• Journal of Korea Association of Health Promotion
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• v.3 no.2
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• pp.137-146
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• 2005

The Community based cancer screening program passed in 1960 was a milestone for initiating a national and local health program in Japan. And since then local governments and Cancer Society have been developing and providing cancer screening programs of Stomach, Cervix, Breast and Colorectum for population. To apply the effectiveness of community based cancer screening program, it is important to understand the key issue related to cancer screening participation of population and technology of cancer detection. The purpose of this study was to understand the community based cancer screening program in Japan, and to apply the information for establishment of community based cancer screening program in Korea. The characteristics of community based cancer screening program in Japan were as follows. The first, community based cancer screening program was implemented by the National Health and Medical Services Law for the Aged since 1983. The second, Cancer Society and Cancer Detection Center were core for cancer screening program. The third, the budget for cancer screening program was established by the National Health and Hygiene. The fourth, the continuous quality control for medical staff was provided by Cancer Society and Cancer Detection Center The fifth, the efforts for the promotion of cancer screening rate.

• The Korean Journal of Health Service Management
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• v.10 no.4
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• pp.87-95
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• 2016

Objectives : The aim of this study was to investigate the degree of awareness of the national cancer screening program by the Korean public and define its relationship with cancer screening intention. Methods : The study collected data by conducting an online survey from April 19 to 24, 2016, and received a total 354 responses. Additionally, we performed frequency analysis, chi-square test, and logistic regression analysis. Results : Based on the results for the degree of awareness for the national cancer screening program, 151 (42.7%) people were aware of the program, while 203 (57.3%) were not aware the program. From the chi-square test and logistic regression analysis, marital status and awareness of the national cancer screening program were found to have a statistically significant influence on screening intention. Conclusions : An increase in the screening rate should be established with a systematic promotion plan for the national cancer screening program.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.589-594
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• 2014

Few studies have examined reasons why those with low socioeconomic status do not adequately receive cancer screening. We therefore conducted a qualitative study to assess the barriers to cancer screening in people with low socioeconomic status, and to examine the reasons why Medical Aid Program (MAP) recipients do not participate in the National Cancer Screening Program (NCSP). A focus group methodology was used. Participants included MAP recipients (men aged 45-79 years, women aged 35-79 years) who had been invited to cancer screening at least twice based on the NCSP protocol, but had not been screened for any cancer from 2009-2012. We recruited participants living in the cities of Goyang and Paju. A total of 23 MAP recipients participated in four focus group discussions, including 12 men and 11 women. In this qualitative study, we identified six barriers to screening: lack of trust in the NCSP and cancer screening units; fear of being diagnosed with cancer; discomfort or pain from the screening procedure; lack of time, lack of knowledge about cancer screening or lack of awareness of the existence of the NCSP; physical disability or underlying disease; and logistic barriers. Interventions such as individualized counseling, letters and reminders, or other individually-targeted strategies, especially for those with lower socioeconomic status are required to increase participation and reduce disparities in cancer screening.

• Health Policy and Management
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• v.27 no.4
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• pp.296-303
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• 2017

Background: This study purposed to analyze regional factors related to gastric cancer screening rate provided by national cancer screening program in Korea. Methods: The unit of analysis was administrative districts of si gun gu level. Dependent variable was regional gastric cancer screening rate provided by national cancer screening program, and regional variables were selected to represent the regional characteristics such as demographic, health behavior and status, socioeconomic, and health resource. Tobit regression was applied for the analysis. Results: Analysis results showed that gastric cancer screening rate was varied depending on regions from 47.8% to 69.1%. Tobit regression showed that gastric cancer screening rate had negative relationships with smoking rate, financial independence rate, and National Health Insurance premium per capita. And regional gastric cancer screening rate had positive relationships with sex ratio and number of gastric cancer screening center. Conclusion: Regional characteristics should be considered in establishing regional policies for increasing the gastric cancer screening rate.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8461-8467
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• 2014

