🇰🇷 Cancer in South Korea

The Korea Central Cancer Registry counted 288,613 new malignant cancers in 2023 (151,126 in men, 137,487 in women), up 7,296 or 2.5 per cent on 2022, at a crude rate of 564.3 per 100,000. Standardised to Korea's own 2020 population the rate was 522.9 (587.0 in men and 488.9 in women; one table on the same page prints the men's figure as 587.9), described by the National Cancer Center as flat, the growth in cases coming from ageing. Excluding thyroid cancer the count was 253,173. The leading sites were thyroid 35,440 (12.3 per cent), lung 32,953 (11.4), colon and rectum 32,610 (11.3), breast 29,871 (10.3), stomach 28,943 (10.0), prostate 22,640 (7.8) and liver 14,707 (5.1). In men the order was prostate, lung, stomach, colorectal, liver and thyroid; in women breast, thyroid, colorectal, lung, stomach and pancreas. 145,452 cases (50.4 per cent) were in people aged 65 or over. The registry estimates that a Korean who lives to average life expectancy (80.8 years for men and 86.6 for women, 2024) has a 44.6 per cent chance of cancer if male and 38.2 per cent if female. A further 38,204 carcinomas in situ were registered, led by the cervix (11,202), colon and rectum (8,540) and breast (7,032).

On the world standard, thyroid cancer incidence went from 6.5 per 100,000 in 1999 to 50.7 in 2023. The registry's joinpoint analysis finds three phases: a rise of 22.4 per cent a year from 1999 to 2011, a fall of 12.1 per cent a year from 2011 to 2016, and a rise of 5.3 per cent a year from 2016 to 2023, while thyroid cancer mortality fell by 4.2 per cent a year from 2003. A national study using health-insurance and cause-of-death data found incidence of 46.6 per 100,000 in 2006, 115.0 in 2012 and 63.5 in 2015 with mortality unchanged, and found screening, diagnosis and post-operative complications all highest among the best-off, which its authors read as evidence of overdiagnosis. Thyroid cancer is not part of the national screening programme. It remains the commonest cancer in people aged 15 to 34, 54.1 per cent of all their cancers, and the largest group among the 2.73 million Koreans living after a cancer diagnosis (587,292 of them), and its five-year relative survival is 100.2 per cent, which is to say no different from people of the same age without it.

On the world standard, stomach cancer incidence fell from 43.6 per 100,000 in 1999 to 25.5 in 2023 (falling 4.3 per cent a year since 2011) and stomach cancer mortality from 23.9 to 5.4 (falling 6.9 per cent a year since 2003). Liver cancer incidence fell from 27.9 to 12.8 and mortality from 20.6 to 7.9 (falling 5.7 per cent a year since 2014). Among men stomach cancer remains the fourth commonest world-standard rate in Korea at 35.8 per 100,000 in 2023, against 40.9 estimated for Japan, while GLOBOCAN does not place it in the top five for men in the United States or the United Kingdom. Two thirds of stomach cancers (65.3 per cent) are now found while still localised, when five-year survival is 97.6 per cent; found after it has spread, survival is 7.5 per cent. The registry reports the lowest mortality-to-incidence ratio among major high-income countries for stomach cancer (0.21), and for colorectal (0.22) and breast cancer (0.08).

Five-year relative survival for all cancers was 42.9 per cent for cases diagnosed in 1993 to 1995, 54.2 per cent in 2001 to 2005 and 73.7 per cent in 2019 to 2023 (68.2 in men, 79.4 in women); excluding thyroid cancer it rose from 41.2 to 69.6 per cent over the same span. The largest gains since 2001 to 2005 were lung (16.6 to 42.5 per cent), stomach (58.0 to 78.6) and liver (20.6 to 40.4). Survival was highest for thyroid (100.2), prostate (96.9) and breast (94.7) and lowest for lung (42.5), liver (40.4), gallbladder and biliary tract (29.0) and pancreas (17.0). Women with lung cancer now have 56.7 per cent five-year survival against 35.4 per cent for men. By summary stage, 46.1 per cent of cancers diagnosed in 2019 to 2023 were localised, with 92.7 per cent survival; 17.8 per cent had distant spread, with 27.8 per cent survival. 43.3 per cent of pancreatic and 40.7 per cent of lung cancers were found with distant spread. The registry's paper notes that its international comparison sets Korea's observed figures against modelled estimates for other countries, and that lead time from earlier detection may contribute to the gains and should be considered.

