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Jung, Won, Kong, Lee, and The Community of Population-Based Regional Cancer Registries: Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016
Special Article

Cancer Res Treat 2019;51(2):417-430.

Published online: 18 March 2019

DOI: https://doi.org/10.4143/crt.2019.138

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016

Kyu-Won Jung, MS1, 2, Young-Joo Won, PhD1, 2, 3, Hyun-Joo Kong, MS1, 2, Eun Sook Lee, MD, PhD1, 4; The Community of Population-Based Regional Cancer Registries*

1The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea

2National Cancer Control Institute, National Cancer Center, Goyang, Korea

3Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea

4Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea

Correspondence: Young-Joo Won, PhD The Korea Central Cancer Registry, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea Tel: 82-31-920-2015 Fax: 82-31-920-2179 E-mail: astra67@ncc.re.kr

* The members of the group are listed at the end of this article.

Received 12 March 2019       Accepted 13 March 2019

Copyright © 2019 by the Korean Cancer Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study presents the 2016 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality.

Materials and Methods

Cancer incidence data from 1999 to 2016 were obtained from the Korea National Cancer Incidence Database and followed until December 31, 2017. Mortality data from 1983 to 2016 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2017 among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence and 5-year relative survivals were also calculated.

Results

Overall, 229,180 and 78,194 Koreans were newly diagnosed and died from cancer in 2016, respectively. The ASRs for cancer incidence and mortality in 2016 were 269.0 and 79.8 per 100,000 individuals, respectively. The all-cancer incidence rate increased significantly by 3.6% annually from 1999 to 2011 and started to decrease after 2011 (2011-2016; annual percent change, –3.1%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2012 and 2016 was 70.6%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995.

Conclusion

The cancer prevalence in Korea has increased very fast as survival has improved remarkably. The high prevalence of cancer emphasizes the need for comprehensive cancer control efforts in Korea.

Keywords: Incidence, Survival, Prevalence, Mortality, Neoplasms, Korea

Introduction

The global cancer burden has risen to 18.1 million cases and 9.6 million cancer deaths in 2018 [1]. Cancer incidence and mortality are rapidly growing worldwide. The reasons are complex but reflect both aging and growth of the population, as well as changes in the prevalence and distribution of the main risk factors for cancer [2].
In Korea, cancer accounts for one in four deaths and more than 200,000 new cancer cases were diagnosed in 2015 [3]. The number of cancer incidences and deaths are expected to increase with an aging population and westernized lifestyles [4].
In this context, cancer statistics are the most important indicator to assess the national cancer burden, which can be used to establish cancer control strategies. This article aimed to provide nationwide cancer statistics including incidence, survival, prevalence, and mortality in 2016.

Materials and Methods

1. Data sources

The Korea Central Cancer Registry (KCCR) was established by the Ministry of Health and Welfare in 1980 as a nationwide hospital-based cancer registry. Since 1999, the KCCR has collected cancer incidence data nationwide by integrating a nationwide hospital-based KCCR database with data from regional cancer registries. The KCCR currently provides the nationwide cancer incidence, survival, and prevalence statistics annually [5].
The KCCR built the Korea National Cancer Incidence Database (KNCI DB) from hospitals, 11 population-based registries, and additional medical record reviews. The KNCI DB contains information regarding age, sex, region, date of diagnosis, primary cancer site, histological type, most valid diagnostic method, summary stage of surveillance, epidemiology and end results program (SEER) and first course of treatment within four months after diagnosis. The completeness of cancer incidence data for 2016 was estimated to be 98.2% based on the method proposed by Ajiki et al. [6]. The mid-year population and cancer mortality data from 1983 to 2016 were obtained from Statistics Korea [7]. To ascertain vital status and to calculate survival and prevalence, the KNCI DB was linked to mortality data and population registration data from the Ministry of the Interior.

2. Classification

All incidence cases were registered according to the International Classification of Diseases for Oncology, third edition [8] and converted to the International Classification of Diseases, 10th edition (ICD-10) [9]. The mortality cases were registered according to ICD-10. All cancer cases were reported based on the 24 cancer types.

3. Statistical analyses

Rates were expressed as crude and age-standardized rates (CR and ASR, respectively) per 100,000 individuals. The CR was calculated as the total number of incidence/mortality cases divided by the mid-year population of the specified years. The ASR is a weighted average of the age-specific rates, where the weights are the proportions of persons in the corresponding age groups of a standard population [10]. In this report, ASRs were calculated using Segi’s world standard population [11]. The cumulative risk of developing cancer from birth to life expectancy was calculated using cumulative rates; that is, the sum of the age-specific rates from birth to life expectancy, as follows [12]:
Cumulative risk of developing cancer from birth to life expectancy =100×1-e-cumulative rate100
Trends in ASRs were summarized as an annual percentage change (APC) by using a Joinpoint regression. APC is the average percentage change of ASRs and is calculated as follows [10]:
APC=Ry+1–RyRy×100=eb1-1×100
, where log(Ry)=b0+b1y,
log(Ry) is the natural log transformed age standardized rates.
y=year, b0=intercept, b1=slope
The survival duration for each cancer case was determined as the interval between the date of initial diagnosis and the date of death, date of loss of follow-up, or closing date for follow-up, whichever came first. The 5-year relative survival rate was calculated as the ratios of the observed survival of the cancer patients to the expected survival of the general population, which was derived from the standard life table provided by Statistics Korea. Trends in 5-year relative survival rates were evaluated as percentage differences in 5-year relative survival rates from 1993-1995 and 2012-2016. Relative survival rates were calculated using the Ederer II method [13] with some minor corrections, based on an algorithm by Paul Dickman [14].
Prevalent cases were defined as the number of cancer patients alive on January 1, 2017 among all cancer patients diagnosed between 1999 and 2016. Limited-duration prevalences were calculated using SEER*Stat software. Any p-values less than 0.05 were considered statistically significant. SEER*Stat 8.1.2 (National Cancer Institute, Bethesda, MD), Joinpoint 4. 1. 1 (National Cancer Institute), and SAS ver. 9.4 (SAS Institute, Cary, NC) were used for statistical analysis.

