• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.569-573
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• 2016

Background: A colorectal cancer screening program was piloted in two districts of Kedah in 2013. There is scarcity of information on colorectal cancer screening in Malaysia. Objective: Thus, this research was conducted to evaluate the colorectal cancer screening program in the districts to provide insights intop its efficacy. Materials and Methods: A cross sectional study was conducted using data on the colorectal cancer screening program in 2013 involving Kota Setar and Kuala Muda districts in Malaysia. We determined the response rate of immunochemical fecal occult blood test (iFOBT), colonoscopy compliance, and detection rates of neoplasia and carcinoma. We also compared the response of FOBT by demographic background. Results: The response rate of FOBT for first iFOBT screening was 94.7% while the second iFOBT screening was 90.7%. Participants from Kuala Muda district were 27 times more likely to default while Indians had a 3 times higher risk of default compared to Malays. The colonoscopy compliance was suboptimal among those with positive iFOBT. The most common finding from colonoscopy was hemorrhoids, followed by tubular adenoma. Detection rate of carcinoma and neoplasia for our program was 1.2%. Conclusions: In summary, the response rate of iFOBT was encouraging but the colonoscopy compliance was suboptimal which led to a considerably low detection rate.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3271-3274
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• 2012

Purpose : This study was performed to assess whether the weight status is associated with screening rates of breast and cervical cancer in Korean women. Methods: Study participants included women aged between 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Body mass index was classified into ${\sim}18.4kg/m^2$ (underweight), $18.5{\sim}22.9kg/m^2$ (normal), $23{\sim}24.9kg/m^2$ (overweight), $25.0{\sim}29.9kg/m^2$ (moderate obesity) and $30.0kg/m^2$~ (severe obesity) according to the Asia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervical cancer were estimated by the recommendation of the National Cancer Screening Program of the National Cancer Center, Korea. Results : The overall screening rates for breast and cervical cancer were 51.3% and 50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidence interval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Conclusion: Obesity is associated with lower compliance with breast and cervical cancer screening guidelines in Korean women.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4313-4318
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• 2016

Background: This study documented the performance of providers of visual inspection with acetic acid (VIA) at primary health centers, assessing their compliance with the VIA skills checklist and determinants of non-compliance, and exploring their perceptions of VIA training sessions. Materials and Methods: A cross-sectional study was conducted among VIA providers in the $Mekn\grave{e}s$-Tafilalet region of Morocco. Structured observation of their performance was conducted through supervisory visits and multiple focus group discussions (FGDs). Results: Performance of all the recommended steps for effective communication was observed in a low proportion of procedures (36.4%). Midwives/nurses had higher compliance than general practitioners (GPs) (p<0.001). All recommended steps for VIA examination were performed for a high proportion of procedures (82.5%). Compliance was higher among midwives/nurses than among GPs (p<0.001) and among providers in rural areas than those in urban areas (p<0.001). For pre-VIA counselling, all recommended steps were performed for only 36.8% of procedures. For post-VIA counseling, all recommended steps were performed in a high proportion (85.5% for VIA-negative and 85.1% for VIA-positive women). Midwives/nurses had higher compliance than GPs when advising VIA-positive women (p=0.009). All infection prevention practices were followed for only 14.2% of procedures, and compliance was higher among providers in rural areas than those in urban areas (p<0.001). Most FGD participants were satisfied with the content of VIA training sessions. However, they suggested periodic refresher training and supportive supervision. Conclusions: Quality assurance of a cervical cancer screening program is a key element to ensure that the providers perform VIA correctly and confidently.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.51-61
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• 2016

Objectives : The purpose of this study was to find factors influencing compliance with the national cancer screening program in middle-aged men. Methods : The data were collected from July 28, to October 31, 2015. Total subjects were 615 middle-aged men living in Busan. Results : The Rate of compliance with the NCSP(National Cancer Screening Program) for middle-aged men was 52.2%. There were significant differences in the compliance with the NCSP for the following barrier of exam(${\chi}^2=7.327$, p=.007), self-efficacy(${\chi}^2=23.074$, p<.001), age(${\chi}^2=38.823$, p<.001), marital status(${\chi}^2=19.012$, p<.001), cancer diagnosis in family(${\chi}^2=7.615$, p=.006), smoking(${\chi}^2=9.012$, p=.011), drinking(${\chi}^2=7.073$, p=.008), exercise(${\chi}^2=14.615$, <.001). Factors influencing the rate of compliance for the NCSP in middle-aged men were self-efficacy, age, marital status, exercise, and cancer diagnosis in family. Conclusion: To increase the rate of compliance to the NCSP in middle-aged men it is necessary to elevate the self-efficacy. Additional more positive support needed in men who are younger have no cancer diagnosis in their family are smokers and not m married encourage and improvve paticipation in the examination.

