as the leading cause of death in korea , cancer has been the country s major public health concern since 1983 .
over 210,000 patients were newly diagnosed with cancer in korea , and one in four deaths is due to cancer . although the cancer registration system in korea is highly efficient and can provide nationwide cancer statistics within a relatively brief period , a lag time of at least 2 years is required for collection , compilation , and analysis of the data on a specific year . for planning and implementation of 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 2015 based on data from the 1990s through 2013 .
the korean ministry of health and welfare initiated a nationwide , hospital - based cancer registry , the korea central cancer registry ( kccr ) , in 1980 .
the history , objectives , and activities of the kccr have been documented in detail elsewhere .
incidence data from 1999 to 2012 were obtained from the korea national cancer incidence database ( knci db ) .
cancer cases were classified according to the international classification of diseases for oncology , third edition , and converted according to the international classification of diseases , 10th edition ( icd-10 ) .
the cancer sites included in this study were ( 1 ) all cancers combined and ( 2 ) the 24 common cancers as follows : lip , oral cavity , and pharynx ( c00-c14 ) , esophagus ( c15 ) , stomach ( c16 ) , colon and rectum ( c18-c20 ) , liver and intrahepatic bile ducts ( liver ) ( c22 ) , gallbladder and other parts of the biliary tract ( gallbladder ) ( c23-c24 ) , pancreas ( c25 ) , larynx ( c32 ) , lung and bronchus ( 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-c85 , c96 ) , multiple myeloma ( c90 ) , leukemia ( c91-c95 ) , and others . population data from 1993 to 2014 were obtained from the resident registration population , as reported by statistics korea .
data on the mid - year population , as of july 1 of the respective years , were analyzed .
however , for the year 2015 , we used population data as of december 31 , 2014 because the mid-2015 resident registration population was not yet available at the time of analysis . due to
the time required for data collection , compilation , quality control , and analysis , the incidence and mortality data for a specific year are usually available 2 - 3 years later .
therefore , to provide an estimate of the nation s current cancer burden , we attempted to project , ahead of 2015 , the expected number of new cancer cases and deaths in korea for the year .
linear regression models   were used to assess time trends and projections . based on the observed cancer incidence data from 1999 to 2012 , a linear regression model was fitted to age - specific rates by 5-year age groups against the observed years .
the estimated number of new cancer cases was calculated from the projected age - specific rates for 2015 by multiplying the rates by the projected 2015 agespecific population size . for thyroid and prostate cancer , which showed significant curvilinear trends ,
we used a square - root transformation when fitting a linear regression model and converted the predicted values back to the original scale . to predict the cancer mortality rate in 2015
, we first performed a joinpoint regression analysis on the data available for 1993 - 2013 to determine the year when significant changes occurred in cancer mortality 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 .
4.0.1 , http://surveillance.cancer.gov/joinpoint ) from the surveillance research program of the us national cancer institute . after identifying the year during which significant trend changes occurred through joinpoint regression analysis , a simple linear regression model was fitted to the last line segment for estimation of age - specific cancer mortality rates in 2015 .
similar to the method used for the projection of cancer incidence , the number of new deaths in 2015 was then predicted by multiplying age - specific cancer mortality rates by the year s age - specific population .
we summarized the results using crude rates ( crs ) and age - standardized rates ( asrs ) of cancer incidence and mortality .
a total of 280,556 new cancer cases are anticipated in 2015 ( table 1 , fig .
1 ) with more female ( n=142,809 ) than male ( n=137,747 ) cancer patients expected in the coming year .
the projected crs per 100,000 of all sites combined in 2015 are 541.9 and 561.3 in men and women , respectively .
moreover , the projected asrs per 100,000 of all sites combined are 361.1 and 353.1 , respectively ( table 2 ) . in men ,
the five leading primary sites of cancer are expected to be the stomach ( cr , 94.1 ; asr , 61.3 ) , colon and rectum ( cr , 92.4 ; asr , 60.7 ) , lung ( cr , 69.5 ; asr , 44.7 ) , prostate ( cr , 58.3 ; asr , 38.1 ) , and liver ( cr , 50.1 ; asr , 32.6 ) , accounting for 67.3% of all newly diagnosed cancers in 2015 . in women ,
the five leading primary sites are expected to be the thyroid ( cr , 214.2 ; asr , 150.4 ) , breast ( cr , 76.5 ; asr , 50.5 ) , colon and rectum ( cr , 57.2 ; asr , 31.0 ) , stomach ( cr , 43.8 ; asr , 24.3 ) , and lung ( cr , 31.3 ; asr , 15.8 ) , accounting for 75.3% of all newly diagnosed cancers ( fig .