Selected Findings

1. Incidence

A total of 229,180 cancer cases were newly diagnosed in 2016, which included 120,068 men (52.4%) and 109,112 women (47.6%) (Table 1). Stomach cancer was the most commonly diagnosed cancer in 2016, followed by colorectal, thyroid, lung, and breast cancer. The overall cumulative risk of developing cancer from birth to life expectancy was 36.2%. The cumulative risk of developing cancer from birth to life expectancy was higher in men (38.3%) than in women (33.3%) (data not shown).
The total CR and ASR for overall cancer incidences in 2016 were 448.4 and 269.0 per 100,000, respectively (Table 2). According to sex, CRs for all sites combined were 470.3 per 100,000 in men and 426.5 per 100,000 in women. The ASRs were 298.0 and 254.6 per 100,000 in men and women, respectively. Stomach cancer (CR, 80.3 per 100,000) was the most common cancer in men, followed by lung (CR, 69.7 per 100,000), colorectal (CR, 65.3 per 100,000), prostate (CR, 46.2 per 100,000), and liver cancer (CR, 46.1 per 100,000). These five cancers accounted for 65.4% of newly diagnosed cases in men during the study period. In contrast, breast cancer (CR, 85.0 per 100,000) was the most common cancer among women, followed by thyroid (CR, 80.2 per 100,000), colorectal (CR, 44.8 per 100,000), stomach (CR, 39.1 per 100,000), and lung cancer (CR, 31.2 per 100,000). These five cancers accounted for 65.7% of cases in women.

2. Mortality

The total number of deaths from cancer in 2016 was 78,194, accounting for 27.8% of all deaths (Table 3). According to sex, 61.7% and 38.3% of cancer deaths occurred in men and women, respectively (Table 1).
The total CR and ASR for cancer deaths were 153.0 and 79.8 per 100,000, respectively, in 2016 (Table 4). The total CR and ASR for cancer deaths per 100,000 were higher among men (CR, 188.8; ASR, 115.5) than in women (CR, 117.2; ASR, 53.6).
According to the cancer sites, lung cancer (CR, 52.2 per 100,000) was the leading cause of death in men, followed by liver (CR, 31.5 per 100,000), stomach (CR, 20.8 per 100,000), colorectal (CR, 18.3 per 100,000), and pancreatic cancer (CR, 11.4 per 100,000). The top five causes of deaths from cancer in women included lung (CR, 18.1 per 100,000), colorectal (CR, 14.5 per 100,000), liver (CR, 11.6 per 100,000), stomach (CR, 11.5 per 100,000), and pancreatic cancer (CR, 10.6 per 100,000).

3. Trends in cancer incidence and mortality

Fig. 1 shows trends in cancer incidence and mortality from 1983 to 2016. The ASR for all-cancer incidence increased by 3.6% annually from 1999 to 2011, and then started to decrease from 2011 to 2016 (APC, –3.1%) (Table 5). Cases of stomach, colorectum, lung, and thyroid cancers started to decrease around 2011. Specifically, ASR for thyroid cancer increased rapidly to 22.6% from 1999 to 2011, but then decreased swiftly by 12.6% annually starting in 2011. The incidence of breast cancer increased constantly throughout the period; however, the APC slowed from 2005 onward. Conversely, the incidence rates of cervix and liver showed a constant decrease for the whole period. Thyroid cancer decreased the most drastically starting in the early 2010s (Fig. 2).
The ASR for all-cancer mortality rate increased until 2002 (Table 6). After that year, it started to decrease (2002-2016; APC, –2.7%). The same patterns were evident in men and women. Cancer incidence at most sites, including the cervix uteri, thyroid, liver, gallbladder, lung, brain and central nervous system, and colorectum started to decrease in the early 2000s. Furthermore, cancers of the lips, oral cavity and pharynx, esophagus, stomach, larynx, and non-Hodgkin lymphoma decreased from 1999. Breast cancer showed constant increasing trends for the whole period (Fig. 3).

4. Age-specific incidence rates

Leukemia was the most commonly diagnosed cancer among children between 0-14 years of age. Thyroid cancer was the most common cancer among adolescents and young adults between 15 and 34 years of age (Table 7). Stomach cancer was the most commonly diagnosed cancer among men aged 35 to 64 years, while lung cancer was the most common among men aged 65 years and above (Fig. 4A). In contrast, breast cancer was the most commonly diagnosed cancer among women aged 35 to 64 years, while colorectal cancer was the most common among women aged 65 years and above. Thyroid and breast cancers showed an inverted U-shaped incidence rate by age (Fig. 4B).

5. Survival rates

The 5-year relative survival rates for all cancer combined improved remarkably in both sexes, from 41.2% in 1993-1995 to 70.6% in 2012-2016 (Table 8). After excluding thyroid cancer, the 5-year relative survival rates for all cancer still increased from 1999 to 2016 (Fig. 5B).
The 5-year relative survival rate during 2012-2016 for all cancer combined was 63.2% in men and 78.0% in women, respectively. The 5-year relative survival rate for thyroid cancer was over 100%, while the 5-year relative survival rates for testis, prostate, and breast cancer were over 90% in 2012-2016 for both sexes, respectively. However, the 5-year relative survival rate for pancreatic cancer was only 11.4% in both sexes in 2012-2016.
When compared to the 5-year relative survival rate for men in 1993-1995, prostate cancer diagnosed from 2012 to 2016 showed the most outstanding improvement, followed by stomach, leukemia, ‘lip, oral cavity, and pharynx,’ esophagus and liver cancer. Among women, stomach cancer diagnosed during 2012-2016 showed the greatest improvement in 5-year relative survival rates compared to those between 1993 and 1995, followed by lung, leukemia, multiple myeloma, liver, and colorectal cancer.