Compiled from the national cause-of-death statistics, cancer (C00 to C97) caused 90,203 of 362,968 deaths in 2025, 24.9 per cent. The leading causes were lung 19,805 (22.0 per cent of cancer deaths), liver 10,383 (11.5), colon and rectum 9,752 (10.8), pancreas 8,677 (9.6), stomach 6,995 (7.8), gallbladder and biliary tract 5,723 (6.3), breast 3,031 (3.4), prostate 2,884 (3.2), non-Hodgkin lymphoma 2,391 (2.7) and leukaemia 2,153 (2.4). Cancer has been the leading cause of death in Korea since 1983. The registry's 2023 report gives 85,271 cancer deaths that year at a world-standard rate of 64.3 per 100,000, down from 115.1 in 1999, and cancer.go.kr sets that 64.3 against 78.6 for Japan and 82.3 for the United States. The same cancer.go.kr deaths page also carries an older footnote giving 79,153 deaths and a crude rate of 154.3, which belongs to an earlier year; the 2025 figures above are the ones in its table.

The registry counts as prevalent anyone diagnosed between 1 January 1999 and 31 December 2023 and alive on 1 January 2024: 2,732,906 people (1,193,944 men and 1,538,962 women), 144,827 more than a year earlier and 5.3 per cent of the population. 1,408,234 of them (51.5 per cent) were 65 or over, 14.9 per cent of everyone in that age group. 1,697,799 (62.1 per cent) were more than five years from diagnosis, 552,373 (20.2 per cent) two to five years and 482,734 (17.7 per cent) two years or less. Excluding thyroid cancer the figure was 2,145,614. Cancer survivorship support centres (암생존자통합지지센터) run at the National Cancer Center and at regional university hospitals, with separate services for adult survivors and for children and adolescents.

The Ministry of Health and Welfare designates and runs a central registry (중앙암등록본부) at the National Cancer Center and regional registries, and their data are combined into the Korea National Cancer Incidence Database. Each year the central registry collects the previous year's patients from hospitals across the country; the regional registries add patients missed by hospital registration, so a year's statistics take two years to complete. Cases are coded in ICD-O-3 and converted to ICD-10; since 2021 colorectal neuroendocrine tumours and gastric stromal tumours have been counted as malignant. Vital status is checked by linkage to mortality and resident registration data from the Ministry of the Interior and Safety. The 2023 database was estimated to be 97.4 per cent complete by the Ajiki method. Deaths come separately from the Ministry of Data and Statistics, the renamed Statistics Korea.

cancer.go.kr standardises its headline rates to Korea's 2020 mid-year resident population (522.9 per 100,000 for 2023), which is older than the Segi world standard used by IARC; on the world standard the 2023 rate is 288.6, the figure the registry itself uses for international comparison. cancer.go.kr also still carries a 2018-based comparison table on the same page (Korea 270.4 against an OECD average of 301.1), so check the year of any figure taken from it. Thyroid cancer was 12.3 per cent of all 2023 cases; on the world standard it is the commonest cancer in Korean women at 76.1 per 100,000, above breast at 69.7. GLOBOCAN's modelled 2022 estimate for Korea, the source of the table further down this page, is 237,701 new cancers including non-melanoma skin cancer, while the registry counted 281,317 in 2022; the registry's paper notes that its international comparison sets observed Korean data against modelled estimates. OnCo has not established why the two differ by that much. IARC's Korea fact sheet now carries GLOBOCAN 2024 instead, which gives 250,247 new cancers and 101,333 deaths for 2024, again including non-melanoma skin cancer.

NHIS describes itself as a non-profit single insurer providing health insurance to all citizens living in Korea, under the Ministry of Health and Welfare, which sets policy. Membership is compulsory, contributions are set by household income and property, and providers may not refuse to treat insured patients. NHIS manages eligibility, collects contributions, contracts fees with providers and pays benefits; the Health Insurance Review and Assessment Service (HIRA) evaluates fees, quality and appropriateness. For a drug, the company applies for coverage once MFDS has approved it, HIRA's Pharmaceutical Benefit Assessment Committee assesses clinical efficacy and cost-effectiveness, and the price of a newly listed drug is negotiated between the company and NHIS. Cancer drugs are first considered by HIRA's cancer disease deliberation committee (암질환심의위원회), which decides the criteria under which a drug is paid for; in March 2025, for example, it voted to widen the reimbursement criteria for trastuzumab deruxtecan in gastric cancer to patients previously treated with any platinum drug rather than only cisplatin, a decision that then goes to the Pharmaceutical Benefit Assessment Committee.