• Women's Health Nursing
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• v.13 no.3
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• pp.157-164
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• 2007

Purpose: This study was done to determine the effect of nursing interventions on the knowledge of cervical cancer, and health beliefs, self efficacy and rate of rescreening compliance. Method: This was a nonequivalent control group pretest-posttest design. The subjects were 93 women who had experienced cervical cancer screening in S city and were randomly assigned to the experimental or control group. Intervention tools were a screening record pocket book, phone-coach. and watching a video(17mins). The data was collected from April to December, 2003 and analyzed using an $X^2-test$. t-test and ANCOVA. Results: The 1st hypothesis, "The Posttest know ledge score of the experimental group will be significantly higher than that of the control group" was supported(F=11.16, p= .001). The 2nd hypothesis, "The Posttest health belief score of the experimental group will be significantly higher than that of the control group" was not supported(F=3.38, p= .069). The 3rd hypothesis, "The Posttest self efficacy score of the experimental group will be significantly higher than that of the control group" was supported(F=4.36, p= .040). The 4th hypothesis, "The Rescreening compliance rate of the experimental group after the nursing intervention will be significantly higher than that of the control group" was supported($X^2=3.45$, p= .050). Conclusion: This nursing intervention was effective in increasing the knowledge of cervical cancer, and self efficacy percentage of rescreening compliance. Therefore I think this intervention can be used for promoting the rescreening compliance of women.

• Journal of Korean Biological Nursing Science
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• v.20 no.3
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• pp.169-176
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• 2018

Purpose: This study was performed to elucidate whether the obesity or body image is a barrier to breast screening compliance in Korean women. Methods: We included 54,017 women aged between 35 to 70 years from the Korea Community Health Survey (KCHS) 2014 dataset. To identify whether a mutual relationship exists between weight perceptions and breast cancer screening rates, the participants were divided into three groups according to the level of concordance between Body Mass Index (BMI) and a subjective body image. Descriptive analyses, a chi-square test, and multivariate logistic regression analyses were performed. Results: After covariate adjustment, the screening rate of the overweight group was 1.09 times higher than the normal weight group (odds ratio [OR], 1.09; confidence interval [CI], 0.00-0.16; p= .038) and the severe obesity group was 1.20 times lower (OR, 0.83; CI, -0.36-0.00; p= .047). Weight misperception also had a significant influence on breast cancer screening. Especially, The overweight distortion group was less likely to undergo breast cancer screening (OR, 0.93; CI, -0.15-0.00; p= .037). Conclusion: Obesity and weight misperceptions are associated with lower compliance with breast cancer screening guidelines.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1761-1766
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• 2012

Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5153-5157
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• 2016

Objective: The benefits of screening and early detection of breast cancer, including reduced morbidity and mortality, have been well-reported in the literature. In 2011, a breast cancer screening program was launched in Meknes-Tafilalt region of Morocco. The aim of this study was to evaluate the early performance indicators of this program. Materials and Methods: This retrospective evaluative study was conducted between April 2012 and December 2014, in Meknes-Tafilalt region of Morocco. Several performance indicators of the breast cancer screening program were calculated: the compliance rate, the positivity rate, the referral rate, the cancer detection rate and the organizational indicators. Results: During 2012-2014, a total of 184,951 women participated in the breast cancer screening program. The compliance rate was 26%, the positive rate was 3.3%, the referral rate was 36.7%, and the cancer detection rate was 1.2 per 1,000 women. The median time between the date of clinical breast examination and the date of biopsy (or cyto-puncture) was 36 days. The median time between the date of positive mammography and the date of biopsy (or cyto-puncture) was 6 days. The median time between the date of clinical breast examination and the date of the first received treatment was 61 days. Conclusions: The program needs better monitoring, as well as implementation of quality assurance tools to improve performance in our country.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3281-3288
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• 2013

Background: Breast cancer is the leading cause of cancer-related deaths in women. Despite being associated with high morbidity and mortality, breast cancer is a disease that can be diagnosed and treated early. Materials and Methods: In this cross-sectional study of 321 women, data were collected by Questionnaire, Breast Cancer Risk Assessment Form and Champion's Health Belief Model Scale. Mann-Whitney U, Kruskal-Wallis, Chisquared tests and logistic regression were used in the statistical analysis. Results: It was found that only 2.2% of women have high and very high risk levels of breast cancer risk. There is a positive correlation between early diagnosis techniques and Health Belief Model Sub-Dimension scores which are sensibility, health motivation, BSE (Breast self-examination) self-efficient perception and negative correlation between mammography barrier score and BSE barrier score (p 0.05). When factors for not having BSE were examined, it was determined that the women who do not have information about breast cancer and the women who smoke have a higher risk of not having BSE. Conclusions: It is important to determine health beliefs and breast cancer risk levels of women to increase the frequency of early diagnosis. Women's health beliefs are thought to be a good guide for planning health education programs for nurses working in this area.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2549-2554
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• 2016

Background: Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. Materials and Methods: A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. Results: The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Conclusions: Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other important factors that would improve the acceptance and compliance for mammography screening programs.