6. Prevalence rates

A total of 1,739,951 cancer prevalent cases were identified on January 1, 2017 (Table 1). Of these cases, 764,103 (43.9%) were men and 975,848 (56.1%) were women. The overall CR and ASR for cancer prevalence were 3,404.1 per 100,000 individuals and 2,046.2 per 100,000 individuals for both sexes, respectively, in 2016 (Table 9).
The five most common cancers for men were stomach (CR, 709.9 per 100,000), colorectal (CR, 551.8 per 100,000), prostate (CR, 304.1 per 100,000), thyroid (CR, 255.9 per 100,000), and liver cancer (CR, 190.6 per 100,000). In contrast, thyroid cancer was most common in women (CR, 1,229.7 per 100,000), followed by breast (CR, 771.0 per 100,000), colorectal (CR, 373.6 per 100,000), stomach (CR, 361.4 per 100,000), and cervix uteri cancer (CR, 206.2 per 100,000).
Analysis of the period after cancer diagnosis revealed that stomach cancer (14.1%) was the most prevalent cancer within 2 years after diagnosis, followed by thyroid (14.0%) and colorectal cancer (13.1%) (Fig. 6). Thyroid cancer (25.5%) was most prevalent for 2-5 years, followed by stomach (14.3%) and colorectal cancer (13.4%). After 5 years, thyroid cancer (23.1%) was the most prevalent cancer, followed by stomach (17.1%) and colorectal cancer (13.9%).

Notes

Conflict of interest relevant to this article was not reported.

The Community of Population-Based Regional Cancer Registries

Chang-Hoon Kim (Busan Cancer Registry, Pusan National University Hospital), Cheol-In Yoo (Ulsan Caner Registry, Ulsan University Hospital), Yong-Dae Kim (Chungbuk Cancer Registry, Chungbuk National University Hospital), Hae-Sung Nam (Daejeon/ Chungnam Cancer Registry, Chungnam National University and Hospital), Jung-Sik Huh (Jeju Cancer Registry, Jeju National University and Hospital), Jung-Ho Youm (Chonbuk Cancer Registry, Chonbuk National University Hospital), Kyu-Hyoung Lim (Kangwon Cancer Registry, Kangwon National University Hospital), Nam-Soo Hong (Deagu/Gyeongbuk Cancer Registry, Kyungpook National University Medical Center), Sun-Seog Kweon (Gwangju/ Jeonnam Cancer Registry, Chonnam National University Hwasun Hospital), Woo-Chul Kim (Incheon Cancer Registry, Inha University Hospital), Ki Soo Park (Gyeongnam Cancer Registry, Gyeongsang National University and Hospital)

ACKNOWLEDGMENTS

The authors would like to specially thank the tumor registrars (Health information manager) of the KCCR-affiliated hospitals and non-KCCR-affiliated hospitals for data collecting, abstracting, and coding. Additionally, we acknowledge the cooperation of the National Health Insurance Service and Statistics Korea for the data support.
This work was supported by the Health Promotion Fund, Ministry of Health & Welfare (No. 1860390) and research grant (No. 1910130) from the National Cancer Center, Republic of Korea.

References

1. Global cancer observatory [Internet]. Lyon: International Agency for Research on Cancer;2018. [cited 2019 Jan 23]. Available from: https://gco.iarc.fr/.
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6. Ajiki W, Tsukuma H, Oshima A. Index for evaluating completeness of registration in population-based cancer registries and estimation of registration rate at the Osaka Cancer Registry between 1966 and 1992 using this index. Nihon Koshu Eisei Zasshi. 1998; 45:1011–7.
7. Statistics Korea [Internet]. Daejeon: Statistics Korea;2017. [cited 2019 Feb 15]. Available from: http://kosis.kr.
8. Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, et al. International classification of diseases for oncology. 3rd ed. 1st revision. Geneva: World Health Organization;2013.
9. World Health Organization. International statistical classification of diseases and related health problems. 10th rev. ed. Geneva: World Health Organization;1994.
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Fig. 1.
Annual age-standardized cancer incidence and death rates by sex for all sites from 1983 to 2016 in Korea. Age standardization was based on the Segi’s world standard population.
crt-2019-138f1.tif
Fig. 2.
Trends in age-standardized incidences of selected cancers by sex from 1999 to 2016 in Korea. (A) Men. (B) Women. Age standardization was based on the Segi’s world standard population.
crt-2019-138f2.tif
Fig. 3.
Annual age-standardized cancer mortalities of selected cancers by sex from 1983 to 2016 in Korea. (A) Men. (B) Women. Age standardization was based on the Segi’s world standard population.
crt-2019-138f3.tif
Fig. 4.
Age-specific incidence rates of common cancers for 2016 in Korea. (A) Men. (B) Women.
crt-2019-138f4.tif
Fig. 5.
Trends in relative survival by year of diagnosis from 1999 to 2016. (A) All sites for both sexes. (B) All sites except thyroid cancer for both sexes.
crt-2019-138f5.tif
Fig. 6.
Prevalence of common cancer sites by time period after cancer diagnosis. Prevalent cases were defined as the number of cancer patients alive on January 1, 2017 among all cancer patients diagnosed between 1999 and 2016.
crt-2019-138f6.tif
Table 1.
Cancer incidence, deaths, and prevalence by sex in Korea, 2016
Site/Type New cases
 Deaths
 Prevalent casesa)
Both sexes Men Women Both sexes Men Women Both sexes Men Women
All sites 229,180 120,068 109,112 78,194 48,208 29,986 1,739,951 764,103 975,848
Lip, oral cavity, and pharynx 3,543 2,527 1,016 1,203 909 294 23,639 15,847 7,792
Esophagus 2,499 2,245 254 1,524 1,379 145 9,777 8,780 997
Stomach 30,504 20,509 9,995 8,264 5,318 2,946 273,701 181,234 92,467
Colon and rectum 28,127 16,672 11,455 8,358 4,659 3,699 236,431 140,852 95,579
Liver 15,771 11,774 3,997 11,001 8,044 2,957 64,864 48,666 16,198
Gallbladderb) 6,685 3,490 3,195 4,408 2,248 2,160 21,011 10,776 10,235
Pancreas 6,655 3,384 3,271 5,614 2,901 2,713 10,595 5,502 5,093
Larynx 1,167 1,101 66 334 310 24 10,532 9,914 618
Lung 25,780 17,790 7,990 17,963 13,324 4,639 76,544 47,438 29,106
Breast 21,839 92 21,747 2,472 16 2,456 198,006 743 197,263
Cervix uteri 3,566 - 3,566 897 - 897 52,758 - 52,758
Corpus uteri 2,771 - 2,771 313 - 313 23,135 - 23,135
Ovary 2,630 - 2,630 1,204 - 1,204 19,509 - 19,509
Prostate 11,800 11,800 - 1,745 1,745 - 77,635 77,635 -
Testis 288 288 - 14 14 - 3,204 3,204 -
Kidney 5,043 3,410 1,633 1,032 724 308 38,836 26,161 12,675
Bladder 4,361 3,488 873 1,389 1,029 360 33,543 27,347 6,196
Brain and CNS 2,015 1,104 911 1,327 720 607 11,116 5,734 5,382
Thyroid 26,051 5,538 20,513 346 104 242 379,946 65,336 314,610
Hodgkin lymphoma 312 202 110 51 33 18 2,807 1,770 1,037
Non-Hodgkin lymphoma 4,766 2,766 2,000 1,820 1,068 752 30,093 17,130 12,963
Multiple myeloma 1,535 837 698 1,010 527 483 5,798 3,050 2,748
Leukemia 3,416 1,991 1,425 1,842 1,025 817 20,751 11,553 9,198
Other and ill-defined 18,056 9,060 8,996 4,063 2,111 1,952 115,720 55,431 60,289

