In premenopausal and postmenopausal women undergoing three consecutive biennial mammographic screenings, a consecutive increase in breast density augmented future breast cancer risk whereas a conti... Background Although Breast Imaging Reporting and Data System (BI-RADS) density classification has been used to assess future breast cancer risk, its reliability and validity are still debated in li...

Women with dense breasts and benign breast disease had an elevated risk of future breast cancer and could benefit from a tailored mammography screening strategy. Background Mammographic breast density and benign breast disease are strong risk factors for breast cancer. Accordingly, women with both risk factors may have a markedly high risk for developing br...

OBJECTIVES: This study examined how trends in the weekly frequencies of gastrointestinal infectious diseases changed before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and compared them with the trends in the United States.METHODS: We compared the weekly frequencies of gastrointestinal infectious diseases (16 bacterial and 6 viral diseases) in Korea during weeks 5-52 before and after COVID-19. In addition, the weekly frequencies of 5 gastrointestinal infectious diseases in the United States (data from the Centers for Disease Control and Prevention) that overlapped with those in Korea were compared.RESULTS: The mean weekly number of total cases of gastrointestinal infectious diseases in Korea showed a significant decrease (from 522 before COVID-19 to 245 after COVID-19, p<0.01). Only bacterial gastrointestinal infectious diseases caused by Campylobacter increased significantly; other bacterial gastrointestinal infectious diseases showed either a decrease or no change. The incidence of all other viral diseases decreased. In the United States, the weekly numbers of Salmonella, Campylobacter, typhoid, shigellosis, and hepatitis A virus cases sharply decreased after the COVID-19 outbreak. The weekly case numbers of all viral diseases markedly decreased in both countries; however, bacterial gastrointestinal infectious diseases showed a different pattern.CONCLUSIONS: The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak. In contrast, Campylobacter infections showed an increasing trend in Korea, but a decreasing trend in the United States. Further studies are needed to elucidate the different trends in bacterial and viral infectious diseases before and after non-pharmaceutical interventions and between different countries.

OBJECTIVES: This study investigated how changes in metabolic syndrome (MetS) are associated with the subsequent risk of breast and endometrial cancer according to menopausal status.METHODS: This cohort study, using data from the National Health Insurance Service database, included women aged ≥40 years who underwent 2 biennial cancer screenings (2009-2010 and 2011-2012) and were followed up until 2020. Participants were grouped into MetS-free, MetS-recovery, MetS-development, and MetS-persistent groups. Menopausal status (premenopausal, perimenopausal, and postmenopausal) was assessed at 2 screenings. Cox proportional hazard regression was used to assess the association between MetS changes and cancer risk.RESULTS: In 3,031,980 women, breast and endometrial cancers were detected in 39,184 and 4,298, respectively. Compared with the MetS-free group, those who recovered, developed, or had persistent MetS showed an increased risk of breast cancer, with adjusted hazard ratios (aHRs) of 1.05, 1.05, and 1.11, respectively (p<0.005). MetS persistence was associated with an increased risk of breast cancer in postmenopausal women (aHR, 1.12, 95% confidence interval [CI], 1.08 to 1.16) but not in premenopausal or perimenopausal women. MetS persistence was associated with an increased risk of endometrial cancer in premenopausal, perimenopausal, and postmenopausal women, with aHRs of 1.41 (95% CI, 1.17 to 1.70), 1.59 (95% CI, 1.19 to 2.12), and 1.47 (95% CI, 1.32 to 1.63), respectively.CONCLUSIONS: Increased breast cancer risk was associated with recovered, developed, and persistent MetS in postmenopausal women. Meanwhile, increased endometrial cancer risk was found in obese women who recovered from MetS or persistently had MetS, regardless of menopausal status, when compared to MetS-free women.

OBJECTIVES: This study investigated the risk of developing and dying from all types of cancer, as well as cancer-specific mortality, in women diagnosed with prediabetes and diabetes.METHODS: We included women aged ≥40 years who underwent cancer screening from 2009 to 2014 with follow-up until 2020. Diabetes status was determined based on fasting plasma glucose levels, self-reported history of diabetes, and the use of antidiabetic medication. We quantified the risk of cancer and mortality in the prediabetes and diabetes groups, relative to the normoglycemia group, by calculating adjusted hazard ratios (aHRs).RESULTS: The study included 8,309,393 participants with a mean age of 52.7±9.7 years. Among these participants, 522,894 cases of cancer and 193,283 deaths were detected. An increased risk of cancer was observed in both the prediabetes group (aHR, 1.03; 95% confidence interval [CI], 1.02 to 1.04) and the diabetes group (aHR, 1.13; 95% CI, 1.12 to 1.14). The highest risk was identified in those with diabetes who developed liver (aHR, 1.72; 95% CI, 1.66 to 1.79), pancreatic (aHR, 1.68; 95% CI, 1.60 to 1.76), and gallbladder cancer (aHR, 1.43; 95% CI, 1.36 to 1.51). Women with prediabetes and diabetes exhibited a 1.07-fold (95% CI, 1.05 to 1.08) and 1.38-fold (95% CI, 1.36 to 1.41) increased risk of death from cancer, respectively.CONCLUSIONS: Both prediabetes and diabetes were associated with an elevated risk of cancer, as well as an increased risk of death from cancer, in middle-aged Korean women. However, the degree of risk varied depending on the specific site of the cancer.

Background: Diarrhea, a common symptom of gastrointestinal infections, can lead to severe complications and is a major cause of emergency department (ED) visits. Objective: This study explored the temporal association between internet search queries for diarrhea and its synonyms and ED visits for diarrhea-related symptoms. Methods: We used data from the National Emergency Department Information System (NEDIS) and NAVER (Naver Corporation), South Korea’s leading search engine, from January 2017 to December 2021. After identifying diarrhea synonyms using ChatGPT, we compared weekly trends in relative search volumes (RSVs) for diarrhea, including its synonyms and weekly ED visits. Pearson correlation analysis and Granger causality tests were used to evaluate the relationship between RSVs and ED visits. We developed an Autoregressive Integrated Moving Average with Exogenous Variables (ARIMAX) model to further predict these associations. This study also examined the age-based distribution of search behaviors and ED visits. Results: A significant correlation was observed between the weekly RSV for diarrhea and its synonyms and weekly ED visits for diarrhea-related symptoms (ranging from 0.14 to 0.51, P<.05). Weekly RSVs for diarrhea synonyms, such as “upset stomach,” “watery diarrhea,” and “acute enteritis,” showed stronger correlations with weekly ED visits than weekly RSVs for the general term “diarrhea” (ranging from 0.20 to 0.41, P<.05). This may be because these synonyms better reflect layperson terminology. Notably, weekly RSV for “upset stomach” was significantly correlated with weekly ED visits for diarrhea and acute diarrhea at 1 and 2 weeks before the visit (P<.05). An ARIMAX model was developed to predict weekly ED visits based on weekly RSVs for diarrhea synonyms with lagged effects to capture their temporal influence. The age group of <50 years showed the highest activity in both web-based searches and ED visits for diarrhea-related symptoms. Conclusions: This study demonstrates that weekly RSVs for diarrhea synonyms are associated with weekly ED visits for diarrhea-related symptoms. By encompassing a nationwide scope, this study broadens the existing methodology for syndromic surveillance using ED data and provides valuable insights for clinicians.