Korea Health Promotion Institute

BackgroundProstate cancer incidence increases markedly after midlife, coinciding with age-related hormonal decline and alterations in antioxidant defense mechanisms. This study investigated age-specific associations between endogenous antioxidant markers (total bilirubin, albumin, and uric acid) and prostate cancer risk.MethodsData were derived from the Korean Cancer Prevention Study-II (KCPS-II), and a total of 83,371 men were included after excluding individuals with a history of cancer or missing key variables at baseline. Participants were categorized into four age groups: < 45, 45–55, > 55, and > 65 years. During a mean follow-up of 13.5 years, 705 incident cases of prostate cancer (ICD-10: C61) were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) for prostate cancer per 1-standard deviation (SD) increase in each antioxidant marker were estimated using Cox proportional hazards models. Quartile and trend analyses were also performed.ResultsTotal bilirubin showed a statistically significant negative association with prostate cancer risk in men aged 45–55 years (HR: 0.86, 95% CI: 0.75–0.98, p = 0.0208), while a significant positive association was observed in men over 65 years (HR: 1.21, 95% CI: 1.02–1.43, p = 0.0285). Albumin was not significantly associated with prostate cancer risk in most age groups, but a significant positive association was found in men under 45 years (HR: 1.41, 95% CI: 1.07–1.86, p = 0.0152). Uric acid showed a consistent positive association with prostate cancer risk in the overall population (HR: 1.13, 95% CI: 1.06–1.21, p = 0.0003), and in men aged < 45 years (HR: 1.15, 95% CI: 1.02–1.30, p = 0.0241), > 55 years (HR: 1.20, 95% CI: 1.08–1.32, p = 0.0005), and > 65 years (HR: 1.20, 95% CI: 1.04–1.38, p = 0.0121).ConclusionsTotal bilirubin was negatively associated with prostate cancer risk during the andropause period (ages 45–55), but this association reversed with increasing age. Uric acid consistently showed a positive association with prostate cancer risk across all age groups.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12894-025-02029-6.

Tobacco use is a leading cause of preventable death, disease, and disability worldwide. Thus, smoking cessation is a critical public health intervention globally. This clinical practice guideline was developed to provide recommendations on pharmacological and non-pharmacological treatments for smoking cessation, tailored strategies for smoking cessation in special populations, and interventions for users of electronic cigarettes and multiple tobacco products. Thirty key questions and corresponding evidence-based recommendations were derived from systematic reviews, meta-analyses, and de novo development. A multidisciplinary panel of experts participated in the development of this guideline, incorporating evaluation of evidence quality, benefit–risk balance, patient values and preferences, resource use, and feasibility in the development process. This guideline reflects the latest research on smoking cessation treatments and provides practical and adaptable strategies for clinical and policy implementation. In addition, this guideline is expected to support healthcare providers in improving cessation success rates and contribute to the reduction of smoking-related morbidity and mortality rates in Korea. This guideline will be updated periodically in response to emerging evidence and clinical needs.

Background: Bilirubin is a potent endogenous antioxidant that plays a key role in regulating oxidative stress and inflammation, both closely linked to lung carcinogenesis. This study reinterprets the ALBI (Albumin-Bilirubin) and PALBI (Platelet-Albumin-Bilirubin) indices as composite markers of antioxidant and inflammatory status and evaluates their associations with lung cancer risk by sex, including stratified analyses by major lifestyle factors such as smoking and alcohol use. Methods: This study utilized data from the Korean Cancer Prevention Study-II (KCPS-II) cohort, which included 133,630 participants. During a mean follow-up of 13.5 years, 721 incident lung cancer cases were identified. Serum bilirubin and the ALBI and PALBI indices were analyzed by sex, and quartile-based and trend analyses were conducted. Stratified analyses by smoking and alcohol status (never, former, current, ever) and intensity were performed to assess potential effect modification. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. Results: A 1SD increase in total bilirubin and ALBI was inversely associated with lung cancer risk in men (HR: 0.83, 95% CI: 0.75-0.91; HR: 0.86, 95% CI: 0.79-0.94, respectively), whereas PALBI showed a positive association (HR: 1.17, 95% CI: 1.07-1.28). In contrast, in women, total bilirubin and ALBI showed positive associations (HR: 1.19, 95% CI: 1.00-1.40; HR: 1.19, 95% CI: 1.02-1.40, respectively), while PALBI was inversely associated (HR: 0.82, 95% CI: 0.69-0.97). These associations were significant among men who were smokers (former, current, ever) and men who drank alcohol (current, ever), whereas in women, significance was observed only among never drinkers. Stronger interactions were observed in men who were heavy smokers and low-to-moderate drinkers. Conclusions: Bilirubin and the ALBI and PALBI indices exhibit sex-specific and contrasting associations with lung cancer risk, highlighting the need to consider sex-based physiological differences in cancer risk assessment.

