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Jung, Kang, Park, Yun, Kim, Kong, Im, and Seo: Prediction of Cancer Incidence and Mortality in Korea, 2023
Special Article

Cancer Res Treat 2023;55(2):400-407.

DOI: https://doi.org/10.4143/crt.2023.448

Prediction of Cancer Incidence and Mortality in Korea, 2023

Kyu-Won Jung1, 2, Mee Joo Kang1, 2, Eun Hye Park1, 2, E Hwa Yun1, 2, 3, Hye-Jin Kim1, 2, Hyun-Joo Kong1, 2, Jeong-Soo Im4, Hong Gwan Seo1, 3

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

2Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea

3National Cancer Control Institute, National Cancer Center, Goyang, Korea

4National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea

Correspondence: Kyu-Won Jung, 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: ara@ncc.re.kr

Received 8 March 2023       Accepted 10 March 2023

Copyright © 2023 by the Korean Cancer Association

(open-access):

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 aimed to report the projected cancer incidence and mortality for the year 2023 to estimate Korea’s current cancer burden.

Materials and Methods

Cancer incidence data from 1999 to 2020 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2021 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2023. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend.

Results

In total, 273,076 new cancer cases and 81,818 cancer deaths are expected to occur in Korea in 2023. The most common cancer site is expected to be the lung, followed by the thyroid, breast, colon and rectum, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and gallbladder cancers.

Conclusion

The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

Keywords: Incidence, Mortality, Neoplasms, Forecasting, Korea, 2023

Introduction

As the leading cause of death in Korea [1], cancer has been a major public health concern in the country since 1983. 250,000 patients were newly diagnosed with cancer in Korea, and 27% of deaths were due to cancer in 2020 [2]. Although the cancer registration system in Korea is highly efficient and can provide nationwide cancer statistics within a relatively short period, a lag time of at least 2 years is required to collect and analyze data for a specific year. For planning and implementing comprehensive cancer-control programs, it is important to assess the number of new cases and deaths that are expected to occur during the current year. In this study, we report the projected cancer incidence and mortality for the year 2023 based on data from the 1990s to 2020.

Materials and Methods

The Korean Ministry of Health and Welfare initiated a nationwide, hospital-based cancer registry, known as the Korea Central Cancer Registry (KCCR), in 1980. The history, objectives, and activities of the KCCR have been documented in detail elsewhere [3]. Cancer incidence data from 1999 to 2020 were obtained from the Korea National Cancer Incidence Database (KNCI DB). Cancer cases were classified according to the International Classification of Diseases for Oncology, 3rd edition [4] and converted according to the International Classification of Diseases, 10th edition (ICD-10) [5]. Mortality data from 1993 to 2021 were acquired from Statistics Korea [1]. The cause of death was coded and classified according to the ICD-10 [5].
The cancer sites included in this study were (1) all cancer sites combined and (2) the 24 cancer sites as follows: lips, oral cavity, and pharynx (C00–C14), esophagus (C15), stomach (C16), colon and rectum (C18–C20), liver (C22), gallbladder etc. (C23–C24), pancreas (C25), larynx (C32), lung (C33–C34), breast (C50), cervix uteri (C53), corpus uteri (C54), ovary (C56), prostate (C61), testis (C62), kidney (C64), bladder (C67), brain and central nervous system (C70–C72), thyroid (C73), Hodgkin lymphoma (C81), non-Hodgkin lymphoma (C82–C86, C96), multiple myeloma (C90), leukemia (C91–C95), and other and ill-defined sites (remainder of C00–C96).
The population data from 1993 to 2023 were obtained from the resident registration population data, reported by Statistics Korea. Data of the mid-year population (July 1 of the respective year) were used as the denominator to obtain the annual incidence and mortality rates. However, for the year 2023, we used the population data on December 31, 2022, as the mid-2023 resident registration population data were not yet available at the time of the analysis.
Linear regression models [6] were used to assess time trends and create projections. We first performed a joinpoint regression analysis on the data available to detect the year when significant changes occurred in cancer trends according to sex and cancer site. A joinpoint regression describes changes in data trends by connecting several different line segments on a log scale at “Joinpoints.” This analysis was performed using Joinpoint software (version 4.7.0.0, http://surveillance.cancer.gov/joinpoint) from the Surveillance Research Program of the US National Cancer Institute [7]. For the analysis, we arranged to have at least four data points between consecutive joinpoints. Secondly, to predict age-specific cancer rates, a linear regression model was fitted to age-specific rates by 5-year age groups against their respective years, based on the observed cancer incidence data of the latest trends. Finally, we multiplied the projected age-specific rates by the age-specific population to get the projected number of cancer cases and deaths for the year 2023.
We summarized the results using crude rates (CRs) and age-standardized rates (ASRs) of cancer incidence and mortality. ASRs were standardized using the world standard population [8] and expressed per 100,000 persons.

