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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-
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Population in Korea(1990)
40-
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Population in Korea (1995)
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Population in Korea (2000)
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Population in Korea (2005)
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Population in Korea (2010)
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Population in Korea (2015)
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Population in Korea (2020)
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Population in Korea (2025)
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Population in Korea (2030)
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Male
0 50 100 150 200 250
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10,000
Thank Thank youyouyouyou
Sohee ParkSohee [email protected]@ncc.re.kr