Endocrinology and Metabolism

Original Articles

Diabetes, obesity and metabolism
Comparison of Population Attributable Fractions of Cancer Incidence and Mortality Linked to Excess Body Weight in Korea from 2015 to 2030: Youjin Hong, Jihye An, Jeehi Jung, Hyeon Sook Lee, Soseul Sung, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seung-Ho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Sangjun Lee, Woojin Lim, Kyungsik Kim, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Kwang-Pil Ko, Sue K. Park; Endocrinol Metab. 2024;39(6):921-931. Published online November 28, 2024; DOI: https://doi.org/10.3803/EnM.2024.2071

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Background
The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs.
Methods
Levin’s formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used.
Results
The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030.
Conclusion
The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.

Citations

Citations to this article as recorded by

Over one‐third of cancer cases and two‐fifths of cancer deaths in southern China are preventable: Insights from the latest representative population‐based cancer registry data and risk factor survey
Xiaolan Wen, Yu Liao, Jiayue Li, Qian Zhu, Xinmei Lin, Bingfeng Han, Li Li, Ru Chen, Ruilin Meng, Ni Xiao, Xueyan Zheng, Xiaojun Xu, Dejian Zhao, Yue Gao, Liming Pu, Ye Wang, Wenqiang Wei, Shaoming Wang
International Journal of Cancer.2026; 158(4): 909. CrossRef
Application and interpretation of attributable fraction measures from clinical practice to policy: a narrative review
Sue Kyung Park
Journal of the Korean Medical Association.2026; 69(5): 411. CrossRef
Cancer attributable to excess body weight in Korea: a focus on primary prevention
Yoon-Jung Choi
Journal of the Korean Medical Association.2025; 68(2): 100. CrossRef
Population attributable fraction as a key measure of primary cancer prevention strategy
Sohee Park, Yoon-Jung Choi, Sue Kyung Park, Hong Gwan Seo
Journal of the Korean Medical Association.2025; 68(2): 82. CrossRef
Fraction of cancer incidence and mortality attributable to dietary factors in Korea from 2015 to 2030
Hyun Jeong Cho, Jin Young Yoo, Ga-Eun Yie, An Na Kim, Soseul Sung, Sungji Moon, Youjin Hong, Sangjun Lee, Inah Kim, Kwang-Pil Ko, Sun-Seog Kweon, Jung Eun Lee, Sue K. Park
Epidemiology and Health.2025; 47: e2025065. CrossRef

Diabetes, Obesity and Metabolism Big Data Articles (National Health Insurance Service Database)
Improvement in Age at Mortality and Changes in Causes of Death in the Population with Diabetes: An Analysis of Data from the Korean National Health Insurance and Statistical Information Service, 2006 to 2018: Eugene Han, Sun Ok Song, Hye Soon Kim, Kang Ju Son, Sun Ha Jee, Bong-Soo Cha, Byung-Wan Lee; Endocrinol Metab. 2022;37(3):466-474. Published online June 29, 2022; DOI: https://doi.org/10.3803/EnM.2022.1440

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Background
Diabetes is a leading cause of death that is responsible for 1.6 million annual deaths worldwide. However, the life expectancy and age at death of people with diabetes have been a matter of debate.
Methods
The National Health Insurance Service claims database, merged with death records from the National Statistical Information Service in Korea from 2006 to 2018, was analyzed.
Results
In total, 1,432,567 deaths were collected. The overall age at death increased by 0.44 and 0.26 year/year in the diabetes and control populations, respectively. The disparity in the mean age at death between the diabetes and control populations narrowed from 5.2 years in 2006 to 3.0 years in 2018 (p<0.001). In a subgroup analysis according to the presence of comorbid diseases, the number and proportion of deaths remained steady in the group with diabetes only, but steadily increased in the groups with diabetes combined with dyslipidemia and/or hypertension. Compared to the control population, the increase in the mean death age was higher in the population with diabetes. This trend was more prominent in the groups with dyslipidemia and/or hypertension than in the diabetes only group. Deaths from vascular disease and diabetes decreased, whereas deaths from cancer and pneumonia increased. The decline in the proportion of deaths from vascular disease was greater in the diabetes groups with hypertension and/or dyslipidemia than in the control population.
Conclusion
The age at death in the population with diabetes increased more steeply and reached a comparable level to those without diabetes.

Citations

Citations to this article as recorded by

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Diabetology.2025; 6(12): 145. CrossRef
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Journal of Diabetes Investigation.2024; 15(9): 1165. CrossRef
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The Journal of Internal Korean Medicine.2024; 45(4): 602. CrossRef
Analysis of Cause-of-Death Mortality in Children and Young Adults with Diabetes: A Nationwide 10-Year Follow-Up Cohort Study
Iee-Ho Choi, Sang-Woo Yeom, Sun-Young Kim, Jihye You, Jong-Seung Kim, Minsun Kim
Children.2023; 10(2): 358. CrossRef
Age at Mortality in Patients with Type 2 Diabetes Who Underwent Kidney Transplantation: An Analysis of Data from the Korean National Health Insurance and Statistical Information Service, 2006 to 2018
Sun Ok Song, Eugene Han, Kang Ju Son, Bong-Soo Cha, Byung-Wan Lee
Journal of Clinical Medicine.2023; 12(9): 3160. CrossRef
Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee
Endocrinology and Metabolism.2023; 38(5): 525. CrossRef
Long-Term Cumulative Exposure to High γ-Glutamyl Transferase Levels and the Risk of Cardiovascular Disease: A Nationwide Population-Based Cohort Study
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