thyroid cancer alone is projected to account for approximately 38.2% ( 54,491 cases ) of incident cases in women in 2015 .
the five most common cancer sites expected in 2015 by 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 the 0 - 14 and 15 - 34 age groups .
stomach cancer is predicted to be the most prevalent in men aged 35 - 64 years , whereas lung cancer is expected to be more frequent in men aged 65 and over .
thyroid cancer is predicted to be the most common cancer in women 35 - 64 years of age , whereas colorectal cancer is expected to be the most prevalent in women aged 65 and over .
these projections indicate that the incidences of stomach , lung , liver , colorectal , and prostate cancers will increase gradually with age for men . in women ,
the age - specific incidence rates of stomach , colorectal , liver , lung , and cervical cancers denote a rising trend in these cancers with age ; however , the incidence of breast and thyroid cancer in women is expected to level off after the late 40s and early 50s , respectively ( fig .
it is estimated that 76,698 cancer deaths will occur in korea during 2015 ( table 1 , fig .
the projected crs per 100,000 of all sites combined in 2015 for men and women are 187.0 and 114.6 , respectively , whereas the projected asrs per 100,000 of all sites combined are 121.7 and 54.5 , respectively ( table 4 ) .
the predicted five leading cancer sites causing mortality in men are lung ( cr , 50.1 ; asr , 31.9 ) , liver ( cr , 31.5 ; asr , 20.4 ) , colon and rectum ( cr , 20.5 ; asr , 13.4 ) , stomach ( cr , 18.9 ; asr , 12.2 ) , and pancreas ( cr , 11.1 ; asr , 7.2 ) . during the same time period , lung cancer ( cr , 19.0
; asr , 8.5 ) is projected to be the leading cancer site in women , causing mortality , followed by the colon and rectum ( cr , 15.0 ; asr , 6.6 ) , liver ( cr , 11.1 ; asr , 5.2 ) , stomach ( cr , 10.7 ; asr , 4.7 ) , and pancreas ( cr , 10.1 ; asr , 4.5 ) . as a result of a continuous decrease in stomach cancer deaths ,
stomach was first predicted to be the fourth - common cancer death site in women .
the predicted age - specific mortality rates of the selected cancers for males and females in 2015 are shown in further detail in fig .
3 . when examined by age , korean men and women aged 60 and over are expected to have the highest mortality rates from lung cancer .
a total of 280,556 new cancer cases are anticipated in 2015 ( table 1 , fig .
1 ) with more female ( n=142,809 ) than male ( n=137,747 ) cancer patients expected in the coming year .
the projected crs per 100,000 of all sites combined in 2015 are 541.9 and 561.3 in men and women , respectively .
moreover , the projected asrs per 100,000 of all sites combined are 361.1 and 353.1 , respectively ( table 2 ) . in men ,
the five leading primary sites of cancer are expected to be the stomach ( cr , 94.1 ; asr , 61.3 ) , colon and rectum ( cr , 92.4 ; asr , 60.7 ) , lung ( cr , 69.5 ; asr , 44.7 ) , prostate ( cr , 58.3 ; asr , 38.1 ) , and liver ( cr , 50.1 ; asr , 32.6 ) , accounting for 67.3% of all newly diagnosed cancers in 2015 . in women ,
the five leading primary sites are expected to be the thyroid ( cr , 214.2 ; asr , 150.4 ) , breast ( cr , 76.5 ; asr , 50.5 ) , colon and rectum ( cr , 57.2 ; asr , 31.0 ) , stomach ( cr , 43.8 ; asr , 24.3 ) , and lung ( cr , 31.3 ; asr , 15.8 ) , accounting for 75.3% of all newly diagnosed cancers ( fig .
thyroid cancer alone is projected to account for approximately 38.2% ( 54,491 cases ) of incident cases in women in 2015 .
the five most common cancer sites expected in 2015 by 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 the 0 - 14 and 15 - 34 age groups .
