about 178,000 people develop cancer annually , with an age - standardized rate of 321.3 per 100 thousand in 2009 .
this cancer incidence rate is less than the 335.0 per 100 thousand rate in the us ( 2008 ) , but higher than the 280.0 per 100 thousand in the uk ( 2008 ) and 247.3 per 100 thousand in japan ( 2008 ) .
cancer patients ' 5-year survival rate between 2005 and 2009 was 62.0% , which showing how far the state of the art has advanced globally .
the five leading primary cancer sites in 2009 were stomach , colon , lung , liver , and prostate among males , whereas the most common cancer sites among females were thyroid , breast , colon , stomach , and lung . according to recent research findings , infection and smoking are the most important contributing factors in korea .
the smoking rate in korea is still high , 46.9% in men and 7.1% in women in 2009 .
the fractions of all cancers attributable to infection were 25.1% and 16.8% for cancer incidence in men and women , and 25.8% and 22.7% of cancer mortality in men and women , respectively .
over 97% of infection - related cancers , such as stomach cancer and liver cancer , were attributable to infection with h. pylori , hepatitis b virus ( hbv ) , hepatitis c virus and human papilloma virus .
occupation is also an important attributing factor at 7.8% [ 5 - 7 ] , compared with france , which reported 2.4% as the attributable fraction ( af ) of occupation to cancer .
drinking alcohol , reproductive factors , obesity , and physical inactivity are minor factors , as each is less than 2% .
afs of radiation and environmental pollution were not calculated because of insufficient data in korea .
but there are reliable data supporting the considerable environmental burden of diseases , including cancer .
the world health organization ( who ) reported the surprising news that korea ranked in 50th place in the world in the burden of disease for environmental risk in 2007 . by another method
, yoon   suggested that korea ranked in 25th place in the world in the burden of disease for environmental risk in 2007 .
the prevalence of people exposed to environmental tobacco smoke ( ets ) in korea is still high , at 44.9% in males and 34.2% in females in 2009 .
many people have been exposed to asbestos in the vicinity of asbestos textile industries and mines in korea , even though the korean government completely prohibited the use of asbestos in 2009 .
especially near highways and high traffic areas , people are exposed to traffic - related air pollutants , including diesel exhaust particles ( dep ) .
dep was classified as a definite human carcinogen ( group 1 ) by the international agency for research on cancer ( iarc ) last year based on sufficient epidemiological evidence [ 13 - 15 ] .
taking environmental carcinogens , such as ets , asbestos , and dep , into consideration , afs due to environmental exposure in korea may be higher than 0.2% , which was the estimated af% in france .
recently in korea , some issues related to carcinogen exposure have received much media attention , i.e. , the first compensation case of breast cancer in a laborer exposed to shift work , radiation and organic solvents , the announcement of iarc 's decision on the carcinogenicity of radiofrequency radiation exposure by mobile phone use   and dep , as well as the fukushima nuclear power plant accident in a neighboring country .
with its rapidly aging population , reducing the cancer burden at the national level has become one of the major public health issues in korea .
the government formulated its first 10-year plan for cancer control in 1996 . in 2000 , the national cancer center was established and the cancer control division was set up within the ministry of health and welfare .
korea 's major national cancer control programs included anti - smoking campaigns , hbv vaccination , cancer registration and networking , reinforcement of research and development activities for cancer control , education and training for cancer control and prevention , management of the national cancer information center , a mass screening program for five common cancers , caring for cancer patients at home , financial support for cancer patients and designation of regional cancer centers .
the second 10-year plan for cancer control was initiated in 2006 to make up for flaws in the first plan and establish an efficient 10-year national cancer plan for a cancer control management system .
the goals for the second plan are as follows : intensifying cancer prevention by stricter management of cancer risk factors , early screening of all people for cancer , extension of support for cancer patients , reinforcing security for cancer patients , strengthening support for rehabilitation and palliative medicine for cancer patients , establishment of infrastructure for active national cancer management , development of diagnostic and therapeutic technology , enforcement of education and public relations to make it touching to people , and a systemic cancer registry and management .
the second 10-year plan for cancer control provides a framework to prepare a great shift in cancer policy from primarily treatment oriented to precautionary health promotion . in spite of the national cancer control plans ,
the increasing number of cancer patients in korea poses devastating social and economic consequences for households , communities , and countries as well .
therefore at this point , we need to steer the main direction of cancer control policy toward carcinogen management and primary prevention of cancer .
it is urgently needed to define the carcinogenicity of suspect substances and monitor their exposures .
the korean toxic chemicals control act ( tcca ) was implemented in 1991 by the ministry of environment ( moe ) for the general management and control of industrial chemicals in korea .
the purpose of this act is to prevent any risk caused by chemicals to human health .
the national institute of environmental research is responsible for new chemical notifications under the act .
the korea chemicals management association of moe is responsible for accepting declarations on details of other chemicals and applications for confirmation certificates .
