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Reliability Analysis under the Competing Risks (경쟁적 위험하에서의 신뢰성 분석)

  • Baik, Jaiwook
    • Journal of Applied Reliability
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    • v.16 no.1
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    • pp.56-63
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    • 2016
  • Purpose: The purpose of this study is to point out that the Kaplan-Meier method is not valid to calculate the survival probability or failure probability (risk) in the presence of competing risks and to introduce more valid method of cumulative incidence function. Methods: Survival analysis methods have been widely used in biostatistics division. However the same methods have not been utilized in reliability division. Especially competing risks cases, where several causes of failure occur and the occurrence of one event precludes the occurrence of the other events, are scattered in reliability field. But they are not noticed in the realm of reliability expertism or they are analysed in the wrong way. Specifically Kaplan-Meier method which assumes that the censoring times and failure times are independent is used to calculate the probability of failure in the presence of competing risks, thereby overestimating the real probability of failure. Hence, cumulative incidence function is introduced and sample competing risks data are analysed using cumulative incidence function and some graphs. Finally comparison of cumulative incidence functions and regression type analysis are mentioned briefly. Results: Cumulative incidence function is used to calculate the survival probability or failure probability (risk) in the presence of competing risks and some useful graphs depicting the failure trend over the lifetime are introduced. Conclusion: This paper shows that Kaplan-Meier method is not appropriate for the evaluation of survival or failure over the course of lifetime. In stead, cumulative incidence function is shown to be useful. Some graphs using the cumulative incidence functions are also shown to be informative.

Breast Cancer in Surat Thani, a Province in Southern Thailand: Analysis of 2004-2012 Incidence and Future Trends

  • Tassanasunthornwong, Sukit;Chansaard, Wasan;Sriplung, Hutcha;Bilheem, Surichai
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6735-6740
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    • 2015
  • Background: With the recent epidemiologic transition in Thailand, featuring decreasing incidences of infectious diseases along with increasing rates of chronic conditions, cancer is becoming a serious problem for the country. Breast cancer has the highest incidence rates among females, not only in the southern regions, but throughout Thailand. Surat Thani is a province in the upper part of Southern Thailand. A study was needed to identify the current burden, and the future trends of breast cancer. Materials and Methods: Here we used cancer incidence data from the Surat Thani Cancer Registry to characterize the incidences of breast cancer. Joinpoint analysis was used to investigate the incidences in the province from 2004 to 2012 and to project future trends from 2013 to 2030. Results: Age-standardized incidence rates (world) of breast cancer in the upper parts of Southern Thailand increased from 35.1 to 59.2 cases per 100,000 female population, which is equivalent to an annual percentage change of 4.5-4.8%. Linear drift effects played a role in shaping the increase of incidence. Joinpoint projection suggested that incidence rates would continue to increase in the future with incidence for women aged 50 and above, at a higher rate than for women below the age of 50. Conclusions: The current early detection measures increase detection rates of early disease. Preparation of a budget for treatment facilities and human resources, both in surgical and medical oncology, is essential.

Past Trends and Future Estimation of Annual Breast Cancer Incidence in Osaka, Japan

  • Toyoda, Yasuhiro;Tabuchi, Takahiro;Nakayama, Tomio;Hojo, Shigeyuki;Yoshioka, Setsuko;Maeura, Yoshiichi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2847-2852
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    • 2016
  • Background: Although the breast cancer incidence rate in Japan is lower than in western countries, the age-specific rates have markedly increased in recent years, along with the problems of declining birth rate and an aging population. Materials and Methods: We examined past trends of age-specific breast cancer incidence using data from the Osaka Cancer Registry from 1976 to 2010, and estimated future trends until 2025 based on the changes observed and population dynamics using a log linear regression model. Results: The age-specific breast cancer incidence rate has increased consistently from the 1970s, and the rates have caught up with those of Japanese-Americans in the US. Assuming the increasing tendency of age-specific breast cancer incidence to be constant, the average annual incidence of breast cancer will increase 1.7-fold from 2006-2010 to 2021-2025. Furthermore, the number of patients aged 80 years should increase 3.4-fold. Conclusions: The medical demand for breast cancer care in Japan may increase explosively in the future, particularly among the elderly. We need to prepare for such a future increase in demand for care, although careful monitoring is needed to confirm these results.

Analysis of Esophageal Cancer Time Trends in China, 1989-2008

  • Zhao, Jun;He, Yu-Tong;Zheng, Rong-Shou;Zhang, Si-Wei;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4613-4617
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    • 2012
  • National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in order to provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophageal cancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008. Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent change estimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer was found to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardized incidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 in all areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annual decrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreased with 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer age standardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is still a big issue and efforts for control should be continuously enhanced. Cancer registration is playing an important role in cancer control with the number of registries increasing and data quality improving in China.