Under the special co-payment scheme (본인일부부담금 산정특례), set by the National Health Insurance Act article 44, its enforcement decree article 19 and schedule 2, and a Ministry of Health and Welfare notice, cancer carries a 5 per cent co-payment for five years, against 10 per cent for rare and severe intractable diseases and severe dementia and none for tuberculosis. The doctor issues a registration form after the tests the scheme requires; if it reaches NHIS within 30 days of confirmation the 5 per cent applies from the date of diagnosis, otherwise from the date of application, and tests before confirmation are excluded. The rate covers outpatient and inpatient care, CT, MRI and PET, and pharmacies, and complications with a clear medical link to the cancer. It does not cover items charged in full to the patient (100분의100), selectively covered items (선별급여), two- and three-bed rooms, meals or non-covered care (비급여). A patient with residual or metastatic disease, or a recurrence, still on anticancer treatment when the five years end can register again in the three months before they expire.

HIRA's detailed evaluation standard states that it does not use an explicit cost-effectiveness threshold and judges flexibly, with reference to previous decisions, in the light of disease severity, social burden of disease, effect on quality of life and innovation. An amendment in August 2024 defined innovation for this purpose by three conditions that must all be met: no substitute or equivalent treatment, a marked clinical improvement in a final outcome such as survival, and approval through MFDS expedited review under article 35-4(2) of the Pharmaceutical Affairs Act, or a drug the committee accepts as equivalent. As reported by Daily Pharm from HIRA's disclosures, the incremental cost-effectiveness ratios accepted for anticancer drugs were: 2014 to 2021, median 45.32 million won; 2018 to 2022 (10 drugs), median 39.99 million, maximum 47.92 million; 2019 to 2023 (8 drugs), median 39.93 million, minimum 25.88 million, maximum 47.92 million; 2020 to 2024 (8 drugs), median 42.94 million, maximum 55.36 million. For general drugs in 2019 to 2023 the median was 27.66 million and the maximum 36.10 million. Trade press links the jump in the maximum to trastuzumab deruxtecan, listed in April 2024; HIRA does not name the drugs.

Managed entry agreements (위험분담제) were introduced in January 2014. From then to December 2020, 48 medicines were listed under them, 73.4 per cent of the cancer and rare-disease medicines listed, and 97.9 per cent of the contracts were finance-based, with outcome-based contracts 2.1 per cent. A separate economic evaluation waiver is designed for orphan and cancer drugs of high clinical need, while a price-negotiation waiver serves mainly non-orphan, non-cancer drugs; a study of 785 new drugs listed from 2007 to 2022 found negotiation agreement rates for orphan and cancer drugs rose after the waivers were introduced. Thirty-two anticancer drugs reviewed between January 2017 and March 2020 took on average 36.7 months to listing, at 12.6 to 90.2 per cent of the average adjusted price in seven reference countries. Of 171 new drugs approved from 2013 to 2022, 67.8 per cent were reimbursed by 1 January 2024.

Comparing submission, approval and reimbursement timing for the same cancer drugs in Korea, the United States, the European Union and Japan, Lee and Lee found an average delay of one to two years in submission and approval in Korea over 2013 to 2022, an MFDS review time much shorter than those lags and better than the EMA's, and a reimbursement decision delay roughly halved over the decade. Variation in approval delay was largely explained by submission delay, which the authors read as Korea not yet being a preferred first market for new cancer drugs. A new MFDS review procedure began in January 2025, with a dedicated team of reviewers for each product, early manufacturing inspection and scheduled meetings; MFDS reported the first biological product approved under it in December 2025 with an 18-person team. Trade press reported the procedure came with a fee of 410 million won per application and a target of 295 days against an average of about 420; MFDS's own text on those two numbers was not reached for this page.

