Lim Woojin, Sung Soseul, Hong Youjin, Moon Sungji, Lee Sangjun, Kim Kyungsik, Lee Jung Eun, Kim Inah, Ko Kwang-Pil, Park Sue K
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer Research Institute, Seoul National University, Seoul, Korea.
Cancer Res Treat. 2025 Jul;57(3):635-648. doi: 10.4143/crt.2024.644. Epub 2024 Nov 6.
This study aims to estimate and project the population attributable fraction (PAF) of cancer incidence and death due to carcinogenic drug use in Korea from 2015 to 2030, to estimate the degree of cancer prevention from exposure to carcinogenic drugs in Korea. Selected carcinogenic drugs were immunosuppressive and antineoplastic drugs classified as group I by the International Agency for Research on Cancer.
Systematic review and meta-analyses were conducted to estimate the relative risk of cancer associated with carcinogenic drug use. Age was standardized using the annual prevalence rate of the National Health Insurance Service sample cohort (NHIS-NSC) from 2002 to 2013 to calculate the standardized prevalence rate of carcinogenic drug use each year. The PAF of specific cancer incidence and death were calculated using Levin's formula and Monte Carlo methods. The prevalence rates were extrapolated to estimate the trend of PAF from 2015 to 2030.
In 2015, carcinogenic drugs attributed to 0.003% and 0.002% among the causes of cancer incidence and death in Korea. However, carcinogenic drugs attributed to 1.1% among the causes of both cancer incidence and death in patients with clinical indications of carcinogenic drugs.
The PAF in patients with clinical indications of carcinogenic drugs were significantly high and expected to increase rapidly over time. Since these drugs are listed as essential by the World Health Organization, and may be difficult to replace, a surveillance system on susceptible populations using group I carcinogenic drugs must be discussed and implemented.
本研究旨在估计并预测2015年至2030年韩国因使用致癌药物导致的癌症发病率和死亡率的人群归因分数（PAF），以评估韩国因接触致癌药物而预防癌症的程度。所选致癌药物为国际癌症研究机构列为第1组的免疫抑制药物和抗肿瘤药物。
进行系统评价和荟萃分析以估计与使用致癌药物相关的癌症相对风险。使用2002年至2013年国民健康保险服务样本队列（NHIS-NSC）的年患病率对年龄进行标准化，以计算每年致癌药物使用的标准化患病率。使用莱文公式和蒙特卡罗方法计算特定癌症发病率和死亡率的PAF。外推患病率以估计2015年至2030年PAF的趋势。
2015年，在韩国癌症发病率和死亡率的原因中，致癌药物分别占0.003%和0.002%。然而，在有致癌药物临床指征的患者中，致癌药物在癌症发病率和死亡率的原因中占1.1%。
有致癌药物临床指征的患者的PAF显著较高，且预计随时间迅速增加。由于这些药物被世界卫生组织列为基本药物，且可能难以替代，必须讨论并实施针对使用第1组致癌药物的易感人群的监测系统。