Trend Analysis of Gastric Cancer Incidence in Iran and Its Six Geographical Areas During 2000-2005

  • Haidari, Mohmmad;Nikbakht, Mohammad Reza;Pasdar, Yahya;Najafi, Farid
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3335-3341
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    • 2012
  • Objective: gastric cancer is the fourth most common cancer worldwide. While it is one of the most common cancers in Iran, there are only limited data regarding incidence trends in the country. This study is the first of its type to investigate trends across six geographical areas during 2000-2005 using cancer registry data. Materials and methods: The registered data for gastric cancer cases in National Cancer Registry System were extracted from the Ministry of Health and Medical Education, Center for Disease Control & Management, code C16. First, according to WHO population, the sex-standardized incidence rate in both sexes and then the trends of incidence rate during 2000-2005 were investigated separately for different geographical areas of the country. Results: the incidence rates of gastric cancer in Iran and its six geographical areas during 2000-2005 were increasing albeit with differences in their slopes. The overall incidence rate increased from 2.8 in 2000 to 9.1 per 100,000 persons per year in 2005, rising from 4.1 to 13.2 in men. The average six-year incidence of gastric cancer in the central and northwestern border of Caspian Sea was 7.8 per 100,000 persons per year, while it was 0.9 per 100,000 persons per year in the border of the Persian Gulf. Generally the incidence rate in men was higher than in women. Conclusion: Iran is one of the high-risk areas for gastric cancer. Increase in incidence might continue in the future partly because of improvement in cancer registry systems as well as increase in risk of this cancer.

Epidemiologic characteristics of type 1 diabetes in children aged 14 years or under in Korea, 1985-2000 (1985-2000년에 15세 미만 한국인에서 발생한 1형 당뇨병의 역학적 특징)

  • Shin, Choong Ho
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.569-575
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    • 2008
  • Type 1 diabetes mellitus (T1 DM) develops in genetically susceptible individuals as a result of progressive autoimmune destruction of beta cells. There is larger global variation in incidence among children aged 0-14 years. The incidence of T1 DM in Korea is very low. The latest survey in Korea was conducted in 2001 by Korean Society of Pediatrics to analyse the childhood (0-14 years) national-wide incidence during 1 995-2000. The average childhood incidence (/100,000 and year) was 1.36 (95% CI: 1.23-1.48), higher than 1.06 of Korea in 1 994. This survey reported that higher mean annual incidence was observed in female (girls, 1.67 vs boy 1.07), older age group (10-14 years, 1.98; 5-9 years, 1.43; 0-4 years, 0.73), Kangwondo (2.09) and Seoul (1.99), and more new patients developed in spring (spring, 27.1%; winter, 26.6%; summer, 24.8%; autumn, 21.5%). The increase of childhood T1 DM incidence has occurred in every region (4.0% in Asia, 3.2% in Europe during 1990-1999). Also, steady increase in incidence was observed during 1985-2000 in Korea. This trends may be maintained or accelerated by environmental factors, known as triggers, modifiers and promoters of the T1 DM occurrence. The rising incidence of T1 DM suggests the need for continuous monitoring of incidence by using standardized methods in order to plan or assess prevention strategies.

Differences in Cancer Incidence among Predominantly Muslim and Buddhist Subpopulations in Songkhla

  • Sriplung, Hutcha;Bilheem, Surichai;Kuntipundee, Tirada;Geater, Sarayut Lucian
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9979-9983
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    • 2014
  • Background: The population of Songkhla, a province in Southern Thailand, can be divided into a predominantly Muslim subpopulation (PMSP, approximately 70% Muslim) and a predominantly Buddhist subpopulation (PBSP, around 14% Muslim). Objectives: This study was conducted to 1) describe the incidence of various cancers in both PMSP and PBSP, and 2) compare the incidence of various cancers between the two subpopulations. Materials and Methods: Cancer cases diagnosed between 1990 and 2010 were drawn from the database of Songkhla Cancer Registry. Population denominators were estimated from the 3 population censuses surveyed by the National Statistical Office of Thailand in 1990, 2000, and 2010. Results: The age-standardized incidence rates (ASR) of the 5 commonest male cancers among both subpopulations were calculated. In females, a lower incidence of cancers of the cervix and breast in PMSP compared to PBSP, with odds ratios of 0.54 (95% CI: 0.45-0.64) and 0.51 (95% CI: 0.43-0.60) respectively, was observed. In males, the incidence of cancers of the lung, liver, colon-rectum, and some other cancers were significantly different between the two populations in the past, but only prostate cancer showed a lower incidence among males in PMSP in recent years. Independent of sex and year of diagnosis, the incidence of lung, liver, NHL, and colorectal cancers was lower in MPSP compared to BPSP, with odds ratios of 0.75 (95% CI: 0.65-0.85), 0.74 (95% CI: 0.62-0.88), 0.74 (95% CI: 0.60-0.91), and 0.67 (95% CI: 0.56-0.78) respectively. Conclusions: The differences in incidence of some cancers and religionrelated culture between the two subpopulations need 2 sets of cancer-control plans and goals to fit the unique population context in deep Southern Thailand. This plan can be used in the 3 southernmost provinces of Thailand where the percentage of Muslims is over 85%.