Results

1. Incidence

In total, 273,076 new cancer cases are expected to occur in 2023 (Table 1, Fig. 1); more men (n=144,379) than women (n=128,697) are expected to be affected.
The projected CRs per 100,000 for all of the sites combined in 2023 are 563.4 cases and 499.0 cases for men and women, respectively (Table 2). The projected ASRs per 100,000 for all of the sites combined are 280.4 cases and 270.6 cases for men and women, respectively. In men, the five leading primary sites of cancer are expected to be the prostate (CR, 89.1; ASR, 39.0), lung (CR, 86.7; ASR, 38.3), colon and rectum (CR, 64.0; ASR, 31.7), stomach (CR, 63.9; ASR, 30.5), and liver (CR, 40.8; ASR, 19.6), accounting for 61.2% of all new cancer cases in 2023. In women, the five leading primary sites are expected to be the breast (CR, 111.9; ASR, 67.7), thyroid (CR, 92.7; ASR, 69.4), colon and rectum (CR, 43.6; ASR, 17.7), lung (CR, 43.4; ASR, 17.3), and stomach (CR, 32.4; ASR, 14.0), accounting for 64.9% of all new cancer cases in 2023 (Fig. 1).
The five most common cancer sites expected in 2023 according to sex and age group are shown in Table 3. Leukemia and thyroid cancer are expected to be the most common forms of cancer in both sexes for those aged 0–14 years and 15–34 years, respectively. Colorectal cancer is predicted to be the most prevalent cancer in men aged 35–64 years, while prostate cancer is expected to be more frequent in men aged 65 years and above. Breast cancer is predicted to be the most common cancer in women aged 35–64 years, whereas lung cancer is expected to be the most common form in women aged 65 years and above. According to the projection, the incidences of stomach, lung, liver, colorectal, and prostate cancers will increase gradually with age for men (Fig. 2A). In women, the age-specific incidence rates for stomach, colorectal, liver, lung, and cervical cancers denote an increasing trend with age; however, the incidences of breast and thyroid cancers in women are expected to level off after the age of 45 and 50 years, respectively (Fig. 2B).

2. Mortality

It is estimated that 81,818 cancer deaths will occur in Korea during 2023 (Table 1, Fig. 1). The projected CRs per 100,000 for all of the sites combined in 2023 for men and women are 194.0 cases and 124.4 cases, respectively, whereas the projected ASRs per 100,000 for all sites combined for men and women are expected to be 85.0 cases and 43.2 cases, respectively (Table 4). The predicted five leading cancer sites causing mortality in men are the lung (CR, 53.7; ASR, 22.4), liver (CR, 26.7; ASR, 12.1), colon and rectum (CR, 18.9; ASR, 8.4), pancreas (CR, 15.1; ASR, 6.7), and stomach (CR, 12.7; ASR, 5.6). During the same period, lung cancer (CR, 18.5; ASR, 5.7) is projected to be the leading cause of cancer death in women, followed by colon and rectal (CR, 15.2; ASR, 4.6), pancreatic (CR, 14.4; ASR, 4.7), breast (CR, 11.4; ASR, 5.7), and gallbladder (CR, 10.1; ASR, 2.8) cancers.
The predicted age-specific mortality rates of the leading causes of cancer-associated death in men and women in 2023 are shown in detail in Fig. 3. According to age, Korean men and women aged at least 60 years are expected to have the highest mortality rates due to lung cancer.