stomach cancer is predicted to be the most prevalent in men aged 35 - 64 years , whereas lung cancer is expected to be more frequent in men aged 65 and over .
thyroid cancer is predicted to be the most common cancer in women 35 - 64 years of age , whereas colorectal cancer is expected to be the most prevalent in women aged 65 and over .
these projections indicate that the incidences of stomach , lung , liver , colorectal , and prostate cancers will increase gradually with age for men . in women ,
the age - specific incidence rates of stomach , colorectal , liver , lung , and cervical cancers denote a rising trend in these cancers with age ; however , the incidence of breast and thyroid cancer in women is expected to level off after the late 40s and early 50s , respectively ( fig .
it is estimated that 76,698 cancer deaths will occur in korea during 2015 ( table 1 , fig .
1 ) . the projected crs per 100,000 of all sites combined in 2015 for men and women are 187.0 and 114.6 , respectively , whereas the projected asrs per 100,000 of all sites combined are 121.7 and 54.5 , respectively ( table 4 ) .
the predicted five leading cancer sites causing mortality in men are lung ( cr , 50.1 ; asr , 31.9 ) , liver ( cr , 31.5 ; asr , 20.4 ) , colon and rectum ( cr , 20.5 ; asr , 13.4 ) , stomach ( cr , 18.9 ; asr , 12.2 ) , and pancreas ( cr , 11.1 ; asr , 7.2 ) . during the same time period ,
lung cancer ( cr , 19.0 ; asr , 8.5 ) is projected to be the leading cancer site in women , causing mortality , followed by the colon and rectum ( cr , 15.0 ; asr , 6.6 ) , liver ( cr , 11.1 ; asr , 5.2 ) , stomach ( cr , 10.7 ; asr , 4.7 ) , and pancreas ( cr , 10.1 ; asr , 4.5 ) . as a result of a continuous decrease in stomach cancer deaths ,
stomach was first predicted to be the fourth - common cancer death site in women .
the predicted age - specific mortality rates of the selected cancers for males and females in 2015 are shown in further detail in fig .
3 . when examined by age , korean men and women aged 60 and over are expected to have the highest mortality rates from lung cancer .
a total of 280,556 new cancer cases and 76,698 cancer deaths are expected to occur in korea during 2015 . in korean males , it is anticipated that stomach , colorectal , lung , prostate , and liver cancers will be the most commonly occurring , whereas it is expected that lung , liver , colorectal , stomach , and pancreatic cancers will be the most common causes of cancer - related deaths . in korean women
, it is anticipated that thyroid , breast , colorectal , stomach , and lung cancers will be the most prevalent , whereas it is projected that lung , colorectal , liver , stomach , and pancreatic cancers will be the most common causes of cancer - related deaths .
the country will likely see its cancer burden continue to grow with the aging of its population .
the current projections of cancer incidence and mortality for 2015 represent an important resource for planning and evaluation of cancer - control programs .
as the estimates in this study are model - based , these results should be interpreted with caution .
 purposefor estimation of korea s current cancer burden , this study aimed to report on the projected cancer incidence and mortality rates for the year 2015 . materials and methodscancer 
 incidence data from 1999 to 2012 were obtained from the korea national cancer incidence database , and cancer mortality data from 1993 to 2013 were acquired from statistics korea . the cancer incidence in 2015 was projected by fitting a linear regression model to the observed age - specific cancer incidence rates against the observed years and then multiplying the projected age - specific rates by the age - specific population . 
 a similar procedure was used for cancer mortality , except a joinpoint regression model was used to determine at which year the linear trend changed significantly . 
 resultsa total of 280,556 new cancer cases and 76,698 cancer deaths are expected to occur in korea in 2015 . 
 the crude incidence rate per 100,000 of all sites combined will likely reach 551.6 and the age - standardized incidence rate , 347.6 . 
 the estimated five leading primary cancer incidence sites are the stomach , colorectum , lung , prostate , and liver in men ; and thyroid , breast , colorectum , stomach , and lung in women . 
 the projected crude mortality rate of all sites combined and age - standardized rate is 150.8 and 82.4 , respectively . 
 conclusioncancer is currently one of the foremost public health concerns in korea , and as the population ages , the nation s cancer burden will continue to increase . 
Introduction
Materials and Methods
Results
1. Incidence
2. Mortality
Conclusion