CNS, central nervous system.

a) Limited-duration prevalent cases on January 1, 2016. These are patients who were diagnosed between January 1, 1999 and December 31, 2016 and who were alive on January 1, 2017. Multiple primary cancer cases were counted multiple times,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 2.
Crude and age-standardized cancer incidence rates by sex in Korea, 2016
Site/Type Crude incidence rate per 100,000
 Age-standardized incidence rate per 100,000a)
Both sexes Men Women Both sexes Men Women
All sites 448.4 470.3 426.5 269.0 298.0 254.6
Lip, oral cavity, and pharynx 6.9 9.9 4.0 4.2 6.4 2.3
Esophagus 4.9 8.8 1.0 2.7 5.4 0.5
Stomach 59.7 80.3 39.1 34.0 49.6 20.5
Colon and rectum 55.0 65.3 44.8 30.7 40.4 22.4
Liver 30.9 46.1 15.6 17.6 28.5 7.8
Gallbladderb) 13.1 13.7 12.5 6.7 8.3 5.5
Pancreas 13.0 13.3 12.8 7.0 8.1 6.0
Larynx 2.3 4.3 0.3 1.3 2.6 0.1
Lung 50.4 69.7 31.2 27.1 42.3 15.4
Breast 42.7 0.4 85.0 27.7 0.2 54.9
Cervix uteri 7.0 0.0 13.9 4.6 - 9.1
Corpus uteri 5.4 0.0 10.8 3.4 - 6.8
Ovary 5.1 0.0 10.3 3.4 - 6.7
Prostate 23.1 46.2 0.0 12.5 28.2 -
Testis 0.6 1.1 0.0 0.6 1.1 -
Kidney 9.9 13.4 6.4 6.1 8.7 3.8
Bladder 8.5 13.7 3.4 4.5 8.4 1.6
Brain and CNS 3.9 4.3 3.6 3.1 3.5 2.7
Thyroid 51.0 21.7 80.2 36.6 15.6 58.1
Hodgkin lymphoma 0.6 0.8 0.4 0.5 0.6 0.4
Non-Hodgkin lymphoma 9.3 10.8 7.8 6.2 7.7 4.8
Multiple myeloma 3.0 3.3 2.7 1.7 2.0 1.4
Leukemia 6.7 7.8 5.6 5.6 6.6 4.7
Other and ill-defined 35.3 35.5 35.2 21.2 23.7 19.1

CNS, central nervous system.

a) Age-adjusted using the Segi’s world standard population,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 3.
The top 10 leading causes of death in Korea, 2016
Rank Cause of death No. of deaths (%) Age-standardized death rate per 100,000a)
All causes 280,827 (100) 280.8
1 Cancer 78,194 (27.8) 79.8
2 Heart disease 9,807 (3.5) 9.0
3 Cerebrovascular disease 5,416 (1.9) 4.6
4 Pneumonia 29,735 (10.6) 27.8
5 Intentional self-harm (suicide) 23,415 (8.3) 21.4
6 Diabetes mellitus 16,476 (5.9) 14.3
7 Chronic lower respiratory diseases 6,992 (2.5) 6.0
8 Disease of liver 6,798 (2.4) 7.7
9 Transport accidents 5,150 (1.8) 6.8
10 Hypertensive diseases 13,092 (4.7) 17.7
Others 85,752 (30.5) 85.9

Source: Mortality Data, 2016, Statistics Korea [1].

a) Age-adjusted using the Segi’s world standard population.