for example , radioactive substances prescribed by the atomic safety act ; medicines , non - pharmaceutical drugs , and cosmetics by the pharmaceutical affairs act ; technical ingredients and agrochemicals by the agrochemicals control act ; fertilizers by the fertilizer control act ; foods and food additives by the food sanitation act ; explosives by the control of firearms , swords , explosives , etc .
carcinogens are prescribed by many authorities , such as the ministry of health and welfare , moe , ministry of labor , ministry of science and technology and ministry of agriculture , according to their properties and legislation in korea ( table 1 ) .
the tcca covers new chemicals , toxic chemicals , observational chemicals and restricted or banned chemicals . but
internationally , the who resolution on cancer control ( wha58.22 )   provides a strong impetus for countries to develop programs aimed at reducing cancer incidence and mortality .
the iarc was established in may , 1965 through a resolution of the xviiith world health assembly as an extension of the who .
europe and the us have carried out the task of defining carcinogens and classifying them with criteria .
hazard information including usages and amount in circulations have been received from companies for all chemicals with more than 1 ton in circulation in the registration , evaluation , authorization and restriction of chemicals ( reach ) , eu . based on lists of dangerous substances ,
assessments of carcinogens and rankings are being done in the eu [ 24 - 26 ] . the us national toxicology program ( ntp )
determines carcinogens based on authoritative data from the iarc combined with its own animal experimentation data .
the ntp prepares the report on carcinogens ( rog ) on behalf of the secretary , health and human services .
the 12th roc , the latest edition , was published on june 10 , 2011 .
the roc is a congressionally mandated , science - based , public health report that identifies agents , substances , mixtures , or exposures ( collectively called " substances " ) in our environment that may potentially put people in the us at increased risk for cancer .
the ntp 's report is limited because it evaluates few agents and does not distinguish between probable and possible human carcinogens on its b - list [ 27 - 29 ] .
many countries are making international collaborative networks with the iarc and who to share their carcinogen lists ( table 2 ) [ 30 - 33 ] .
the korean government is also trying to classify carcinogens by introducing a globally harmonized system of classification and labeling of chemicals ( ghs ) .
the moe and labor has provided information about ghs material safety data sheets ( msds ) on 43,000 chemicals since 2009 .
the moe is trying to build a chemical registration and assessment system based on ghs and the iarc 's carcinogen list . however , there are no integrated regulatory laws and management systems guarding against carcinogen exposure in korea .
many separate laws have been put into effect to manage carcinogen exposure ( table 1 ) . yet
some carcinogens are still not regulated by the toxic chemicals control law in korea ( table 3 ) . in these circumstances
, it is inevitable there is a chance of exposure to some definite and probable human carcinogens in certain workers and citizens .
there remain several dead zones where carcinogen exposures can not be controlled properly in korea .
for example , crystalline silica , controlled by the industrial safety and health act , is a hazardous substance for which occupational exposure limits are established . yet even though crystalline silica is a definite human carcinogen , there is no regulation by the tcca .
besides crystalline silica , certain other definite human carcinogens , including 1,3-butadiene and beryllium , are not regulated by the tcca in korea ( table 3 ) .
korean governmental bodies need to establish a national action plan on management of carcinogenic risk in korea .
the importance of primary prevention has been recognized , but it has not been actively carried out because of limited budgets and difficulties in proving its effects in a short period of time .
current cancer control programs are focused on management of existing cancers . under this system ,
all natural cycles , including etiologies , exposures , diseases , and aftereffects were not taken into comprehensive consideration .
effective cancer prevention strategies were not established in the current system . a national carcinogen list in korea should be established soon and should be based on the ghs . to deal with some carcinogens in our environment that may potentially increase risk for cancer
, we can start our own ntp , an interagency program to evaluate agents of public health concern by developing and applying tools of modern toxicology and molecular biology .
this list may include three categories of substances and processes regarded as carcinogenic , primarily by iarc , and to a lesser extent , the government 's annual report on carcinogens from an ntp - like program .
if we can have national carcinogen lists , the korean government could reach the first milestone on the way toward its final goal of primary prevention of cancer .
 cancer has been the leading cause of death in korea for the last 30 years . 
 cancer patients ' 5-year survival rate between 2005 and 2009 was 62.0% , representing a highly advanced standard of care , as much as developed countries in the eu and the us . 
 the korean government formulated its first 10-year plan for cancer control in 1996 and has been carrying out a second 10-year plan for cancer control since 2006 . but despite the korean government 's efforts , the cancer burden in korea continues to increase . 
 many separate laws have gone into effect concerning the management of carcinogen exposure . however , there are no integrated regulatory laws or management systems against carcinogen exposure in korea . 
 dead zones remain where carcinogen exposure can not be controlled properly in korea . in this paper 
 , we suggest the need to establish a national carcinogen list based on international harmonization as a prerequisite for a paradigm shift in cancer control policy from treatment to primary prevention . 
Introduction
Cancer Management in Korea
Laws Related to Carcinogen Control in Korea
Conclusion