Trends in major cancer mortality in Korea, 1983-2012, with a joinpoint analysis

Cancer is the leading cause of death in Korea. This study aims to examine changes in temporal trends in major cancer mortality.

Mortality data for 1993-2012 were obtained from the Korean Statistics Information Service(KOSIS) database and age-standardized to the 2000 Korean population. Joinpoint analysis was used to identify significant changes in trends over time. The annual percentage rate change (APC) was computed for each segment of the trends.

The age-standardized mortality rates (ASR) for all cancer sites combined decreased by 9.1% and 1.1% in men and women, respectively, from 1983 to 2012. ASRs from cancers of esophagus, stomach, and liver decreased substantially, whereas ASRs from cancer for all other sites increased markedly. ASRs for all cancer sites combined increased until 1994 and thereafter decreased significantly in both genders except for the period of 1998-2002 (APC: -5.5% for men [p<0.05] and 0.07% for women). ASRs for esophagus and liver cancers increased until the early 1990s and thereafter declined, leading to significant decreases [p<0.05] for esophagus cancer (APC: -1.85% for men and -3.82% for women) and liver cancer (APC: -1.55% for men and -0.56% for women) in 1983-2012. ASRs for stomach cancer declined (APC: -4.06% for men and -4.07% for women) except for 1990-1994. ASRs for uterine cancer peaked in 2003 and then declined (APC: 2.85%). ASRs increased significantly until 2002 for colorectal cancer in men (APC: 7.52%) and lung cancer in both genders. The most consistently upward trend was observed for non-Hodgkin's lymphoma (APC: 3.55% for men and 5.29% for women; number of joinpoints=0). The greatest ASR increase was seen for prostate cancer for which mortality increased until 2002 at an APC of 12.56%.

While mortality decreased significantly for esophagus, stomach and liver cancers in recent decades in Korea, challenges still remain for many other cancers, especially pancreatic, breast, and prostate cancers and non-Hodgkin's lymphoma. Surveillance of cancer mortality trends can lend valuable insights as to the prevention and control of cancer. Public health promotion efforts to control cancer such as lowering smoking rate and obesity could reduce the burden of cancer in many sites.