Table 4.
Crude and age-standardized cancer mortality rates by sex in Korea, 2016
Site/Type Crude mortality rate per 100,000
 Age-standardized mortality rate per 100,000a)
Both sexes Men Women Both sexes Men Women
All sites 153.0 188.8 117.2 79.8 115.5 53.6
Lip, oral cavity, and pharynx 2.4 3.6 1.1 1.3 2.2 0.5
Esophagus 3.0 5.4 0.6 1.6 3.2 0.2
Stomach 16.2 20.8 11.5 8.3 12.7 5.0
Colon and rectum 16.4 18.3 14.5 8.2 11.1 5.9
Liver 21.5 31.5 11.6 11.7 19.2 5.2
Gallbladderb) 8.6 8.8 8.4 4.2 5.3 3.4
Pancreas 11.0 11.4 10.6 5.7 7.0 4.6
Larynx 0.7 1.2 0.1 0.3 0.8 0.0
Lung 35.1 52.2 18.1 17.6 31.2 7.7
Breast 4.8 0.1 9.6 2.9 0.0 5.5
Cervix uteri 1.8 0.0 3.5 1.0 - 1.8
Corpus uteri 0.6 0.0 1.2 0.4 - 0.7
Ovary 2.4 0.0 4.7 1.3 - 2.5
Prostate 3.4 6.8 0.0 1.5 4.2 -
Testis 0.0 0.1 0.0 0.0 0.0 -
Kidney 2.0 2.8 1.2 1.1 1.8 0.5
Bladder 2.7 4.0 1.4 1.3 2.5 0.5
Brain and CNS 2.6 2.8 2.4 1.7 2.0 1.4
Thyroid 0.7 0.4 0.9 0.3 0.2 0.4
Hodgkin lymphoma 0.1 0.1 0.1 0.1 0.1 0.0
Non-Hodgkin lymphoma 3.6 4.2 2.9 1.9 2.6 1.4
Multiple myeloma 2.0 2.1 1.9 1.0 1.2 0.9
Leukemia 3.6 4.0 3.2 2.3 2.8 1.9
Other and ill-defined 7.9 8.3 7.6 4.3 5.3 3.5

CNS, central nervous system.

a) Age-adjusted using the world standard population,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 5.
Trends in cancer incidence rates from 1999 to 2016 in Korea
Site/Type Both sexes
 Men
 Women
1999 2016 Trend 1
 Trend 2
 1999 2016 Trend 1
 Trend 2
 1999 2016 Trend 1
 Trend 2
Year APC Year APC Year APC Year APC Year APC Year APC
All sites 210.5 269.0 1999-2011 3.6a) 2011-2016 –3.1a) 285.0 298.0 1999-2011 1.7a) 2011-2016 –3.0a) 161.1 254.6 1999-2011 5.8a) 2011-2016 –3.5a)
Lip, oral cavity, and pharynx 3.6 4.2 1999-2016 0.6a) - - 6.1 6.4 1999-2016 –0.1 - - 1.6 2.3 1999-2016 1.5a) - -
Esophagus 4.1 2.7 1999-2016 –2.2a) - - 8.8 5.4 1999-2016 –2.7a) - - 0.6 0.5 1999-2016 –1.5a) - -
Stomach 43.6 34.0 1999-2011 –0.2 2011-2016 –4.9a) 66.2 49.6 1999-2011 –0.4a) 2011-2016 –5.4a) 26.7 20.5 1999-2011 –0.4 2011-2016 –4.5a)
Colon and rectum 20.4 30.7 1999-2010 6.0a) 2010-2016 –4.5a) 26.2 40.4 1999-2010 6.5a) 2010-2016 –5.0a) 16.4 22.4 1999-2010 4.9a) 2010-2016 –3.9a)
Liver 27.9 17.6 1999-2010 –1.7a) 2010-2016 –4.4a) 46.8 28.5 1999-2009 –1.9a) 2009-2016 –4.1a) 12.3 7.8 1999-2010 –1.5a) 2010-2016 –4.8a)
Gallbladderb) 6.5 6.7 1999-2004 1.5 2004-2016 –0.3 8.1 8.3 1999-2016 0.1 - - 5.4 5.5 1999-2003 2.4 2003-2016 –0.5a)
Pancreas 5.6 7.0 1999-2016 1.4a) - - 7.8 8.1 1999-2016 0.5a) - - 4.0 6.0 1999-2016 2.3a) - -
Larynx 2.3 1.3 1999-2016 –3.6a) - - 4.9 2.6 1999-2016 –3.8a) - - 0.4 0.1 1999-2007 –9.0a) 2007-2016 –4.1a)
Lung 28.5 27.1 1999-2011 0.1 2011-2016 –1.4a) 51.4 42.3 1999-2005 –0.1 2005-2016 –1.6a) 12.4 15.4 1999-2011 2.0a) 2011-2016 –0.1
Breast 10.7 27.7 1999-2005 7.6a) 2005-2016 4.5a) 0.2 0.2 1999-2016 –0.8 20.9 54.9 1999-2005 7.8a) 2005-2016 4.6a)
Cervix uteri 8.5 4.6 1999-2016 –3.8a) - - - - - - - - 16.3 9.1 1999-2016 –3.6a) - -
Corpus uteri 1.4 3.4 1999-2003 8.8a) 2003-2016 4.6a) - - - - - - 2.8 6.8 1999-2003 9.1a) 2003-2016 4.7a)
Ovary 2.7 3.4 1999-2016 1.6a) - - - - - - - - 5.0 6.7 1999-2016 1.9a) - -
Prostate 3.1 12.5 1999-2009 15.1a) 2009-2016 1.0 8.4 28.2 1999-2009 13.5a) 2009-2016 0.2 - - - - - -
Testis 0.3 0.6 1999-2016 4.9a) - - 0.6 1.1 1999-2016 4.7a) - - - - - - - -
Kidney 3.0 6.1 1999-2009 6.6a) 2009-2016 1.7a) 4.5 8.7 1999-2010 6.0a) 2010-2016 0.8 1.7 3.8 1999-2008 6.9a) 2008-2016 2.2a)
Bladder 4.6 4.5 1999-2004 2.2a) 2004-2016 –1.2a) 9.0 8.4 1999-2004 2.0a) 2004-2016 –1.5a) 1.6 1.6 1999-2003 2.2 2003-2016 –1.4a)
Brain and CNS 2.9 3.1 1999-2016 0.2 - - 3.2 3.5 1999-2016 0.3 - - 2.6 2.7 1999-2016 0.1 - -
Thyroid 6.3 36.6 1999-2011 22.6a) 2011-2016 –12.6a) 2.1 15.6 1999-2012 22.5a) 2012-2016 –14.0a) 10.4 58.1 1999-2011 22.3a) 2011-2016 –13.5a)
Hodgkin lymphoma 0.2 0.5 1999-2016 4.0a) - - 0.4 0.6 1999-2016 3.2a) - - 0.1 0.4 1999-2016 5.1a) - -
Non-Hodgkin lymphoma 4.3 6.2 1999-2016 2.4a) - - 5.6 7.7 1999-2016 2.0a) - - 3.3 4.8 1999-2016 2.6a) - -
Multiple myeloma 1.0 1.7 1999-2012 3.7a) 2012-2016 0.8 1.2 2.0 1999-2012 3.5a) 2012-2016 0.5 0.8 1.4 1999-2006 6.1a) 2006-2016 2.2a)
Leukemia 4.7 5.6 1999-2016 1.0a) - - 5.5 6.6 1999-2016 1.1a) - - 3.9 4.7 1999-2016 0.8a) - -
Other and ill-defined 14.4 21.2 1999-2007 3.6a) 2007-2016 1.7a) 18.1 23.7 1999-2016 1.9a) - - 11.9 19.1 1999-2008 4.2a) 2008-2016 1.7a)

