Cancer Registration and Statistics in Korea · Data source: Annual Report of Causes of Death, NSO 0...

Cancer Registration and Cancer Registration and

Statistics in KoreaStatistics in Korea

Sohee Park

Division of Cancer Registration and Surveillance

National Cancer Center, Korea

APAN Healthcare-2 Session

August 11, 2010

Cancer Registration System in Korea

• Korea Central Cancer Registry

Contents

• Regional Cancer Registries

Cancer Statistics in Korea

Korea ranks high in cancer burden

Global (2008)

Population: 6,750 M

Korea (2007)

Population: 49 M

(0.73% of world)

Incidence: 12.7 millionMortality: 7.6 million

Source: GLOBOCAN 2008, IARC, 2010Korea Central Cancer Registry, 2010 (ICD-O2)Cause of Death, NSO, 2010 (ICD-10)

Incidence: 161,920Mortality: 67,561

Causes of Death

15

20

25

30 Cancer CVA Heart Dis. Liver Dis. DM(%)

12.3%

27.6%

Year of death

Data source: Annual Report of Causes of Death, NSO

0

5

10

15

'83 '84 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 07

Cancer is the leading burden of disease

Diabetes mellitus

Digestive disease

Cardiovascular

disease

Cancer

0 200 400 600 800 1,000 1,200 1,400 1,600 1,800

Infectious and

parasitic disease

Musculo-skeletal

disease

Neuro-psychiatric

conditions

Respiratory

disease

DALYs per 100,000 population

YLL

YLD

Year of calculation, 2003

The Korea Central

Cancer Registry Cancer Registry

History of The Korea Central Cancer Registry

In 1980 The Korea Central Cancer Registry (KCCR) was established and

operated within the National Medical Center

Sep 2000 KCCR moved from the National Medical Center to the National Cancer

Center

May 2003 Constitution of The Cancer Act (law, basis for Cancer Registration)

Mar 2004 The Cancer Control Law (“Request of personal information is

prohibited”) � difficulty in National cancer registration

Dec 2004 “Korea central cancer registry” and “population-based regional cancer

registries” were designated officially

April 2005 Setup of the national cancer incidence data and the first calculation of

national cancer incidence rates throughout the country

Oct i2006 Revision of The Cancer Act (Collection and management of personal

information are permitted for national cancer registration)

Aug 2007 Publication of cancer incidence statistics in 2002

Oct 2008 Publication of cancer statistics (Incidence, Survival) in 2003-2005

Dec 2009 Publication of cancer statistics (Incidence, Survival, Prevalence) in

2006-2007

hospital-based

since 1980

headquarter :

population-based

11 Regional Cancer

Registries

Regional Cancer

RegistriesHospital Cancer RegistriesHospital Cancer Registries

KCCRKCCR

Cancer Registry System in Korea

headquarter :

NCC

coverage:

90% of all cancers

Registries

Busan

Daegu / Gwangju

Incheon / Daejeon

Ulsan / Jeju

Chungbuk, etc

KCCRKCCR

atat

NCCNCC

Site-specific Cancer Registries

Academic Societies: breast, uterine, cervix etc.

KCCR• Data collection

• Data management

• Quality assurance

• Data dissemination

• Develop manual / training

Cancer

Billing Claims

NHIC

NSO

Death data

Data process and

KCCR

Passive Active

Cancer Registration System in Korea

• Cancer statistics

Regional

• Data collection for the region

• DB construction

• Collaboration with KCCR

• DB management

• Regional cancer IncidenceRegional Cancer Registry

MR review from

small hospital

dissemination

Chart

reviewingRegional

Busan, Daegu,

Daejeon, B..

Others

Passive Active

Active

Personal : Name, PIN (sex, age), Address, Occupation

Case information: Diagnosis date, Primary site,

Morphology, Behavior, Method of diagnosis,

Treatment method

Information in Cancer Registry Data

Treatment method

Outcome: Death date, Cause of death

Others: Summary Staging (SEER),

TNM stage (optional)

730101- 1 1111 1 1

Birth place

Random no.

Korean Personal Identification Number

Magic !!

