• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2317-2322
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• 2015

Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4897-4902
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• 2013

Here we assessed the effectiveness of cervical cancer screening using data from the Hiroshima Prefecture Cancer Registry regarding patient age at the start of screening and differences in screening intervals. A screening model was created to calculate the health status in relation to prognosis following cervical cancer screening and its influence on life expectancy. Epidemiological data on the mortality rate of cervical cancer by age groups and mortality rates from the Hiroshima Prefecture Cancer Registry were used for the model projections. Our results showed that life expectancy when screening rate was 100% compared with 0% was extended by approximately 1 month. Furthermore, when the incidence of cervical cancer was 0% compared with the screening rate was 100%, life expectancy was extended by a maximum of 3 months. Moreover, among individuals affected by cervical c ancer, a difference of 13 years in life expectancy was calculated between screened and unscreened groups.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.99-108
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• 2000

Objectives : The purpose of this study was to examine the present status of cancer screening recommendations(beginning age, interval, recommended screening methods, etc.) by physicians and analyze the association between physician's characteristics and the content of their recommendations. Methods : Data were collected from March 1 to April 30 of 1997, and 373 physicians who were from different hospital settings all over Korea were interviewed by telephone about their screening recommendations for stomach, cervical and breast cancer for these who provided cancer screening services. Results : For stomach cancer screening, respondents recommended that cancer screening begin at 40 years of age(57.8%), with a 1 year interval(77.2%), and by gastrofibroscopy (86.2%). For cervical cancer screening, respondents recommended that cancer screening begin at 25 years of age(42.0%), with a 1 year interval(67.8%), and by using a Pap smear(100.0%). For breast cancer screening, respondents recommended that cancer screening begin at 35 years of age(38.7%), with a 1 year interval(57.3%), and by mammography (97.3%). Conclusions : To establish appropriate cancer screening recommendations for Korea, if may be useful to consider the above results concerning medical care providers.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3773-3779
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• 2012

Objective: Despite government efforts to increase participation in gastric cancer screening, the rate is still suboptimal in Korea. Therefore, we explored barriers to and predictors of gastric cancer screening participation among a nationally representative sample. Methods: We used the Health Interview Survey sub-dataset derived from the Fourth Korean National Health and Nutrition Examination Survey 2008 (KNHANES IV) to evaluate participation in gastric cancer screening and factors associated with attendance in individuals age ${\geq}40$ years. We enrolled 4,464 subjects who completed the questionnaire and were not previously diagnosed with gastric cancer. Four groups of factors were considered potential predictors of gastric cancer screening in a multivariate analysis: sociodemographic, health behavior, psychological and cognitive, and dietary factors. Results: Overall, 41.3% complied with the gastric cancer screening recommendations. Younger age, lower education level, living without a spouse, frequent binge drinker, and current smoker were significantly associated with less participation in gastric cancer screening. Conclusions: To improve participation in gastric cancer screening, more focused interventions should be directed to vulnerable populations, such as groups with low socioeconomic status or unhealthy behavior. In addition, there should be new promotional campaigns and health education to provide information targeting these vulnerable populations.

• 보건교육건강증진학회지
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• 제23권2호
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• pp.77-89
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• 2006

Objectives: Recent studies have shown that tailoring to women's individual beliefs and stage of cancer screening adoption increase the probability that cancer screening will ensue. To identify variables associated with cancer screening behavior, many studies for cancer screening have used the Transtheoretical Model(TTM). This study was carried out to identity the cognitive and behavioral factors associated with breast cancer screening by stages of change among women, forties aged. Methods: Building on the TTM constructs, we collected the data to test the association with cognitive and behavioral factors for breast cancer screening by stage of change among women, forties aged (N=232), using the self-reported questionnaire. The stages of change were grouped according to screening participation and intention for breast cancer as precontemplation, contemplation, preparation, action, and maintenance. We found out the association between breast cancer screening and cognitive and behavioral factors, and testified the difference between stages of change by chi-square test, one-way ANOVA, and multiple comparison analysis(Duncan test). Results: Analyses of 232 women showed that participation on mammography was 68.1% within lifetime and 46.1% within last 2 years, and we found out the association with breast cancer screening participation, intention and cognitive-behavioral factors. The stages of change based on participation and intention were different from the decisional balance, the screening attitude, and the self-efficacy(p<0.01). The decisional balance was differ from stages of change because the difference on opinions about pros(positives) and cons(negative) were likely to significant by stages of change(p<0.05, p<0.01). Conclusion: To increase the screening rate for breast cancer, it should be developed the tailored message and recommend guideline. And the tailored message should be designed to increase the pros of breast cancer screening(mammography) and to decrease the cons, and considered the woman's stage of adoption.

