BackgroundChanges in the local population are intricately linked to healthcare infrastructure, which subsequently impacts the healthcare sector. A decreasing local population can result in lagging health infrastructure, potentially leading to adverse health outcomes as patients may be at risk of not receiving optimal care and treatment. While some studies have explored the relationship between chronic diseases and local population decline, evidence regarding cancer is insufficient. In this study, we focused on how deteriorating management of chronic diseases such as dyslipidemia could influence the risk of cancer. We investigated the relationship between changes in the local population and cancer incidence among patients with dyslipidemia.MethodsThis cohort study was conducted using claims data. Data from adult patients with dyslipidemia from the National Health Insurance Service–National Sample Cohort conducted between 2002 and 2015 were included. Population changes in each region were obtained from the Korean Statistical Information Service and were used to link each individual's regional code. Cancer risk was the dependent variable, and Cox proportional hazards regression was used to estimate the target associations.ResultsData from 336,883 patients with dyslipidemia were analyzed. Individuals who resided in areas with a decreasing population had a higher risk of cancer than those living in areas with an increasing population (decrease: hazard ratio (HR) = 1.06, 95% CI = 1.03–1.10; normal: HR = 1.05, 95% CI = 1.02–1.09). Participants living in regions with a low number of hospitals had a higher risk of cancer than those in regions with a higher number of hospitals (HR = 1.20, 95% CI = 1.12–1.29).ConclusionPatients in regions where the population has declined are at a higher risk of cancer, highlighting the importance of managing medical problems caused by regional extinction. This could provide evidence for and useful insights into official policies on population decline and cancer risk.

中文翻译：

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当地人口变化与血脂异常患者癌症发病率有何关系：韩国当地灭绝影响的证据

背景当地人口的变化与医疗保健基础设施密切相关，进而影响医疗保健行业。当地人口减少可能会导致卫生基础设施滞后，从而可能导致不良的健康结果，因为患者可能面临得不到最佳护理和治疗的风险。虽然一些研究探讨了慢性病与当地人口下降之间的关系，但有关癌症的证据还不够。在这项研究中，我们重点关注血脂异常等慢性疾病的管理恶化如何影响癌症风险。我们调查了当地人口变化与血脂异常患者癌症发病率之间的关系。方法本队列研究是利用索赔数据进行的。纳入了 2002 年至 2015 年间进行的国家健康保险服务全国样本队列中血脂异常成年患者的数据。每个地区的人口变化是从韩国统计信息服务处获得的，并用于链接每个人的地区代码。癌症风险是因变量，Cox比例风险回归用于估计目标关联。结果分析了336,883名血脂异常患者的数据。居住在人口减少地区的个体比居住在人口增加地区的个体患癌症的风险更高（减少：风险比（HR）= 1.06，95% CI = 1.03-1.10；正常：HR = 1.05，95） % CI = 1.02–1.09）。居住在医院数量较少地区的参与者比居住在医院数量较多地区的参与者患癌症的风险更高（HR = 1.20，95% CI = 1.12–1.29）。患癌症的风险更高，凸显了管理区域灭绝造成的医疗问题的重要性。这可以为关于人口下降和癌症风险的官方政策提供证据和有用的见解。