APC was calculated using age-standardized incidence data based on the Segi’s world standard population. APC, annual percentage change; CNS, central nervous system.

a) Significantly different from zero (p < 0.05),

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 6.
Trends in cancer mortality rates from 1999 to 2016 in Korea
Site/Type Both sexes
 Men
 Women
1999 2016 Trend 1
 Trend 2
 1999 2016 Trend 1
 Trend 2
 1999 2016 Trend 1
 Trend 2
Year APC Year APC Year APC Year APC Year APC Year APC
All sites 114.3 79.8 1999-2002 1.1 2002-2016 –2.7a) 176.6 115.5 1999-2002 1.3 2002-2016 –3.2a) 70.6 53.6 1999-2002 1.0 2002-2016 –2.2a)
Lip, oral cavity, and pharynx 1.1 1.3 1999-2016 –1.8a) - - 2.0 2.2 1999-2016 –2.0a) - - 0.4 0.5 1999-2016 –2.5a) - -
Esophagus 3.1 1.6 1999-2016 –4.3a) - - 6.8 3.2 1999-2016 –4.6a) - - 0.5 0.2 1999-2010 –6.4a) 2010-2016 –0.6
Stomach 23.8 8.3 1999-2003 –3.2a) 2003-2016 –6.7a) 36.9 12.7 1999-2003 –2.5a) 2003-2016 –7.1a) 14.6 5.0 1999-2003 –4.4a) 2003-2016 –6.6a)
Colon and rectum 7.7 8.2 1999-2004 5.8a) 2004-2016 –1.5a) 10.5 11.1 1999-2010 1.9a) 2010-2016 –3.8a) 6.0 5.9 1999-2004 5.1a) 2004-2016 –2.0a)
Liver 20.4 11.7 1999-2002 1.0 2002-2016 –3.8a) 35.3 19.2 1999-2002 0.2 2002-2016 –3.9a) 8.3 5.2 1999-2002 2.9 2002-2016 –3.8a)
Gallbladderb) 5.2 4.2 1999-2001 6.9 2001-2016 –2.6a) 6.8 5.3 1999-2001 5.5 2001-2016 –2.6a) 4.1 3.4 1999-2001 9.0 2001-2016 –2.6a)
Pancreas 5.4 5.7 1999-2016 0.3a) - - 7.6 7.0 1999-2016 –0.4a) - - 3.9 4.6 1999-2016 0.9a) - -
Larynx 1.6 0.3 1999-2016 –9.5a) - - 3.4 0.8 1999-2016 –9.1a) - - 0.4 0.0 1999-2010 –15.3a) 2010-2016 –8.0a)
Lung 22.4 17.6 1999-2002 1.9 2002-2016 –2.1a) 41.5 31.2 1999-2001 4.3 2001-2016 –2.5a) 9.4 7.7 1999-2002 2.6 2002-2016 –1.7a)
Breast 2.2 2.9 1999-2016 1.4a) - - 0.1 0.0 1999-2016 –4.3a) - - 4.2 5.5 1999-2016 1.6a) - -
Cervix uteri 1.4 1.0 1999-2003 8.3a) 2003-2016 –5.1a) - - - - - - 2.6 1.8 1999-2003 7.7a) 2003-2016 –4.8a)
Corpus uteri 0.1 0.4 1999-2002 52.0a) 2002-2016 3.4a) - - - - - - 0.1 0.7 1999-2002 51.7a) 2002-2016 3.7a)
Ovary 0.9 1.3 1999-2001 10.2 2001-2016 0.4 - - - - - - 1.7 2.5 1999-2006 1.0a) - -
Prostate 0.9 1.5 1999-2004 9.7a) 2004-2016 0.1 2.6 4.2 1999-2004 9.6a) 2002-2016 –0.4 - - - - - -
Testis 0.0 0.0 1999-2016 –2.6 - - 0.1 0.0 1999-2016 –3.1a) - - - - - - - -
Kidney 1.1 1.1 1999-2016 –0.1 - - 1.8 1.8 1999-2016 0.0 - - 0.5 0.5 1999-2016 –0.7 - -
Bladder 1.3 1.3 1999-2011 10.0 2011-2016 –1.7a) 2.6 2.5 1999-2016 –1.6a) - - 0.5 0.5 1999-2001 10.3 2001-2016 –1.7a)
Brain and CNS 1.9 1.7 1999-2002 4.2 2002-2016 –1.9a) 2.2 2.0 1999-2016 –1.5a) - - 1.6 1.4 1999-2016 –1.4a) - -
Thyroid 0.4 0.3 1999-2003 7.4a) 2003-2016 –4.4a) 0.3 0.2 1999-2003 10.3 2003-2016 –4.5a) 0.5 0.4 1999-2004 4.5 2004-2016 –4.9a)
Hodgkin lymphoma 0.0 0.1 1999-2004 22.5a) 2004-2016 –1.4 0.0 0.1 1999-2004 19.5a) 2004-2016 –2.3 0.0 0.0 1999-2003 43.6a) 2003-2016 0.0
Non-Hodgkin lymphoma 2.1 1.9 1999-2016 –0.5a) - - 3.0 2.6 1999-2016 –0.8a) - - 1.4 1.4 1999-2016 –0.2 - -
Multiple myeloma 0.6 1.0 1999-2003 12.7a) 2003-2016 0.9 0.8 1.2 1999-2003 11.0a) 2003-2016 0.8 0.4 0.9 1999-2005 9.8a) 2005-2016 0.3
Leukemia 2.9 2.3 1999-2016 –1.7a) - - 3.5 2.8 1999-2016 –1.6a) - - 2.4 1.9 1999-2016 –1.9a)
Other and ill-defined 7.8 4.3 1999-2016 –3.1a) - - 9.0 5.3 1999-2008 –0.3 2009-2016 –5.7a) 7.0 3.5 1999-2005 –7.0a) 2005-2016 –2.1a)

