프레일티 모형을 이용한 주요 암 종별 부산시 소지역별 생존율 비교 연구

Abstract

Cancers, also called malignant neoplasm, correspond to International Classification of Diseases (ICD-10) C00-C97. They are still one of the major causes of death in Korea and mortality rates have been increasing until recently. In particular, the cancer mortality rates of Busan have been higher than those of the whole country or Seoul since 2001, and the gap became more and more widening. Using ​​cancer registry data of Busan, in this paper, we conducted the survival analysis for the survival time which is defined as time from initial diagnosis to death of cancer. For this purpose, we compared the survival rates estimated by gender, age groups, and summary stages of stomach cancer, colorectum cancer, lung cancer and liver cancer classified as major cancer types in Korea. As the survival rates of cancers may be different according to small area, the analysis was performed using the frailty survival models considering the unit of Eup-Myeon-Dong as random effects. Also, various and effective visualizations for the fitting results was presented including the disease mapping of Busan. In addition, the inference results were compared according to whether or not the deprivation index variable indicating the socioeconomic index by small area was included. As a result, the deprivation index reduced the significance of risk for cancer death among dongs.