Conclusion

A total of 273,076 new cancer cases and 81,818 cancer deaths are expected to occur in Korea during 2023. Prostate cancer is predicted to be the most common type of cancer among men, followed by lung, colorectal, stomach, and liver cancers. Lung, liver, colorectal, pancreatic, and stomach cancers are expected to be the most common causes of cancer deaths among men. In women, the five leading primary cancer sites are expected to be the breast, thyroid, colon and rectum, lung, and stomach, while lung, colorectal, pancreatic, breast, and gallbladder cancers are projected to be the most common causes of cancer deaths.
Cancer is currently one of the foremost public health concerns in Korea. Although cancer incidence rates are anticipated to slightly decrease, the burden of most types of cancers will continue to grow with the increasing age of the population. The current projections of cancer incidence and mortality for 2023 represent an important resource for planning and evaluating cancer-control programs. As the estimates in this study are model-based, these results should be interpreted with caution. Also due to coronavirus disease 2019 epidemic, the number of cancer cases in 2020 decreased by 3.6% compared to the previous year. As a result, it may be affected by the predict of 2023, so attention should be paid to the interpretation.

Notes

Author Contributions

Conceived and designed the analysis: Jung KW.

Contributed data or analysis tools: Jung KW, Kong HJ, Kim HJ.

Performed the analysis: Jung KW.

Wrote the paper: Jung KW.

Interpretation and review: Kang MJ, Park EH, Yun EH, Kim HJ, Im JS, Seo HG.

Conflicts of Interest

Conflict of interest relevant to this article was not reported.

Acknowledgments

The authors thank the tumor registrars (health information managers) of the KCCR-affiliated hospitals and non-KCCR-affiliated hospitals for their assistance with data collection, abstraction, and coding. Additionally, we acknowledge the cooperation of the National Health Insurance Service and Statistics Korea for their support with the data. This work was supported by the National Cancer Center research grant (No. 2211110).

References

1. Statistics Korea [Internet]. Daejeon: Statistics Korea;2023. [cited 2023 Feb 8]. Available from: http://kosis.kr.
2. Hong S, Won YJ, Lee JJ, Jung KW, Kong HJ, Im JS, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2018. Cancer Res Treat. 2021; 53:301–15.
3. Shin HR, Won YJ, Jung KW, Kong HJ, Yim SH, Lee JK, et al. Nationwide cancer incidence in Korea, 1999–2001: first result using the national cancer incidence database. Cancer Res Treat. 2005; 37:325–31.
4. Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, et al. International classification of diseases for oncology. 3rd ed. . 1st rev. . Geneva: World Health Organization;2013.
5. World Health Organization. International statistical classification of diseases and related health problems. 10th rev. . Geneva: World Health Organization;1994.
6. Boyle P, Parkin DM. Statistical methods for registries. Jensen OM, Parkin DM, MacLennan R, Muir CS, Skeet RG, editors. Cancer registration: principles and methods IARC Scientific Publication No 95. Lyon: IARC Press;1991. p. 126–58.
7. National Cancer Institute. Joinpoint regression program, version 4.7.0.0 [Internet]. Bethesda, MD: National Cancer Institute;2023. [cited 2023 Feb 18]. Available from: http://surveillance.cancer.gov/joinpoint/.
8. Segi M. Cancer mortality for selected sites in 24 countries 1950–1957. Sendai: Tohoku University School of Medicine;1960.

