• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.433-439
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• 2014

We attempted to develop an indicator combining incidence with mortality rates (single measure of cancer burden, SMCB) and to compare the magnitudes of cancer burden by world region. The SMCB was used to measure the size of cancer burden summarizing the incidence and mortality. The incidence and mortality were divided in equivalent forms and were split. The criteria dividing the size of cancer burden were used as the maximum incidence and mortality by men and women according to the world database, and the value corresponding to 10% of each maximum was set as the cut-off value. In SMCB, the size of cancer burden was highest for men with lung cancer (SMCB=18) and for women with breast cancer (SMCB=14) in MDR (more developed regions) compared to the size of burden in LDR (lower developed regions) (lung, SMCB=11, breast, SMCB=8). For men, the size of cancer burden by region was highest in EURO (SMCB=18, lung), followed by WPRO (SMCB=16, lung), PAHO (SMCB=14, prostate), AFRO (SMCB=8, prostate) and SEARO (SMCB=7, lung). Moreover, for women, the size of cancer burden was greatest in EURO (SMCB=14, breast), followed by PAHO (SMCB=13, breast), AFRO (SMCB=11, cervix uteri), EMRO (SMCB=9, breast) or SEARO (SMCB=8, cervix uteri) and WPRO (SMCB=7, lung). The summary indicator will help to provide a priority setting for reducing cancer burden in health policy.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.331-341
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• 2000

Since cancer is not easily curable, patients who suffer from cancer may have physical, psychological and spiritual problems for the rest of their lives. Especially when cancer patients do not have much to live for and are placing a burden on their family they will experience more suffering emotionally as much as physically. This study was conducted to provide a basis of data for nursing intervention strategies to minimize a cancer patient`s suffering and to understand the relationship between suffering, burden and the meaning of life in cancer patients. The samples were composed of 160 cancer patients who were inpatients or outpatients of two university hospitals and two general hospitals in Seoul. Data collection were carried out from January, 25, 1999 to February, 26, 1999. The data were analyzed using a SAS program for descriptive statistics, pearson correlations, ANOVA, and Duncan tests. The results were as follows; 1. The scores on the two suffering scale ranged from 132 to 40 with a mean of 87.3(SD 17.5). The mean scores on the burden scale is 28.9(SD 6.9) and the score of the meaning of life ranged from 35 to 51 with a mean of 95.6(SD 18.4). 2. There were significant correlations between the amount of suffering and the magnitude of burden (r=.74, p=.00), the suffering and the meaning of life (r=-.59, p=.00) and the burden and meaning of life (r=-.61, p=.00). 3. In the degree of the suffering, the burden and the meaning of life were two very strong factors, the level of the suffering in cancer patients by age (F=2.64, p=.03) and education level (F=4.16, p=.00). The level of the burden in cancer patients differed by education level (F=4.70, p=.00) and type of cancer (F=2.97, p= .03). Also the level of the meaning of life in cancer patients was different by education level (F=3.55, p=.02). In conclusion, the burden and the meaning of life was identified as important variable that is contributed to reduce the suffering of cancer patients.

• Journal of Preventive Medicine and Public Health
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• v.50 no.4
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• pp.217-227
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• 2017

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.537-550
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• 2014

The actual burden of head and neck cancer in India is much greater than reflected through the existing literature and hence can be regarded as a 'tip of iceberg' situation. This has further been evident by the recent reports of 'Net-based Atlas of Cancer in India'. South-east Asia is likely to face sharp increases of over 75% in the number of cancer deaths in 2020 as compared to 2000. Since the percentage increase of Indian population has been nearly twice that of the world in last 15 years there is a likelihood of increase in cancer burden with the same proportion. The distribution of population based cancer registries is grossly uneven with certain important parts of the country being not represented at all and hence the current cancer burden is not reflected by registry data. However, the pathetic situation of health care system in major parts of the country as also emphasized by the World Bank, is not suitable to provide anywhere near accurate data on cancer burden. Head and neck cancer (including thyroid lesions) is third most common malignancy seen in both the sexes across the globe but is the commonest malignancy encountered in Indian males. Also oral cavity cancer is the most prevalent type amongst the males and one of the highest across the globe. This article reviews the latest global and national situation with an especial emphasis on head and neck cancer. Furthermore this review focuses on burden in different sub sites at national and global levels.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.384-395
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• 2000

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

• Asian Oncology Nursing
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• v.1 no.1
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• pp.65-74
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• 2001