• 보건교육건강증진학회지
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• 제28권1호
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• pp.69-80
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• 2011

Objectives: This study aims to identify the factors associated with colorectal cancer screening behaviors. Methods: The nation-wide representative samples of 2,928 adults aged ${\geq}50$ years for colorectal cancer screening were derived from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). This study investigated socio-demographic, health behavioral and contextual factors associated with colorectal cancer screening using descriptive statistics and multivariate logistic regression analysis. Results: In terms of socio-demographic factors, gender, age, marital status, occupation, monthly income, and resident region were significantly different between screening group and non-screening group. Among health behavioral and contextual factors, regular physical checkup, weight control, physical activity, smoking, drinking and having other cancers were significantly different. From the multivariate logistic regression analysis, marital status, education level, regular physical checkup and weight control were associated with colorectal cancer screening behavior. Conclusions: It is necessary to understand the importance of early detection and cancer screening. Appropriate health education and active promotion about the cancer screening should be developed based on the study findings in order to motivate people to have cancer screening. Also, these findings should be reflected in the health policy.

• 종양간호연구
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• 제8권2호
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• pp.138-146
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• 2008

Purpose: This study was to investigate the cancer screening rates and influence factors in island residents. Methods: The participants were 1,223 Shinan gun island residents. Data were collected using structured questionnaires from June 23th to September 8th, 2007 and analyzed using the SAS win 12.0 program. Results: The cancer screening rate was 49.9%. There were significant differences for sex, age, living with family, economic level, smoking, exercise, private health insurance, familial history, health concern. The highest practice rate was of stomach cancer (55.9%), which is gastric endoscopic exam. The most common motivation of getting a screening test was the concern of health (40.8%), and many had no recommender of the screening test (30.0%). 58.4% of the subjects were satisfied with the screeing tests and the most frequent reason of the satisfaction was 'rapid result report' (33.1%). The msot common reason of unsatisfaction was 'long waiting time' (25.7%). Most participants agreed with the necessity of cancer screening (74.9%). More than half participants said they would participate in another cancer screening tests in the future (51.9%). Private health insurance, exercise, health concern and smoking showed significant predictors (20.6%) of obtaining cancer screening. Conclusion: The results suggest that health care professionals should give more attention to help the residents obtain cancer screening tests. A further study is necessary to develop any effective intervention for people who do not practice cancer screening tests.

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5237-5242
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• 2016

Background: Cancer screening rates are lower in Japan than those in western countries. Health professionals publish procancer screening messages on the internet to encourage audiences to undergo cancer screening. However, the information provided is often difficult to read for lay persons. Further, anti-cancer screening activists warn against cancer screening with messages on the Internet. We aimed to assess and compare the readability of pro- and anti-cancer screening online messages in Japan using a measure of readability. Methods: We conducted web searches at the beginning of September 2016 using two major Japanese search engines (Google.jp and Yahoo!.jp). The included websites were classified as "anti", "pro", or "neutral" depending on the claims, and "health professional" or "non-health professional" depending on the writers. Readability was determined using a validated measure of Japanese readability. Statistical analysis was conducted using two-way ANOVA. Results: In the total 159 websites analyzed, anti-cancer screening online messages were generally easier to read than pro-cancer screening online messages, Messages written by health professionals were more difficult to read than those written by non-health professionals. Claim ${\times}$ writer interaction was not significant. Conclusion: When health professionals prepare pro-cancer screening materials for publication online, we recommend they check for readability using readability assessment tools and improve text for easy comprehension when necessary.

• 대한간호학회지
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• 제44권2호
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• pp.139-148
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• 2014

Purpose: This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors. Methods: Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0. Results: The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon). Conclusion: It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.

• Journal of Preventive Medicine and Public Health
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• 제43권1호
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• pp.62-72
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• 2010

Objectives: To identify factors associated with cancer screening intention using the Theory of Planned Behavior (TPB). Methods: Among 55,920 eligible persons for National Cancer Screening Program (NCSP) in J city, 1,100 individuals were contacted. Of these, 797 were interviewed using a structured questionnaire. Thirty-six responses were excluded due to incomplete data. The remaining 761 completed questionnaires were analyzed to find factors associated with cancer screening intention. Results: Cancer screening intention was significantly associated with behavioral attitude (p<0.01) and subjective norm (p<0.01), but not with perceived behavioral control (p=0.29) in the TPB model. These three constructs explained 29.7% of cancer screening intention in multiple linear regression analysis. External factors such as socio-demographic status, health and health behavior variables explained 8.9% of screening intention. Among them, household monthly income, past cancer screening experience, exercise and daily eating habit were significantly associated with screening intention. Conclusions: Cancer screening intention may be influenced by focusing attitude, subjective norm in TPB model and other external factors. However, further studies are warranted to identify factors influencing cancer screening intention and behavior.