APC was calculated using age-standardized incidence data based on the Segi’s world standard population. APC, annual percentage change; CNS, central nervous system.

a) Significantly different from zero (p < 0.05),

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 7.
The five common sites of cancer incidence by age group and sex in Korea, 2016
Rank Age (yr)
0-14 15-34 35-64 ≥ 65
Men
 1 Leukemia (5.2) Thyroid (13.7) Stomach (85.6) Lung (435.1)
 2 Non-Hodgkin lymphoma (2.9) Leukemia (3.8) Colon and rectum (65.1) Stomach (353.1)
 3 Brain and CNS (2.3) Non-Hodgkin lymphoma (3.1) Liver (55.6) Prostate (313.4)
 4 Kidney (0.6) Colon and rectum (2.6) Lung (44.0) Colon and rectum (302.6)
 5 Liver (0.4) Testis (2.3) Thyroid (33.3) Liver (175.5)
Women
 1 Leukemia (4.5) Thyroid (50.5) Breast (147.5) Colon and rectum (175.2)
 2 Brain and CNS (2.0) Breast (12.0) Thyroid (127.9) Stomach (137.2)
 3 Non-Hodgkin lymphoma (1.2) Cervix uteri (5.7) Colon and rectum (37.6) Lung (126.8)
 4 Ovary (0.5) Ovary (3.3) Stomach (37.6) Breast (89.5)
 5 Kidney (0.4) Leukemia (2.8) Lung (24.9) Liver (65.6)

CNS, central nervous system.

