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. 2023 Aug;12(16):17418-17427.
doi: 10.1002/cam4.6365. Epub 2023 Jul 25.

Changes in spatial clusters of cancer incidence and mortality over 15 years in South Korea: Implication to cancer control

Cham Thi Nguyen  1 , Insang Song  2 , Inkyung Jung  3 , Yoon-Jung Choi  1 , Sun-Young Kim  1   4
Affiliations

Changes in spatial clusters of cancer incidence and mortality over 15 years in South Korea: Implication to cancer control

Cham Thi Nguyen et al. Cancer Med. 2023 Aug.

Abstract

Background: The temporal investigation of high-risk areas of cancer incidence and mortality can provide practical implications in cancer control. We aimed to investigate the changes in spatial clusters of incidence and mortality from 1999 through 2013 by major cancer types in South Korea.

Methods: We applied flexible scan statistics to identify spatial clusters of cancer incidence and mortality by three 5-year periods and seven major cancer types using the counts of new cases and deaths and population in 244 districts during 1999-2013. Then, we compared the changes across three periods in the locations of primary clusters of incidence and mortality by cancer types. To explore the determinants that possibly affect cancer cluster areas, we compared geographic characteristics between clustered and non-clustered areas.

Results: While incidence clusters for lung, stomach, and liver cancer remained in the same areas over 15 years, mortality clusters were relocated to the areas similar to those of incidence clusters. In contrast, colorectal, breast, cervical, and prostate cancer displayed consistently different locations of clusters over time, indicating the disappearance of existing clusters and the appearance of new clusters. Cluster areas tended to show higher portions of older population, unemployment, smoking, and cancer screening compared to non-cluster areas particularly for mortality.

Conclusions: Our findings of diverse patterns of changes in cancer incidence and mortality clusters over 15 years can indicate the degree of effectiveness in cancer prevention and treatment depending on the area and suggest the need for area-specific applications of different cancer control programs.

Keywords: cluster analysis; incidence; mortality; neoplasms; prevention & control.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Maps of crude incidence (above) and mortality (below) for lung and breast cancer across 244 districts in the first and last 5‐year periods over 1999–2013 in South Korea.
FIGURE 2
FIGURE 2
Maps of cluster areas for incidence and mortality by seven cancer types and three time periods for 1999–2013 in South Korea.
FIGURE 3
FIGURE 3
Eight types of changes in cancer incidence and mortality clusters between the period 1 (1999–2003) and period 3 (2009–2013) by stomach and colorectal cancer in South Korea.
See this image and copyright information in PMC

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