Register orderYYMMDD

SEX

Med Ins DB (ID: 2212011 **** 10)

Korean Personal Identification NumberKorean Personal Identification Number

Korea Central Cancer Registry

DB (ID: 2212011 **** 10)

Death Certificate DB

(ID: 2212011****10)

Unique PINCancer Death

Certificate DB

Medical

Insurance DB Cohort DB

Korean Personal Identification Number

Unique PIN Registry DW Certificate DB

Incidence, Mortality,

Prevalence, Survival

Valid Accurate

Korea Central Cancer RegistryKorea Central Cancer Registry

Korea Central Cancer RegistryKorea Central Cancer Registry DBDB

Korea National Korea National

Statistical OfficeStatistical Office

(Cancer Mortality DB(Cancer Mortality DB))

Academic Societies

(Relevant cancer

registration)

**MOPASMOPAS ((residential

address DBDB))

Collection & feedback of

Cancer Mortality DB

Collection & feedback of

Cancer registration DB

Collection of resident

registration address DB

Participating Participating HospitalsHospitalsRegistration Of Cancer patientRegistration Of Cancer patient

Cancer registration DB per hospitalCancer registration DB per hospital

Billing claims

Data quality & feedback

Cancer registration data

Cancer incidence survey &

resultGenerate list of potential cancer

Incidence cases (using medical

billing claims data and death

Result report

Regional Cancer RegistryRegional Cancer Registry

Regional Cancer RegistryRegional Cancer Registry DBDB

Ministry of Health & Welfare Ministry of Health & Welfare

(Management & Publication (Management & Publication

of Cancer of Cancer incidence rates) incidence rates)

* MOPAS : Ministry of public administration and security

* NHIC : National Health Insurance Corporation

* NHIC* NHICPatients of cancer diagnosis & visit Patients of cancer diagnosis & visit

data & data & Catastrophic Diseases DBCatastrophic Diseases DB

NonNon-- ParticipatingParticipating HospitalsHospitalsCooperation Of cancer incidence SurveyCooperation Of cancer incidence SurveyCancer patients DB in hospitalCancer patients DB in hospital

Billing claims

Cancer Cancer

patientpatientRelevant cancer incidence DB

Medical Record Review

Medical Record Review

Send Review Results

National and Regional

Cancer Statistics

certificate data)

Result DB

Result report

Standardization: Software, Manual

Check for Multiple Primary 1988-2001

Training Courses for Cancer Registrar

Quality Control of Cancer Registry Data

Constant check with Death data-

National Statistic Office

Breast Cancer: Korean Society of Breast Cancer

Cervix Cancer (Ovary, Edometrium, etc):

Gynecolgic Oncologic Committee/Korean Society for OB & GY

Liver Caner: Liver Cancer Study Group

Collaboration with site-specific

cancer registry data

Liver Caner: Liver Cancer Study Group

Brain Tumor: KS for Neurosurgeon

Head and Neck Cancer, Oral Cancer

Colon Cancer, Stomach Cancer, etc

Cancer Incidence in Korea (1999-2002)

Quality Indices ofCancer Incidence Data in Korea (1999-2002)

Death Certificate Only : 5.9% (not acceptable: > 20%)

Microscopic Verification : 75.5% (not acceptable: < 75%)

Mortality/Incidence ratio : 0.554 (acceptable: 0.3~0.7)

Korean cancer incidence statistics (1999-2002) was published in Cancer Incidence in Five

Continents, Volume IX (IARC, 2007)

Cancer Statistics in Korea

National Cancer Incidence, 2006~2007

Trend of Cancer Incidence by Sex, Year

Cumulative Risk of Cancer in Korea, 2007

Relative Frequency of Cancer Sites in Korea, 2007

Relative Frequency of Cancer Sites in Korea, 2007

Age-specific incidence rates by sex, 2007

Age-specific incidence rates by cancer sites, Male, 2007

Age-specific incidence rates by cancer sites, Female, 2007

International Comparison of Breast Cancer IncidenceInternational Comparison of Breast Cancer Incidence

Bray et al. Breast Cancer Res 2004

Age-specific rates of breast cancer: Female

Peak in

45-49 years age45-49 years age

Trend of age-standardized cancer incidence rates

Trend of Major Cancers in Korea, Male

Trend of Major Cancers in Korea, Female

Korea (2007)

Korea (2008)2)

Japan (2008)2)

China (2008)2)Male Female

International Comparison of Age-standardized Rates 1)

by Sex: All Cancers

1) Incidence rate of all types of cancer except for other skin (C44) to compare globally 2) Data source : GLOBOCAN 2008, IARC, 2010

(단위: 명/10만명)

Thailand (2008)2)

France (2008)2)

England (2008)2)

USA (2008)2)

Male Female

Trend of Five-Year Relative Survival by Sex : All Cancers

International Comparison of

Five-Year Relative survival

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea(1990)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (1995)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2000)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2005)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2010)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2015)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2020)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2025)

40-

45-

50-

55-

60-

65-

70-

75-

80-

40-

45-

50-

55-

60-

65-

70-

75-

80-

Population in Korea (2030)

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

Male

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

Female

0 50 100 150 200 250

0-

5-

10-

15-

20-

25-

30-

35-

40-

050100150200250

0-

5-

10-

15-

20-

25-

30-

35-

40-

10,000

Thank Thank youyouyouyou

Sohee ParkSohee Parkshpark@ncc.re.krshpark@ncc.re.kr