Fig. 1
The 10 leading types of estimated new cancer cases and deaths by sex in 2023. (A) Estimated new cases. (B) Estimated deaths.
crt-2023-448f1.gif
Fig. 2
Projected age-specific incidences of major cancers during 2023 in Korea. (A) Men. (B) Women.
crt-2023-448f2.gif
Fig. 3
Projected age-specific mortality rates of major cancers during 2023 in Korea. (A) Men. (B). Women.
crt-2023-448f3.gif
Table 1
Estimated new cancer cases and deaths by sex during 2023 in Korea
Site Estimated new cases Estimated deaths
Both sexes Men Women Both sexes Men Women
All sites 273,076 144,379 128,697 81,818 49,730 32,088
Lip, oral cavity, and pharynx 4,347 3,111 1,236 1,278 927 351
Esophagus 2,778 2,439 339 1,240 1,092 148
Stomach 24,735 16,385 8,350 4,972 3,243 1,729
Colon and rectum 27,657 16,407 11,250 8,767 4,839 3,928
Livera) 14,164 10,466 3,698 9,340 6,831 2,509
Gallbladderb) 8,315 4,797 3,518 5,675 3,077 2,598
Pancreas 9,718 4,981 4,737 7,577 3,873 3,704
Larynx 1,047 991 56 223 212 11
Lungc) 33,413 22,225 11,188 18,536 13,767 4,769
Breast 28,969 118 28,851 2,963 19 2,944
Cervix uteri 2,784 - 2,784 729 - 729
Corpus uteri 3,813 - 3,813 445 - 445
Ovary 3,257 - 3,257 1,439 - 1,439
Prostate 22,837 22,837 - 2,425 2,425 -
Testis 351 351 - 18 18 -
Kidney 6,823 4,712 2,111 1,071 713 358
Bladder 5,232 4,303 929 1,616 1,208 408
Brain and CNS 2,203 1,189 1,014 1,415 745 670
Thyroid 32,977 9,079 23,898 337 105 232
Hodgkin lymphoma 358 221 137 58 40 18
Non-Hodgkin lymphoma 6,314 3,637 2,677 2,401 1,376 1,025
Multiple myeloma 2,047 1,136 911 1,098 565 533
Leukemia 4,059 2,338 1,721 2,185 1,281 904
Other and ill defined 24,878 12,656 12,222 6,010 3,374 2,636

CNS, central nervous system.

a) Includes the liver and intrahepatic bile duct,

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

c) Includes the lung and bronchus.

Table 2
Estimated crude and age-standardized cancer incidences by sex during 2023 in Korea
Site Crude incidence rates per 100,000 Age-standardized incidence rates per 100,000a)
Both sexes Men Women Both sexes Men Women
All sites 531.1 563.4 499.0 269.7 280.4 270.6
Lip, oral cavity, and pharynx 8.5 12.1 4.8 4.4 6.4 2.6
Esophagus 5.4 9.5 1.3 2.3 4.3 0.6
Stomach 48.1 63.9 32.4 21.7 30.5 14.0
Colon and rectum 53.8 64.0 43.6 24.4 31.7 17.7
Liverb) 27.5 40.8 14.3 12.2 19.6 5.4
Gallbladderc) 16.2 18.7 13.6 6.1 8.2 4.4
Pancreas 18.9 19.4 18.4 7.9 9.0 6.9
Larynx 2.0 3.9 0.2 0.9 1.7 0.1
Lungd) 65.0 86.7 43.4 26.6 38.3 17.3
Breast 56.3 0.5 111.9 33.9 0.2 67.7
Cervix uteri 5.4 - 10.8 3.5 - 7.0
Corpus uteri 7.4 - 14.8 4.3 - 8.7
Ovary 6.3 - 12.6 3.8 - 7.5
Prostate 44.4 89.1 - 17.9 39.0 -
Testis 0.7 1.4 - 0.7 1.4 -
Kidney 13.3 18.4 8.2 7.1 10.1 4.2
Bladder 10.2 16.8 3.6 4.0 7.4 1.3
Brain and CNS 4.3 4.6 3.9 3.0 3.3 2.7
Thyroid 64.1 35.4 92.7 46.9 25.4 69.4
Hodgkin lymphoma 0.7 0.9 0.5 0.6 0.7 0.5
Non-Hodgkin lymphoma 12.3 14.2 10.4 6.9 8.4 5.5
Multiple myeloma 4.0 4.4 3.5 1.7 2.1 1.4
Leukemia 7.9 9.1 6.7 5.7 6.7 4.7
Other and ill defined 48.4 49.4 47.4 23.4 26.1 21.0

CNS, central nervous system.

a) Age adjusted to the world standard population,

b) Includes the liver and intrahepatic bile duct,

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

d) Includes the lung and bronchus.