MFDS counts 842 trial approvals in 2021, 711 in 2022, 783 in 2023, 747 in 2024 and 783 in 2025, excluding bioequivalence studies. Anticancer drugs were the largest group each year (321, 259, 294, 276 and 304), and in 2025 about 68 per cent of cancer trials (207) were of targeted agents. Multinational trials rose from 372 to 425 in 2025; trials of medicines developed by Korean companies fell from 305 to 259, and 92 per cent of those were run only in Korea. Investigator-initiated trials fell from 188 in 2020 to 83 in 2024 and recovered to 115 in 2025. MFDS's note for 2024, citing an analysis by the Korea National Enterprise for Clinical Trials of company-sponsored studies newly registered on ClinicalTrials.gov, ranked Korea sixth among countries (and eleventh for multinational trials) and Seoul second among cities after Beijing, ahead of Shanghai, Houston and Miami.

The National Cancer Screening Program began in 1999 with stomach, breast and cervical screening for Medical Aid beneficiaries and by 2019 offered six cancers to everyone insured. Under the current rules: stomach, men and women 40 and over, every two years, by upper endoscopy, with a biopsy where needed (sedation and Helicobacter tests are paid by the patient); liver, people 40 and over with cirrhosis, hepatitis B surface antigen, hepatitis C antibody or chronic viral liver disease, every six months, by ultrasound with alpha-fetoprotein; lung, 54 to 74 with a smoking history of at least 30 pack-years who still smoke, every two years, by low-dose CT with results counselling and smoking-cessation advice; colorectal, 50 and over, every year, by faecal occult blood test with colonoscopy if positive; breast, women 40 and over, every two years, by mammography; cervix, women 20 and over, every two years, by Pap smear. A nested case-control study of 16.6 million people in the programme found that people screened by endoscopy had about half the odds of dying of stomach cancer (odds ratio 0.53), while barium X-ray screening showed no association (0.98); the X-ray is no longer the programme's method.

MFDS approved Leclaza (lazertinib) on 18 January 2021 for EGFR T790M-positive locally advanced or metastatic non-small-cell lung cancer after a previous EGFR inhibitor, describing it as the 31st new drug developed in Korea, and extended it on 30 June 2023 to first-line treatment of EGFR exon 19 deletion or L858R disease on the strength of Yuhan's phase 3 trial. Licensed to Janssen, it was approved in the United States in August 2024 and in the EU in January 2025, only in combination with amivantamab, on the basis of MARIPOSA. Before this page OnCo's lazertinib record named only Johnson & Johnson as its company and carried no Korean approval; both are now corrected. Korean companies also supply subcutaneous delivery technology to global cancer drugs: Alteogen's own news describes MSD's subcutaneous pembrolizumab, Keytruda Qlex, as built on its ALT-B4 hyaluronidase platform.

KLASS-01, run by the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group of 15 surgeons at 13 institutions, randomised 1,416 patients with clinical stage I gastric cancer to laparoscopic or open distal gastrectomy and found laparoscopy non-inferior for five-year overall survival (94.2 against 93.3 per cent). CLASSIC, run in South Korea, China and Taiwan, randomised 1,035 patients after D2 gastrectomy for stage II to IIIB gastric cancer to capecitabine and oxaliplatin or surgery alone and found better disease-free survival with chemotherapy. Both are in the corpus with their papers.

MFDS's own text on the 2025 review fee (410 million won) and the 295-day target, which appear here only from trade press. HIRA's annual ICER disclosures themselves, which are cited here through Daily Pharm's reporting of them. The full text of the Ministry of Health and Welfare's notice on the special co-payment scheme, which NHIS links to and summarises. The annual cap on out-of-pocket costs (본인부담상한제), which applies to cancer patients but whose current amounts were not checked. The exact date national lung screening began: the programme's own review says only that all six cancers were offered by 2019. Regional differences in incidence and survival, which the registry publishes but this page does not cover. Korean-language attachments in HWP format were not read; the PDF versions were.

Not yet held: the Korea National Enterprise for Clinical Trials (KoNECT), which publishes the trial-site rankings above; Korean registries of trials (CRIS, the Clinical Research Information Service); Korean patient organisations; the K-MASTER precision oncology programme named in OnCo's own country table, which this page could not verify; ABL Bio and Alteogen as company records; HLB and rivoceranib's Korean development; and the Korean Cancer Association and Korean Society of Medical Oncology as institutions. GLOBOCAN's modelled figures for Korea differ substantially from the registry's counts, and OnCo has not established why.