• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3383-3389
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• 2014

Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

• 한국보건간호학회지
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• 제19권2호
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• pp.229-240
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• 2005

Purpose: To evaluate every step of the cancer screening program. Method: 146 of 233 health centers participated in this study. Data were collected by mailing questionnaires between December 2002 and January 2003. The response rate was 65.5%. Result: The government cancer screening program was directed by a variety of departments of the health centers. 41.1% of persons in charges were nurses. 41.3% of the health centers received a list of the appropriate person from the National Health Insurance Cooperation within one or two months. 26.1% of health centers received ??? after five month from when the program started. All the health centers advertised their services, and most of them used mail and mass media 56.4%, used other institute's materials, and 72.2% of them used the government's materials. 76.7% of the heath centers recommended secondary health screening to the persons who had positive results at the first screening. 71.6% of the health centers ascertained the patients with cancer who were diagnosed at secondary screenings. 67.9% of the health centers had registered home-based cancer patients at the health center. 137 out of 146 health centers had a local institute for cancer screening; an average of 4.9 institutes had cancer screening. 80.1% of the persons in charge of the programs felt they needed this program, but 80.8% of them thought the program should be modified. Conclusion: Organized and standardized programs are needed to promote the efficiency of National Cancer Screening Program.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6459-6463
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• 2013

We investigated the cancer screening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri) using data from the Korean National Cancer Screening Survey (KNCSS), which is a nationwide, annual cross-sectional survey. The eligible study population included cancer-free men 40 years of age and older and women 30 years of age and older. The lifetime screening rate and screening rate with recommendation were calculated. The lifetime screening rates for gastric, liver, colorectal, breast, and cervical cancers were 77.9%, 69.9%, 65.8%, 82.9%, and 77.1%, respectively. The screening rates with recommendation were 70.9%, 21.5%, 44.7%, 70.9%, and 67.9%, respectively. The most common reason for all types of cancer was "no symptoms", followed by "lack of time" and "fear of the examination procedure". Efforts to facilitate participation in liver and colorectal cancer screening among Korean men and women are needed.

• 보건행정학회지
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• 제26권4호
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• pp.382-389
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• 2016

Background: National cancer screening reduces mortality from stomach, colon, breast, and cervical cancer. However, cancer screening rates remain lower than 50% in Korea. This research was designed to make effective guidelines for cancer screening promotion to increase participation rate in cancer screening. Methods: Data was collected from Incheon regional cancer center's telephone survey 'Recognition of cancer prevention and control' of 861 Incheon citizens over age 40. Logistic regression was used to analyse a relationships between cancer screening rates and promotional methods. PASW SPSS ver. 18.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Results: About 27.4% of respondents (236 of 861 respondents) have recognized the promotional program of Incheon regional cancer center for cancer screening participation. Cancer screening rate was associated with age group, educational level for stomach cancer, age group, bus advertisement (odds ratio, 1.19 to 2.75) for colon cancer, educational level, residential area for breast cancer, and age group for cervical cancer. Conclusion: There was relationship between stomach cancer screening rates and promotional methods. Therefore, cancer screening promotion guidelines to increase participation rate should be considered.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.264-272
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• 2022

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted cancer screening services worldwide. We aimed to measure the impact of COVID-19 on gastric cancer screening rates based on age, sex, household income, and residential area. Materials and Methods: We analyzed data from the Korean National Cancer Screening Survey from 2017 to 2021 for adults aged 40-74 years. We evaluated the gastric cancer screening rate within two years in accordance with the National Cancer Screening Program protocol recommendations and that within the previous year. We compared the trends in the pre- and post-COVID-19 outbreak periods. Results: Before the COVID-19 outbreak, there was little change in the gastric cancer screening rates until 2019. After the COVID-19 outbreak, the screening rate as per recommendation decreased from 70.8% in 2019 to 68.9% in 2020 and that for one year decreased from 32.7% in 2019 to 27.2% in 2020. However, as the COVID-19 pandemic continued after 2020, both gastric cancer screening rates as per recommendations and for one year rebounded. Although a similar trend was observed for the upper endoscopy screening rate, the upper gastrointestinal series screening rate decreased from 7.8% in 2020 to 3.1% in 2021. During the pandemic, the screening rate decreased among younger adults (40-49), those residing in metropolitan regions, and those with high incomes. Conclusions: Despite a decline in gastric cancer screening rate during the COVID-19 pandemic, the rate surged in 2021. Further studies are needed to estimate the impact of cancer screening delays on future cancer-related mortalities.