Genome-wide association studies (GWAS) have predominantly focused on European ancestry populations, limiting biological discoveries across diverse populations. Here we report GWAS findings from 153,950 individuals across 36 quantitative traits in the Korean Cancer Prevention Study-II (KCPS2) Biobank. We discovered 301 previously unreported genetic loci in KCPS2, including an association between thyroid-stimulating hormone and CD36. Meta-analysis with the Korean Genome and Epidemiology Study, Biobank Japan, Taiwan Biobank, and UK Biobank identified 4588 loci that were not significant in any contributing GWAS. We describe differences in genetic architectures across these East Asian and European samples. We also highlight East Asian specific associations, including a known pleiotropic missense variant in ALDH2, which fine-mapping identified as a likely causal variant for multiple traits. Our findings provide insights into the genetic architecture of complex traits in East Asian populations and highlight how broadening the population diversity of GWAS samples can aid discovery.

PurposePopulation attributable fractions (PAFs) for hormone and reproductive factors have been estimated in several countries. International Agency for Research on Cancer (IARC) designated as group 1 and group 2A carcinogen for hormone factors in breast, ovarian, endometrial and uterine cervix cancer. This study aimed to estimate the PAFs of hormone/reproductive factor attributed to cancer incidence and deaths in Korean women and projected trends from 2015 to 2030.Materials and MethodsThe PAF was estimated with using the 2005 standardized prevalence rates and 2020 incidence and deaths with a 15-year latency. Based on the Levin’s formula, prevalence rates were calculated using the Korea National Health and Nutrition Examination Survey (KNHANES) and the relative risks, which were the risk of selected female cancer associated with oral contraceptive, hormone replacement therapy and duration of breastfeeding, were estimated from the meta-analysis of studies performed in Korean women population. Studies based on the Asian and Global populations were calculated as a sensitivity analysis.ResultsThe estimation PAFs for hormone was 1.02% with 1,192 cases and reproductive was 2.67% with 3,112 cases. Moreover, 0.40% (125 deaths) and 1.09% (342 deaths) in female-related cancer deaths in order. Estrogen-progesterone combined hormone replacement therapy (HRT) accounted the most proportion in hormone factors and breastfeeding in reproductive factors. Also, the breast cancer had the highest percent in both hormone and reproductive factors.ConclusionThrough this study, 1.02% and 2.67% of female-related cancer incidence will be reduced by encouraging avoiding the use of oral contraceptives and HRT and breastfeeding for more than 6 months in reproductive factors. Additionally, among four selected female cancers in this study, breast cancer was observed to be a significant level of prevention.

There have been inconsistencies in the evidence for a role of dietary patterns in the development of breast cancer. In this study, we used a large-scale cohort [Korean Cancer Prevention Study-II (KCPS-II)] to examine the association between dietary patterns and breast cancer risk in Korean women. The dietary patterns of 14,807 women from the KCPS-II were derived by factor analysis and 135 cases of breast cancer were diagnosed during the follow-up period. Cox proportional models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of breast cancer. The following three major dietary patterns were identified: "Korean dietary pattern" (high intake of Kimchi, vegetables, and rice); "sweet dietary pattern" (high intake of soda and sugar); and "new (Western-like) dietary pattern" (high intake of dairy products, eggs, oil, fruits, and bread). After adjusting for potential confounders, neither the Korean (HR for the highest compared with the lowest tertile, 1.04; 95% CI 0.53-2.06) nor the sweet dietary patterns were associated with the risk of breast cancer. In contrast, the new (Western-like) dietary pattern was found to be significantly associated with an increased risk of breast cancer with an HR (95% CI) of 1.01 (0.65-1.60) for the second tertile and 1.61 (1.04-2.50) for the third tertile as compared with the lowest tertile. After stratifying by menopausal status, these effects were only statistically significant among premenopausal women for the third tertile, compared with those in the bottom tertile (HR 1.69; 95% CI 1.06-2.68; p = 0.028). No significant association was observed between the Korean or sweet dietary pattern and breast cancer among either pre- or postmenopausal women. Our findings revealed that a greater consumption of a new (Western-like) diet was associated with an increased breast cancer risk and consequently offer a potential prevention strategy for Korean women.

The purpose of this study was to explore research trends in sleep from infancy through to adolescence. To achieve this, an examination was conducted of sleep research published in Korea based on the publication year, developmental stages of the study participants, research designs, measurement tools, and research topics. A total of 362 academic journal articles and theses/dissertations published in Korea up until 2023 were selected. In terms of publication year, the first study was conducted in 1967 and the field became more active from 2010 onwards. The age group studied the most was adolescents, with cross-sectional research being the most common study design. Regarding sleep measurement tools, most scales measuring sleep in infants, preschoolers, children, and adolescents were developed abroad, then adapted or validated in Korea, or were modifications of adult scales tailored for specific studies. Lastly, in terms of research topics, the most common focus was the relationship between sleep and developmental characteristics, particularly its effects on emotional development. Based on these results, future research could focus on developing sleep-related intervention programs and measurement tools.