjusted/adjusted models showing no significant difference. Nutritional progression and clinical stage progression showed no significant differences between groups. Kaplan-Meier analysis showed a slower rate of treatment failures in the HIV+/SCD+cohort (P=0.11, log-rank survival test). Trajectory analysis showed that in the time period analysed, the HIV+/SCD+cohort showed a more rapid rise and higher total CD4 count (P=0.012, regression analysis). The study suggests that SCD does not adversely affect the progression of HIV in patients on ART. Further, HIV+/SCD+achieved higher CD4 counts and fewer HIV treatment failures, suggesting physiological effects due to SCD might mitigate HIV progression.

Introduction: Trends in cancer incidence and mortality are determined by contemporary demographic processes. Breast cancer in women is a particular threat. In Germany, the chances of survival after the diagnosis of cancer are among the highest in Europe. The understanding of the latest trends in breast cancer incidence and mortality in Germany and the presentation of the latest screening options, treatment and prevention methods can be used to improve the control of breast cancer in the future. Aim: The aim of the research was to present trends in cancer incidence and mortality, with particular emphasis on breast cancer in women in Germany and Poland on the background of contemporary demographic changes relating to the process of population ageing in 2006–2016. The clinical diagnostic process, the treatment of breast cancer and potential risk factors and prevention methods were described. Material and methods: In the publication the basic statistical indicators have been applied: absolute numbers, percentages, crude rates, age-standardized rates, and demographic aging index. Results and discussion: The cancer mortality in Poland was much higher than in Germany, which is associated with the low five-year survival rate of cancer patients in Poland. The breast cancer was characterized by the highest dynamics in incidence growth with a persistent mortality level. Conclusions: Over the last two decades, breast cancer outcomes of patients have improved significantly due to highly individualized breast cancer therapies and the development of breast cancer treatment options such as immunotherapy, hormone receptor-based therapy and HER2 status-based therapy. The main risk factors are age, hormonal situation and inherited risk genes.

Kidney Disease in HIV Infection: Introduction

The global incidence of syphilis has been increasing in recent years, with multiple factors contributing to this trend. Syphilis disproportionately affects specific populations. We aimed to evaluate trends in the incidence and geographical distribution of syphilis at the provincial level among people living with human immunodeficiency virus (PLWH) and the total population in Korea. PLWH were enrolled from the Korea National Health Insurance Service Database. Early syphilis was defined as having an International Classification of Diseases, 10th revision diagnostic code and the prescription codes for medications. Between 2014 and 2019, syphilis was designated as a nationally notifiable infectious disease, facilitating comprehensive data collection. We compared the number of syphilis cases in the total population and the PLWH cohort. The incidence rates of early syphilis were estimated using Poisson regression, complemented by provincial mapping among the national and PLWH populations. The prevalence of early syphilis among PLWH was 22.4%, with 58.6% occurring after HIV diagnosis. In the total population, primary syphilis accounted for 69.8% of early cases. The age distribution and regional epidemiology of syphilis among PLWH differed from those in the total population. HIV infection was associated with a 5.04-fold higher incidence rate of syphilis (Incidence rate ratio (IRR), 95% Confidence interval (CI): 5.04 [4.77-5.34]), and as the years elapsed, the incidence rate of syphilis increased by 14.5% (IRR, 95% CI: 1.15 [1.13-1.16]). Since 2015, the incidence of new syphilis cases has increased notably in the total population, whereas it remained relatively stable among PLWH, indicating that the absolute rate and trajectories differed from those of the national population. Syphilis is prevalent among PLWH; however, the epidemiology differs from that of the national population. This highlights the need for multifaceted policies to prevent syphilis transmission.

Long-term opioid use and mortality in patients with chronic non-cancer pain: Ten-year follow-up study in South Korea from 2010 through 2019

Very few population-based studies have examined the epidemiology of Wilson’s disease (WD). We investigated the epidemiology of WD using the National Health Insurance Service (NHIS) database in South Korea. We analyzed not only the statistical variables of WD, but also those of WD-related diseases. WD patients were identified with the relevant International Classification of Diseases-10 code out of 50.5 million people. We used the NHIS database from 2009 to 2016 and analyzed the incidence rate, prevalence, and clinical symptoms of WD. A total of 1,333 patients were identified. The average annual incidence rate was 3.8 per million person-years. The prevalence was 38.7 per million people. The mean diagnostic age was 26.1 ± 17.2 with earlier diagnosis in men (P = 0.0003). Among the patients, 988 (74.1%) had hepatic symptoms, 510 (38.3%) had neurologic symptoms, and 601 (45.1%) had psychiatric symptoms. Before the diagnosis of WD, 350 (26.3%) had neurologic symptoms, and 427 (32%) had psychiatric symptoms. The annual mortality rate was 0.7%. Age, liver cirrhosis, and liver failure correlated with a fatal prognosis (P < 0.05). Many patients showed neurologic and psychiatric symptoms before they were diagnosed with WD. Prognosis correlated with age, liver cirrhosis, and liver failure.