• Journal of Preventive Medicine and Public Health
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• 제38권1호
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• pp.93-100
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• 2005

Background : Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the Ten year Plan for Cancer Control was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. Methods : To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. Results : The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. Conclusions : The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.

• Yonsei Medical Journal
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• 제59권9호
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• pp.1034-1040
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• 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
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• 제14권3호
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• pp.2059-2065
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• 2013

This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3279-3286
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• 2014

Background: Cancer is one of the leading causes of death in Korea. To reduce cancer incidence, the Korean National Cancer Center (KNCC) has been expanding its organized cancer screening program. In addition, there are opportunistic screening programs that can be chosen by individuals or their healthcare providers. The purpose of this study was to investigate factors associated with participation in organized and opportunistic cancer screening programs, with a particular focus on socioeconomic factors. Materials and Methods: We used data from the Korea National Health and Nutrition Examination Survey (KNHANES), a cross-sectional nationwide study conducted by the Korean Ministry of Health and Welfare from 2007 to 2011. The study included information from 9,708 men and 12,739 women aged 19 years or over. Multinomial logistic regression analysis was conducted, adjusting for age, year of data collection, residential region, current smoking status, current alcohol consumption status, exercise, marriage status, job status, perceived health status, stress level, BMI, limitation of activities, cancer history, health insurance type, and private insurance status, to investigate the association between education level, economic status, and cancer screening participation. Results: In terms of education level, disparities in attendance were observed only for the opportunistic screening program. In contrast, there was no association between education level and participation in organized screening. In terms of economic status, disparities in opportunistic screening participation were observed at all income levels, but disparities in organized screening participation were observed only at the highest income level. Conclusions: Our findings reveal that socioeconomic factors, including educational level and economic status, were not significantly associated with participation in organized cancer screening, except at the highest level of income.

• 농촌의학ㆍ지역보건
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• 제34권2호
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• pp.214-222
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• 2009

이 연구는 중장년층 여성의 유방암과 자궁경부암 검진을 위한 지식, 인지된 자기효능감, 의사소통 기술을 향상시키기 위하여 디자인된 암 검진네비게이터 교육의 효과를 평가하기 위해 수행되었다. 암 검진 네비게이터는 건강에 대한 조언을 해주는 이웃으로 지역사회에서 필요한 정보를 제공하고 암 검진에 관한 정서적 지지를 해준다. 연구 대상자는 12시간의 교육을 받은 40-69세의 여성 33명과 대조군 30명이며, 자료 분석은 SPSS 14.0을 이용하여 기술 분석과 paired t-test를 실시하였다. 교육내용은 암 조기검진을 통한 조기치료 성공사례, 유방암 및 자궁경부암 조기검진의 이점, 암 검진을 위한 보건의료 서비스, 암 조기검진 지도자의 역할, 의사소통 기술, 변화단계 이론 및 역할극으로 구성되었다. 본 연구에서 개발된 암 검진 네비게이터 교육 프로그램은 지역사회 자원을 활용하여 암수검률을 향상시키고자 하였고, 지역사회 주민의 암에 관한 지식과 의사소통 기술을 증진시키는데 효과가 있었다. 이는 지역사회 주민의 암 조기검진 수검률 향상을 위해 암 검진 네비게이터를 지속적으로 육성해야 함을 시사한다. 또한 유방암과 자궁경부암에 대한 조기검진 수검률이 낮은 것은 암에 대한 지식수준이 낮고 암 발생의 심각성, 암 검진의 편익에 대한 이해가 부족하므로 더 많은 홍보의 필요성을 시사하며 암 검진 네비게이터의 지속적인 활동이 이와 같은 문제를 해결하는데 일익을 담당할 것으로 사료된다. 따라서 암으로 인한 사망률 감소를 위해서는 암 검진 수검률을 향상시켜야 하며 이를 위해서는 본 연구에서 개발된 암검진 네비게이터 교육 프로그램의 지속적인 확대와 평가가 이루어져야 한다. 이상의 결과를 바탕으로 다음과 같이 제언하는 바이다. 첫째, 본 연구 결과를 타 지역사회에 적용해 보는 반복 연구와, 둘째, 지역적, 문화적 특성 및 암종별 특성을 고려한 교육으로 암 검진 네비게이터 프로그램을 수정 보완한 연구를 제언한다.