Relationship between Cancer Incidence and Health Behaviors from Ecological Study in Korea

The aim of this ecological study was to examine the correlation between cancer incidence and health behaviors such as smoking, alcohol consumption, and obesity, and investigated whether there were differences in this correlation between metropolitan areas and other regions. Data on health behaviors exposure/prevalence and cancer incidence rates for 227 administrative districts (cities and counties) were obtained. The average exposure proportion measured annually from 2008 to 2011 in the Korea Community Health Survey data and the age-standardized cancer incidence data from 2014 to 2018, obtained through the cancer registry data, were downloaded from the Statistics Korea website. To examine the relationship between smoking, alcohol consumption, obesity exposure rate (prevalence), and cancer incidence, a correlation analysis was conducted, and Pearson's correlation coefficient was calculated. The correlation coefficient between male smoking and male cancer incidence rate across 227 districts was 0.259. This significance was more pronounced in large metropolitan areas, where the correlation coefficient was 0.631 in the 73 districts belonging to these areas. In large metropolitan areas, the correlation coefficient between alcohol consumption rate and cancer incidence rate was 0.390. In the correlation analysis between obesity prevalence and cancer incidence rate, no correlation was found in large metropolitan areas, while in areas outside of large cities, the correlation coefficient was -0.295, indicating a significant negative correlation. This ecological study demonstrated that the relationship between cancer incidence and health behaviors differed between large metropolitan areas and areas outside of large cities.