Background: In this study we investigated factors influencing cancer screening intention and behavior to develop measures to increase the rate of cancer screening in the Korean elderly. Materials and Methods: Participants included 425 elderly subjects 65 years of age or older from D city, South Korea. The health behavior characteristics and cancer screening-related and theory of planned behavior (TPB) factors influencing the participant attitudes on cancer screening were examined to identify determinants significantly affecting cancer screening intentions and behavior. Results: Predictive factors influencing cancer screening behavior included smoking, exercise, cancer concerns, preference for the type of cancer screening, prior experience with the National Cancer Screening Program, perception of the National Cancer Screening Program, behavioral control with respect to cancer screening and cancer screening intentions. The factors influencing cancer screening behavior were different from those for cancer screening intentions. Conclusions: Increasing the cancer screening intentions of the elderly is necessary to raise the rates of cancer screening. Additionally, identifying the inhibitory factors that serve as obstacles to cancer screening in the elderly and changing screening intentions into actual screening behavior is necessary. This study provides a reference for developing and applying policy measures and intervention strategies to increase the cancer screening rates of the elderly in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2533-2540
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• 2013

Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.63-67
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• 2012

The purpose of this study was to evaluate whether screening by clinical breast examination (CBE) in addition to mammography affected participant satisfaction in the National Cancer Screening Program (NCSP). Data were derived from the Quality Evaluation of National Cancer Screening satisfaction survey. This population-based nationwide telephone survey included participants who had been screened by the NCSP for breast cancer between June and August 2010 (n=2,370), and collected information on satisfaction with screening and screening service use. Five multiple regression models were used to determine satisfaction according to screening method, and according to each of five satisfaction measures (pre-screening information transfer, staff interpersonal skills, physical surroundings, reporting of results and general satisfaction). A total of 1,858 (78.4%) participants were screened by mammography alone and 512 (21.6%) by both mammography and CBE. Satisfaction was significantly higher in subjects screened by both mammography and CBE compared with those screened by mammography alone.

• Health Policy and Management
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• v.19 no.1
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• pp.31-48
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• 2009

The objectives of this study were to evaluate the satisfaction of participants in the National Cancer Screening Program(NCSP) and to identify factors affecting the satisfaction. The telephone survey was conducted in July 2007 for the participants who were screened by the NCSP from January through May 2007. Student's t-tests and analysis of variance were performed first to determine if the mean satisfaction score differed by the characteristics of study objects, followed by multiple linear regression analyses to examine the factors affecting satisfaction. Dependent variable was general satisfaction for the screening service, and three dimensions of independent variables - 'sociodemographic characteristics', 'screening characteristics', and 'perceived service quality' - were used for the empirical analyses. Female, old-aged, less educated, Medicaid recipients, rural residents and the participants with normal results were more likely to be satisfied with the NCSP. The results of multiple regression analyses show that gender, age, location of residence, type of screening units, and perceived quality of screening services were significantly related to satisfaction. This study is meaningful as the first attempt to measure participant satisfaction with the NCSP, and to identify factors affecting the satisfaction. Among the identified factors, the NCSP needs to pay attention to perceived quality of service, in particular, to improve the satisfaction. This study is expected to contribute to raising the compliance rate and to improve the quality of the NCSP.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.731-736
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• 2012

Background and Aims: The National Cancer Screening Program (NCSP) for liver cancer was initiated in 2003 in Korea. The objective of this study was to evaluate the participation rate of the program and to provide preliminary information on its results based on data collected by the NCSP in 2009. Methods: The target population of the NCSP for liver cancer in 2009 was comprised of 373,590 adults aged ${\geq}40$ years at high risk for liver cancer. Participation rates and positivity rates were assessed in this population. Multivariate logistic regression analysis was performed to determine the factors associated with participation in the NCSP for liver cancer. Results: The overall participation rate was 37.9% and 1,126 participants were positive at screening. The highest participation rates were observed in women, those in their 60s, National Health Insurance beneficiaries, and individuals positive for hepatitis B surface antigen. Positivity rates for men, those in their 70s, Medical Aid Program recipients and individuals with liver cirrhosis were the highest in the respective categories of gender, age, health insurance type, and risk factor for liver cancer. Conclusions: The participation rates of the NCSP for liver cancer are still low, despite the fact that the program targets a high-risk group much smaller than the general population. Efforts to facilitate participation and to reduce disparities in liver cancer screening among Korean men and women are needed. These results provide essential data for evidence-based strategies for liver cancer control in Korea.