This study was to investigate the degree of the nurses' burden and the attitude on the terminal cancer patients, as well as the relationship between two variables using questionnaire. The non-randomized convenient samples were 252 nurses with the experiences in caring the terminal cancer patients more than 1year in 5 university hospitals in Seoul and Inchon city. The cross-sectional one time survey was conduced by using the modified questionnaires on the burden and the attitude on the terminal cancer patients at October, 2000. n SPSS for Window, the demographic information and the degree of the burden and the attitude of subjects were analyzed with descriptive statistics. Pearson correlation coefficiency was used to investigate the relationship between the degree of the burden and the attitude from subjects. The additional analysis were performed to examine the differences the degree of the burden and the attitude by the general characteristics of the nurses using t-test and ANOVA. The result was as follow: 1) The degree of the nurses' burden on the terminal cancer patients was the mean of 2.91 ranged from 2.08 to 3.96. 2) The degree of the nurses' attitude on the terminal cancer patients was the mean of 3.52 ranged from 1.83 to 4.68. 3) There was no significant relationship between the degree of the burden and the attitude on the terminal cancer patients(r=.08, p=.23). However, the burden and. the nursing environment among 4 aspects of the attitude showed a significantly positive relationship each other (r=.16, p=.01). 4) The degree of the nurses' burden was different by the nursing specialties (F=2.79, p=.03) and the professional perspectives on nursing(F=3.52, p=.02). 5) The degree of the nurses' attitude was different by the age(F=5.33, p=.01), the married status(t=3.93, p=.05), nursing specialties (F=7.42, p=.00), the amount clinical experience(F=2.85, p=.04), the job satisfaction (F=10.58, p=.00) and, the professional perspectives on nursing (F=6.30, p=.01).

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5249-5255
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• 2013

Background: The purpose of this study was to develop a single measure of cancer burden (SMCB), which can prioritize cancer sites by considering incidence and mortality. Materials and Methods: Incidence data from 1999 to 2010 were obtained from the Korea Central Cancer Registry. Mortality data from 1999 to 2010 were obtained from Statistics Korea. The SMCB was developed by adding incidence and mortality scores. The respective scores were given such that incidence and mortality were classified by ten ranges of equal intervals. Results: According to the SMCB in 2010, stomach cancer ranked $1^{st}$ in males with 20 points, and colorectal cancer was $2^{nd}$ with 11 points. Breast cancer and thyroid cancer were joint $1^{st}$ with 11 points for females. The SMCB for females was less than that for males. The burden of stomach cancer was $1^{st}$ in males from 1999-2010. The incidences of lung cancer and liver cancer decreased, whereas thyroid cancer and colon cancer increased during the period. Breast cancer and thyroid cancer burden showed tendencies to increase in females. Comparison of SMCB with disability-adjusted life years (DALY) and socioeconomic costs in 2005 showed that the top five cancer sites were similar, but there were differences in the size of the cancer burden. Conclusions: The SMCB indicated that the burdens of stomach cancer in males and thyroid and breast cancers in females were large. The single measure showed an advantage, reflected as the equivalent dimensions of incidence and mortality, whereas DALY and economic costs showed tendencies to reflect premature death.

• Journal of Preventive Medicine and Public Health
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• v.33 no.2
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• pp.231-238
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• 2000

Objective : To estimate the burden of diseases in Korea especially caused by major cancers using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined the parameters: such as age-specific standard life expectancy, age on death, sex, cause of death by analyzing the national death certificate data and life table collected during 1996 provided by the National Statistical Office. Secondly, we estimated the age group-specific YLL by employing standard expected years of life lost(SEYLL). Thirdly, final burden of disease due to premature death was estimated by using YLLs measurement which developed by global burden of disease study group. Results : The burden of premature death by cancer for male was attributed mainly to liver cancer(514.5 person-year), stomach cancer(436.4 person-year), and lung cancer(367.7 person-year). Each of these cancers was responsible for the loss of over 100 person-year based on our YLL measurement. The burden of premature death by cancer for female was attributed mainly to liver cancer(135.1 person-year), stomach cancer(252.1 person-year), and lung cancer(121.8 person-year). Each of these cancers was responsible for the loss of over 100 person year based on our YLL measurement. Conclusion : We found the YLL method employed in this study was appropriate to quantify the burden of premature death. Thereby, it would provide a rational bases to plan a national health policy regarding premature death caused by cancer.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.372-378
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• 2001

Objectives : This study introduced the healthy life-year(HeaLY), a composite indicator of disease burden, and used it to estimate the burden of major cancers in Korea. Methods : We collected data from the national death certificate database, the national health insurance claims database and the abridged life table. This data was used to create a spreadsheet and estimate the burden of major cancers by sex in terms of HeaLYs. Results : The burden of 10 major cancers for males was 2,248.97 person-year in terms of HeaLYs. Stomach cancer, liver cancer, and lung cancer were responsible for 75.2% of the burden of 10 major cancers. The disease burden of 10 major cancers for females was estimated to be 1,567.58 person-years. About two thirds of HeaLYs lost were from stomach cancer, liver cancer, lung cancer, colorectal cancer, and breast cancer. The rankings among 10 major cancers were somewhat different in terms of both HeaLYs and deaths as the HeaLY method considers both mortality and morbidity. Conclusions : Despite the limitations of the data sources, we conclude that HeaLY can aid in setting policy priorities concerning major cancers by estimating the disease burden of these cancers. Time-series analysis of the disease burden using HeaLY and DALY will elucidate the strengths and weaknesses of both methods.