Table 8.
Trends in the 5-year relative survival rates (%) by year of diagnosis from 1993 to 2016 in Korea
Site/Type Both sexes
 Men
 Women
1993-1995 1996-2000 2001-2005 2006-2010 2011-2015 2012-2016 Changea) 1993-1995 1996-2000 2001-2005 2006-2010 2011-2015 2012-2016 Changea) 1993-1995 1996-2000 2001-2005 2006-2010 2011-2015 2012-2016 Changea)
All sites 41.2 44.0 54.0 65.2 70.7 70.6 29.4 31.7 35.3 45.4 56.6 62.9 63.2 31.5 53.4 55.3 64.2 74.3 78.3 78.0 24.6
Lip, oral cavity, and pharynx 41.1 46.7 54.3 60.8 64.9 65.4 24.3 35.8 41.1 49.5 56.7 61.3 62.1 26.3 58.1 63.8 67.9 71.8 74.2 73.9 15.8
Esophagus 12.7 15.2 21.4 29.7 36.4 37.4 24.7 11.8 14.3 20.6 29.1 36.1 37.2 25.4 23.7 24.2 29.8 36.9 39.4 39.6 15.9
Stomach 42.8 46.6 57.8 68.1 75.7 76.0 33.2 43.0 46.9 58.5 68.8 76.6 76.9 33.9 42.6 46.0 56.5 66.8 73.8 73.9 31.3
Colon and rectum 54.8 58.0 66.7 73.6 76.2 75.9 21.1 55.3 59.0 68.6 75.5 77.9 77.8 22.5 54.2 56.8 64.3 70.8 73.6 73.2 19.0
Liver 10.7 13.2 20.4 28.1 34.0 34.6 23.9 9.9 12.9 20.3 28.1 34.5 35.2 25.3 13.6 14.2 20.9 28.2 32.6 32.7 19.1
Gallbladderb) 17.3 19.7 23.0 26.7 28.8 29.0 11.7 16.6 20.3 23.4 27.6 29.5 29.7 13.1 18.0 19.1 22.6 25.8 28.0 28.3 10.3
Pancreas 9.4 7.6 8.4 8.4 10.7 11.4 2.0 8.8 7.3 8.4 8.2 10.3 11.2 2.4 10.1 8.1 8.4 8.7 11.2 11.7 1.6
Larynx 59.7 62.3 66.2 72.8 75.2 75.7 16.0 60.2 62.8 66.8 73.1 75.7 76.3 16.1 55.4 57.8 58.5 67.7 67.9 65.8 10.4
Lung 11.3 12.7 16.5 20.1 27.1 28.2 16.9 10.4 11.6 15.2 17.9 23.0 23.7 13.3 14.2 16.2 20.1 25.8 36.5 38.6 24.4
Breast 77.9 83.2 88.6 91.1 92.5 92.7 14.8 75.1 85.6 87.2 89.5 86.3 89.3 14.2 78.0 83.2 88.6 91.1 92.6 92.7 14.7
Cervix uteri 77.5 80.0 81.4 80.6 80.1 79.8 2.3 - - - - - - - 77.5 80.0 81.4 80.6 80.1 79.8 2.3
Corpus uteri 81.5 81.8 84.7 86.4 87.8 87.5 6.0 - - - - - - - 81.5 81.8 84.7 86.4 87.8 87.5 6.0
Ovary 58.7 58.9 61.6 61.1 63.9 64.0 5.3 - - - - - - - 58.7 58.9 61.6 61.1 63.9 64.0 5.3
Prostate 55.9 67.2 80.4 91.1 94.0 93.9 38.0 55.9 67.2 80.4 91.1 94.0 93.9 38.0 - - - - - - -
Testis 85.4 90.4 90.7 93.1 95.3 95.2 9.8 85.4 90.4 90.7 93.1 95.3 95.2 9.8 - - - - - - -
Kidney 62.0 66.1 73.5 78.3 82.3 82.7 20.7 60.8 64.4 72.9 78.2 81.8 82.5 21.7 64.5 69.7 74.8 78.7 83.3 83.1 18.6
Bladder 69.1 73.1 75.7 76.6 76.0 76.0 6.9 70.0 74.8 77.4 78.6 77.9 78.0 8.0 65.5 66.3 68.8 68.6 68.1 68.1 2.6
Brain and CNS 38.5 39.0 41.0 42.8 41.1 41.4 2.9 37.2 37.5 40.2 41.3 39.4 39.3 2.1 40.2 40.7 41.8 44.4 43.1 43.9 3.7
Thyroid 94.2 94.9 98.3 99.9 100.2 100.2 6.0 87.2 89.5 95.9 100.0 100.6 100.5 13.3 95.4 95.9 98.7 99.9 100.1 100.1 4.7
Hodgkin lymphoma 68.0 71.2 76.6 80.9 82.3 83.0 15.0 67.6 68.1 74.6 80.7 82.2 81.9 14.3 68.6 77.4 80.7 81.4 82.5 85.0 16.4
Non-Hodgkin lymphoma 46.6 50.8 55.9 59.3 62.7 63.1 16.5 45.3 48.9 54.9 59.0 62.7 63.2 17.9 48.7 53.5 57.4 59.6 62.8 63.0 14.3
Multiple myeloma 22.1 19.8 29.6 34.9 41.1 41.9 19.8 21.1 17.8 29.7 35.0 40.3 40.3 19.2 23.3 22.1 29.4 34.8 41.9 43.6 20.3
Leukemia 26.5 33.3 41.9 47.6 51.5 51.9 25.4 26.2 32.3 41.8 46.9 51.8 52.5 26.3 26.8 34.6 42.2 48.6 51.1 51.1 24.3
Other and ill-defined 42.1 45.9 57.6 67.2 72.4 73.3 31.2 37.4 42.4 53.8 63.4 69.1 70.1 32.7 47.4 50.0 61.7 71.1 75.7 76.4 29.0

CNS, central nervous system.

a) Percentage change in 5-year relative survival from 1993 to 1995 and 2012 to 2016,

b) Includes the gallbladder and other/unspecified parts of the biliary tract.

Table 9.
Crude and age-standardized rates of cancer prevalence by sex on January 1, 2017 in Korea
Site/Type Crude prevalence rate per 100,000a)
 Age-standardized prevalence rate per 100,000b)
Both sexes Men Women Both sexes Men Women
All sites 3,404.1 2,993.2 3,814.1 2,046.2 1,896.1 2,281.5
Lip, oral cavity, and pharynx 46.2 62.1 30.5 28.2 39.7 18.2
Esophagus 19.1 34.4 3.9 10.5 20.9 1.9
Stomach 535.5 709.9 361.4 297.8 433.6 185.7
Colon and rectum 462.6 551.8 373.6 254.8 338.9 186.9
Liver 126.9 190.6 63.3 74.7 119.1 34.6
Gallbladderc) 41.1 42.2 40.0 21.8 25.6 18.9
Pancreas 20.7 21.6 19.9 11.9 13.5 10.6
Larynx 20.6 38.8 2.4 11.2 23.6 1.2
Lung 149.8 185.8 113.8 82.7 113.6 58.9
Breast 387.4 2.9 771.0 239.0 1.8 470.0
Cervix uteri 103.2 - 206.2 62.6 - 122.3
Corpus uteri 45.3 - 90.4 28.0 - 55.1
Ovary 38.2 - 76.3 25.5 - 50.6
Prostate 151.9 304.1 - 76.1 180.5 -
Testis 6.3 12.6 - 5.7 11.1 -
Kidney 76.0 102.5 49.5 46.3 65.8 29.0
Bladder 65.6 107.1 24.2 34.4 65.2 10.9
Brain and CNS 21.7 22.5 21.0 18.3 19.5 17.1
Thyroid 743.3 255.9 1,229.7 487.5 171.0 801.9
Hodgkin lymphoma 5.5 6.9 4.1 4.5 5.5 3.5
Non-Hodgkin lymphoma 58.9 67.1 50.7 40.8 49.1 33.1
Multiple myeloma 11.3 11.9 10.7 6.4 7.3 5.7
Leukemia 40.6 45.3 36.0 37.4 41.8 33.0
Other and ill-defined 226.4 217.1 235.6 139.9 149.0 132.6

CNS, central nervous system.

a) Crude prevalence rate: number of prevalent cases divided by the corresponding person-years of observation. Prevalent cases were defined as patients who were diagnosed between January 1, 1999 and December 31, 2016 and who were alive on January 1, 2017. Multiple primary cancer cases were counted multiple times,

b) Age-adjusted using the Segi’s world standard population,

c) Includes the gallbladder and other/unspecified parts of the biliary tract.

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