• Journal of Preventive Medicine and Public Health
• /
• v.41 no.1
• /
• pp.17-22
• /
• 2008

Objectives : Period analysis estimates up-to-date survival rates of cancer patients. In this approach, analysis is restricted to recent time period by left-truncating all observations at the beginning of the period and right-censoring at its end. Here, we applied period analysis to examine changes in 5-year relative survival (RS) by age group for 1997 and for 2002. Methods : Using the National Cancer Incidence Database, 5-year RS was estimated for 1997 and 2002 in four age groups (15-54, 55-64, 65-74, and 75 years old and over) using period analysis. After excluding death certificate-only cases, patients with an unknown date of diagnosis or follow-up length, a total of 813,889 patients diagnosed with a first primary invasive cancer during 1992 2002 were included for analysis. Followup for vital status was included until 31 December 2002. Results : Five-year RS increased from 41.7% for 1997 to 46.7% for 2002. Increases in survival occurred in all age groups except in the 75 and over group. Conclusions : The age gradient in cancer prognosis seems to have widened between 1997 and 2002, a finding that requires further study of prognostic factors, including stage at diagnosis. Period analysis accurately estimates survival rates, especially for cancers with better prognosis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6591-6593
• /
• 2013

Background: Environmental tobacco smoking (ETS) significantly contributes to morbidity and mortality and is a known risk factor for lung cancer development in lifelong nonsmokers. The metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (NNAL-Glucs) have now emerged as leading biomarkers for the study of carcinogen exposure in non-smokers exposed to ETS. Materials and Methods: We carried out our study on NNAL in the urine of non-smokers exposed to ETS and the association between ETS and lung cancer. Subjects were enrolled from 2008-2010. NNAL was analyzed for 74 non-smoking lung cancer and 85 healthy controls. The main objective of this study was to provide an estimate of the risk of lung cancer from exposure to ETS in the Korean population. Results: The mean NNAL concentration in urine was significantly lower in non-smoking patient groups (n=74) than in control groups (n=85) ($4.7{\pm}15.0$ pg/mg, $6.5{\pm}17.9$ pg/mg, respectively, Mann-Whitney U test, p<0.001). Conclusions: The urine NNAL of non-smoking patients with lung cancer was not elevated with regard to the non-smoking control group. This may be due to life-style changes after diagnosis. A prospective study will be needed to evaluate the association of NNAL and non-smoking lung cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.19
• /
• pp.8239-8244
• /
• 2014

The Cancer Control Act in Japan became effective in 2006. In Ibaraki, Toyama, and Hyogo prefectures, the Cancer Control Promoter (CCP) plan was created to strengthen partnerships for cancer prevention. This study aimed to examine the curre nt status of CCP utilization and analyze relationships with intersectoral collaboration, both within the government and with outside partners. In 2008, we mailed questionnaires to 100 administrators responsible for disease prevention and health promotion in municipal governments of the three prefectures. Ninety-one administrators responded (response rate, 91.0%). We analyzed responses to questions regarding whether or not the municipalities had used CCPs. Items assessing intersectoral collaboration examined municipality characteristics and relationships with outside partners and sectors specializing in areas other than community health. Among 90 administrators with valid data, 33 municipalities (36.7%) used CCPs while 57 (63.3%) did not. The Fisher's exact test revealed that intersectoral collaboration for using CCPs was associated with communication with all of the municipal government sectors not related to health. The present study indicated that CCPs were not consistently used in municipalities. However, we found that intersectoral collaborations, especially within the local government, may be related to the practical use of CCPs. This, in turn, may result in effective cancer control and prevention, as well as improvement in community health.

• 대한예방의학회:학술대회논문집
• /
• 2005.10a
• /
• pp.506-506
• /
• 2005

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.3
• /
• pp.1295-1301
• /
• 2015

Background: Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. Materials and Methods: The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. Results: In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Conclusions: Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

• Korean Journal of Radiology
• /
• v.23 no.6
• /
• pp.571-573
• /
• 2022

• Journal of Preventive Medicine and Public Health
• /
• v.42 no.4
• /
• pp.243-250
• /
• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• Yonsei Medical Journal
• /
• v.59 no.9
• /
• pp.1034-1040
• /
• 2018

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.4
• /
• pp.2325-2327
• /
• 2016

Gall bladder cancer is generally fatal. The high morbidity and mortality due to gall bladder cancer exerts a significant impact on efforts towards cancer control in high risk populations of the World and a rationale program for control of gall bladder cancer mortality has remained as an unmet need in these populations. Currently there are no effective strategies for controlling gall bladder cancer mortality. This mini review is to highlight the need and feasibility for secondary prevention of gall bladder cancer by screening in high risk populations. A way forward is to assess the role of secondary prevention of gall bladder cancers by conducting randomized-controlled screening trials in high risk populations.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.4
• /
• pp.1709-1710
• /
• 2012

Cancer is a major public health problem in Indonesia, becoming the 7th largest cause of death based on a national survey in 2007, accounting for 5.7 of all mortality. A cancer registry was started in 1970, but it was partial and was stopped mainly because no government body was responsible. Realizing the above situation, the Indonesian government established the Sub Directorate of Cancer Control within the Ministry of Health, with responsibility for developing a national cancer control program, including a cancer registry. A sustainable cancer registry was then started in 2007 within Jakarta Province, first hospital-based but then expanded to be population-based. Steps of cancer registration in Jakarta are data collection, data verification, data validation, data management and analysis, and data publication. Data collection is conducted by health facilities (hospitals, laboratories, primary health centers) at the district/municipal level, with reports to the provincial level. Data are collected passively by holding meetings every three months in the district/municipality. Verification of data is the responsibility of the medical doctor or pathologist in each data source. Data validation is conducted by a team in the cancer registry, consisting of district/municipal/province health officers, pathologists, and registrars. Data management and analyses are conducted by a cancer registry team at the provincial level, assisted by the national team. We use software named Indonesian Cancer Registry System (SRIKANDI) which is adopted from CanReg4 IARC. Data from the population-based cancer registry in Jakarta Province showed the leading cancers among females in 2005-2007 to be breast cancer, cervical cancer, ovarian cancer, colorectal cancer and among males are bronchus and lung cancer, colorectal cancer, liver cancer, pharyngeal cancer, and prostate cancer. The leading childhood cancers are leukaemia and retinoblastoma.