Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study

摘要

Purpose: The incidence of colorectal cancer in Korea has recently increased, making it the second most common cancerin men and the third most common cancer in women. Risk factors for colorectal cancer have been studied worldwide, butrisk factors specific for the Korean population have not been established. In this study, we investigated incidence trendsand risk factors of colorectal cancer in Korea.Methods: A total of 8,846,749 subjects were included. Colorectal cancer incidence was investigated using Korea NationalHealth Insurance Service claim data from 2004 to 2014. Colorectal cancer diagnoses were obtained by evaluating colorectalcancer diagnostic codes and the cancer registry for cost sharing. Risk factor identification for colorectal cancer was obtainedfrom National Health Examination data from 2004 to 2005. Cox proportional hazard model statistical analysis wasused to determine risk factors of colorectal cancer.Results: The incidence of colorectal cancer gradually increased from 2006 to 2014 (from 45.4/100,000 to 54.5/100,000).There was a predominance among men (1.47:1), but incidence trends were similar in both sexes. Old age, high body massindex, and no history of colonoscopy were identified as risk factors in both sexes. High fasting blood glucose, familial historyof cancer, frequent alcohol intake, and current smoker were identified as risk factors, especially in men.Conclusion: The incidence of colorectal cancer has been increasing in Korea. Colonoscopy screening was a protective factorfor colorectal cancer, and active use of colonoscopy may reduce incidence. Early diagnosis and care are important,particularly for the high-risk group.