A Cohort Study of Active and Passive Smoking in Korea

韩国主动吸烟和被动吸烟的队列研究

• 批准号: 6622514
• 负责人: JONATHAN M SAMET
• 金额: $ 5.86万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-19 至 2005-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6622514
• 关键词: Asia; adolescence (12-20); adult human (21+); cancer risk; data collection; disease /disorder proneness /risk; epidemiology; health insurance; hospital utilization; human data; human mortality; information systems; passive smoking; questionnaires; smoking

Although 50 years of research findings have causally linked active and passive smoking to cancer and other diseases, further epidemiologic research on the risks of tobacco smoking is still needed. One specific need is for studies in countries other than the developed, western countries where the majority studies have been conducted to date. Most of the world's smokers live outside of the western countries, primarily in Asia where a majority of males are smokers in many countries. Background disease rats and distributions of lifestyle risk factors are notably distinct in these populations, particularly in comparison with populations of previously studied western males. The majority of women, largely non-smokers, and children in Asian countries are exposed to environmental tobacco smoke (ETS). This small grant application requests support to establish a cohort study of active and passive smoking and risk for cancer and other diseases among persons receiving health insurance coverage through the Korean Medical Insurance Corporation (KMIC). The KMIC provides coverage to civil service workers, teachers, and their dependents in the Republic of Korea (South Korea). The total population insured by the KMIC is substantial, accounting for 11% of the country's 43 million residents in 1990. The insured then included approximately 1.2 million workers and an additional 3.4 dependents. A cohort study will be developed using the database of the KMIC. Risk factor information is collected in biennial medical examinations, which are required for the insured workers and are voluntarily completed by dependents. The data collected in the biennial examinations covering smoking and other lifestyle risk for disease and findings from routine laboratory work are also available. Outcomes are tracked through the hospital record system and also by mortality matches. Family members of the insured can be identified through record linkage using the unique identification number of the insured. In an effort to advance understanding of smoking and cancer and other diseases in Asian countries, as well as among Asian Americans, investigators at the Yonsei University and the Johns Hopkins University School of Hygiene and Public Health plan to collaborate in developing and then using this epidemiologic resource to carry out a major program of research on the risks of active and passive smoking in Korea. The Yonsei University has access to the KMIC cohort and already has shown its potential in several reports on cancer and cardiovascular disease. The Johns Hopkins group adds expertise in cohort studies and smoking. This application requests support to establish a comprehensive database in support of the cohort study and to carry out analyses on active and passive smoker and cancer. During the two years of support requested in this small grant application, data will be abstracted from medical records on key exposure variables from exams carried out in 1992 and 1993, providing lifestyle and laboratory data for cohort expected to number approximately 1.6 million adults. Mortality will be tracked from 1992-2003 and inpatient encounters, coded by diagnosis, will be identified for 1998-2003. To demonstrate the potential of the study, an investigation will be carried out on active and passive smoking and lung cancer risk. We intend to set data collection in place to maintain and extend this cohort. The large size of this cohort and the unusually strong possibility for data linkage makes the KMIC population a unique and cost effective study opportunity. This cohort study would have the potential to generate powerful evidence to describe the risk of smoking in a population with distinct background disease rates and distribution of lifestyle risk factors relative to western populations previously studied.

尽管 50 年来的研究结果表明主动和被动吸烟与癌症和其他疾病之间存在因果关系，但仍需要对吸烟风险进行进一步的流行病学研究。一项具体需求是在发达国家、西方国家以外的国家进行研究，迄今为止，大多数研究都是在西方发达国家进行的。世界上大多数吸烟者生活在西方国家之外，主要是在亚洲，许多国家的大多数男性都是吸烟者。这些人群中的背景疾病大鼠和生活方式危险因素的分布明显不同，特别是与之前研究的西方男性人群相比。亚洲国家的大多数妇女（主要是非吸烟者）和儿童都暴露于环境烟草烟雾 (ETS) 中。这项小额赠款申请请求支持在通过韩国医疗保险公司 (KMIC) 接受健康保险的人群中开展一项主动和被动吸烟与癌症和其他疾病风险的队列研究。 KMIC 为大韩民国（韩国）的公务员、教师及其家属提供保险。 KMIC 投保的总人口数量庞大，占 1990 年该国 4,300 万居民的 11%。当时的投保人包括大约 120 万工人和另外 3.4 名家属。将使用 KMIC 数据库开展队列研究。风险因素信息是在两年一次的体检中收集的，这些体检是参保工人所必需的，并由家属自愿完成。两年一次的检查中收集的数据涵盖了吸烟和其他生活方式疾病风险以及常规实验室工作的结果。通过医院记录系统和死亡率匹配来跟踪结果。使用被保险人唯一的识别号码，可以通过记录联动识别被保险人的家庭成员。为了促进亚洲国家以及亚裔美国人对吸烟、癌症和其他疾病的了解，延世大学和约翰·霍普金斯大学卫生与公共卫生学院的研究人员计划合作开发并使用这一流行病学方法资源，以开展一项有关韩国主动和被动吸烟风险的重大研究计划。延世大学可以访问 KMIC 队列，并已在几份有关癌症和心血管疾病的报告中展示了其潜力。约翰·霍普金斯大学小组增加了队列研究和吸烟方面的专业知识。该申请请求支持建立一个综合数据库以支持队列研究并对主动和被动吸烟者与癌症进行分析。在这项小额赠款申请所要求的两年支持期间，将从 1992 年和 1993 年进行的检查中关键暴露变量的医疗记录中提取数据，为预计约 160 万成年人提供生活方式和实验室数据。将从 1992 年至 2003 年跟踪死亡率，并确定 1998 年至 2003 年按诊断编码的住院病例。为了证明这项研究的潜力，将对主动和被动吸烟与肺癌风险进行调查。我们打算设置数据收集来维持和扩展这个队列。该队列的庞大规模和异常强大的数据关联可能性使 KMIC 人群成为一个独特且具有成本效益的研究机会。这项队列研究将有可能产生强有力的证据来描述与先前研究的西方人群相比具有不同背景疾病发生率和生活方式风险因素分布的人群的吸烟风险。

项目成果

Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases.

• DOI: 10.2337/dc12-1577
• 发表时间: 2013-07
• 期刊: Diabetes care
• 影响因子: 16.2
• 作者: Park C;Guallar E;Linton JA;Lee DC;Jang Y;Son DK;Han EJ;Baek SJ;Yun YD;Jee SH;Samet JM
• 通讯作者: Samet JM