Breast Cancer in Iraq, Incidence Trends from 2000-2009

  • AL-Hashimi, Muzahem Mohammed Yahya;Wang, Xiang Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.281-286
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    • 2014
  • Background: Breast cancer is the most frequent malignancy of women worldwide. In Iraq, breast cancer ranks first among cancers diagnosed in women but no studies have been conducted on incidence trends. The present study of breast cancer in the country during 2000-2009 was therefore performed. Materials and Metbods: The registered data for breast cancer cases were collected from the Iraqi Cancer Registry/Ministry of Health. The significance of incidence rate trends during 2000-2009 was tested using Poisson regression. Age-standardized rates (ASR), and age-specific rates per 100,000 population were calculated. ResultS" A total of 23,792 incident breast cancer cases were registered among females aged ${\geq}15$ years, represented 33.8% of all cancers in females registered during 2000-2009. It ranked first in all the years. The median age at diagnosis was 49 and the mean age was 52 years. The incidence rate of all female breast cancer in Iraq (all ages) increased from 26.6 per 100,000 in 2000 to 31.5 per 100,000 in 2009 (APC=1.14%, p<.0001). The incidence in age groups (40-49), (50-59) and (70+) increased in earlier years and has recently (2005-2009) become stable. The incidence in age group (60-69) did not decline since 2003, while the incidence rates in the age group (15-39) started to decline in 2004. Conclusions' With the Iraqi Cancer Registry data during the period 2000-2009, the incidence of all female breast cancer in Iraq (all ages) has risen. We found rapid increase in the age specific incidence rate among age group 60-69. However, breast cancer among Iraqi women still affects younger age groups than their counterparts in developed countries. Further epidemiological research is needed to examine possible causes and prevention measures.

Recent incidence of congenital heart disease in neonatal care unit of secondary medical center: a single center study

  • Cho, Seon-Young;Oh, Jin-Hee;Lee, Jung-Hyun;Lee, Jae-Young;Lee, Soon-Ju;Han, Ji-Whan;Koh, Dae-Kyun;Oh, Chang-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.7
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    • pp.232-237
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    • 2012
  • Purpose: With feasibility in the diagnoses of congenital heart disease (CHD) in the antenatal period, we suspect changes have occurred in its incidence. No data have been reported about the current incidence of simple forms of CHD in Korea. We have attempted to assess the recent incidence and characteristics of CHD in the neonatal care unit of a secondary referral medical center. Methods: Medical records of 497 neonatal care unit patients who underwent echocardiography in the past 5 years were reviewed. Preterm infants with patent ductus arteriosus and other transient, minimal lesions were excluded from this study. Results: Although the number of inpatients remained stable, the incidence of simple forms of CHD showed a gradual decrease over the 5-year study period; a markedly low incidence of complex forms was seen as well. CHD was observed in 3.7% full-term and 6.8% pre-term infants. CHD was observed in 152 infants weighing >2,500 g (3.5% of corresponding birth weight infants); 65 weighing 1,000 to 2,500 g (9.3%); and 6 weighing <1,000 g (8.0%). The incidence of CHD was higher in the pre-term group and the low birth weight group than in each corresponding subgroup (P<0.001); however, the incidence of complex CHD in full-term neonates was high. The number of patients with extracardiac structural anomalies has also shown a gradual decrease every year for the past 5 years. Conclusion: Findings from our study suggest that the recent incidence and disease pattern of CHD might have changed for both complex and simple forms of CHD in Korea.

Breast Cancer in Lampang, a Province in Northern Thailand: Analysis of 1993-2012 Incidence Data and Future Trends

  • Lalitwongsa, Somkiat;Pongnikorn, Donsuk;Daoprasert, Karnchana;Sriplung, Hutcha;Bilheem, Surichai
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8327-8333
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    • 2016
  • Background: The recent epidemiologic transition in Thailand, with decreasing incidence of infectious diseases along with increasing rates of chronic conditions, including cancer, is a serious problem for the country. Breast cancer has the highest incidence rates among females throughout Thailand. Lampang is a province in the upper part of Northern Thailand. A study was needed to identify the current burden, and the future trends of breast cancer in upper Northern Thai women. Materials and Methods: Here we used cancer incidence data from the Lampang Cancer Registry to characterize and analyze the local incidence of breast cancer. Joinpoint analysis, age period cohort model and Nordpred package were used to investigate the incidences of breast cancer in the province from 1993 to 2012 and to project future trends from 2013 to 2030. Results: Age-standardized incidence rates (world) of breast cancer in the upper parts of Northern Thailand increased from 16.7 to 26.3 cases per 100,000 female population which is equivalent to an annual percentage change of 2.0-2.8%, according to the method used. Linear drift effects played a role in shaping the increase of incidence. The three projection method suggested that incidence rates would continue to increase in the future with incidence for women aged 50 and above, increasing at a higher rate than for women below the age of 50. Conclusions: The current early detection measures increase detection rates of early disease. Preparation of a budget for treatment facilities and human resources, both in surgical and medical oncology, is essential.