Table 3
Estimated cancer incidence by age group and sex during 2023 in Korea
Rank Age group (yr)
0–14 15–34 35–64 ≥ 65
Men
 1 Leukemia (4.8) Thyroid (27.0) Colon and rectum (60.8) Prostate (445.8)
 2 Non-Hodgkin lymphoma (3.3) Colon and rectum (4.7) Stomach (56.6) Lunga) (413.5)
 3 Brain and CNS (2.3) Leukemia (4.1) Thyroid (51.9) Stomach (230.7)
 4 Kidney (0.3) Non-Hodgkin lymphoma (3.4) Lunga) (43.0) Colon and rectum (212.2)
 5 Lip, oral cavity, and pharynx (0.2) Testis (3.2) Prostate (37.7) Liverb) (143.9)
Women
 1 Leukemia (4.2) Thyroid (77.1) Breast (183.6) Lunga) (139.4)
 2 Brain and CNS (1.9) Breast (13.3) Thyroid (139.4) Colon and rectum (137.3)
 3 Non-Hodgkin lymphoma (1.8) Cervix uteri (5.3) Colon and rectum (32.9) Breast (117.5)
 4 Thyroid (1.0) Ovary (3.7) Lunga) (32.3) Stomach (93.3)
 5 Ovary (0.8) Corpus uteri (3.3) Stomach (28.7) Pancreas (67.5)

CNS, central nervous system.

a) Includes the lung and bronchus,

b) Includes the liver and intrahepatic bile duct.

Table 4
Estimated crude and age-standardized cancer mortality rates by sex during 2023 in Korea
Site Crude mortality rates per 100,000 Age-standardized mortality rates per 100,000a)
Both sexes Men Women Both sexes Men Women
All sites 159.1 194.0 124.4 61.1 85.0 43.2
Lip, oral cavity, and pharynx 2.5 3.6 1.4 1.0 1.7 0.5
Esophagus 2.4 4.3 0.6 0.9 1.8 0.2
Stomach 9.7 12.7 6.7 3.6 5.6 2.0
Colon and rectum 17.1 18.9 15.2 6.3 8.4 4.6
Liverb) 18.2 26.7 9.7 7.3 12.1 3.0
Gallbladderc) 11.0 12.0 10.1 3.8 5.0 2.8
Pancreas 14.7 15.1 14.4 5.6 6.7 4.7
Larynx 0.4 0.8 0.0 0.2 0.3 0.0
Lungd) 36.1 53.7 18.5 13.0 22.4 5.7
Breast 5.8 0.1 11.4 2.9 0.0 5.7
Cervix uteri 1.4 - 2.8 0.7 - 1.4
Corpus uteri 0.9 - 1.7 0.4 - 0.8
Ovary 2.8 - 5.6 1.3 - 2.5
Prostate 4.7 9.5 - 1.5 3.7 -
Testis 0.0 0.1 - 0.0 0.1 -
Kidney 2.1 2.8 1.4 0.8 1.3 0.4
Bladder 3.1 4.7 1.6 1.0 1.9 0.4
Brain and CNS 2.8 2.9 2.6 1.5 1.7 1.3
Thyroid 0.7 0.4 0.9 0.2 0.2 0.2
Hodgkin lymphoma 0.1 0.2 0.1 0.0 0.1 0.0
Non-Hodgkin lymphoma 4.7 5.4 4.0 1.8 2.4 1.3
Multiple myeloma 2.1 2.2 2.1 0.8 0.9 0.7
Leukemia 4.3 5.0 3.5 1.9 2.5 1.4
Other and ill defined 11.7 13.2 10.2 4.7 6.2 3.4

CNS, central nervous system.

a) Age adjusted to the world standard population,

b) Includes the liver and intrahepatic bile duct,

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

d) Includes the lung and bronchus.

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