Screening for Gastric Cancer: The Usefulness of Endoscopy

최귀선,서민아 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.6

Gastric cancer screening is common in countries with high prevalence rates of gastric cancer. However, data supporting the effectiveness of gastric cancer screening are lacking. Thus, the aim of this review was to examine the current evidence on gastric cancer screening. Herein, we reviewed radiographic and endoscopic tests as methods of gastric cancer screening. Previous cohort studies and case-control studies have demonstrated reduced gastric cancer mortality in study populations that had undergone gastric cancer screening with radiographic tests. Recently, a case-control study in Japan reported a 30% reduction in gastric cancer mortality when screening was undertaken via endoscopy. Also, endoscopic screening for gastric cancer exhibited higher sensitivity and specificity than radiographic screening. Moreover, most cost-effectiveness analyses on the best strategy for detecting early gastric cancer have generally concluded that endoscopy is more cost-effective than radiographic testing. Although data on the impact of endoscopy screening programs on gastric cancer mortality are limited, recent study results suggest that gastric cancer screening by endoscopy in average-risk populations performs better than radiography screening. Further evaluation of the impact of these screening methods should take into account cost and any associated reduction in gastric cancer mortality.

Oncologists Experience with Second Primary Cancer Screening: Current Practices and Barriers and Potential Solutions

Shin, Dong-Wook,Kim, Yeol,Baek, Young-Ji,Mo, Ha-Na,Choi, Jin-Young,Cho, Ju-Hee Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.2

Objectives: Screening for second primary cancer (SPC) is one of the key components of cancer survivorship care. The aim of the present study was to explore oncologists' experience with promoting second primary cancer screening. Methods: Two focus group interviews were conducted with 12 oncologists of diverse backgrounds. Recurrent issues were identified and placed into thematic categories. Results: Most of the oncologists did not consider SPC screening promotion as their responsibility and did not cover it in routine care. All of the study participants had experience with unexpected SPC cases, and they were under emotional tress. There was no systematic manner of providing SPC screening. Oncologists usually prescribe SPC screening in response to patients' requests, and there was no active promotion of SPC screening. Short consultation time, limited knowledge about cancer screening, no established guideline for SPC screening, and disagreement with patients about oncologists' roles were major barriers to its promotion. An institution-based shared care model was suggested as a potential solution for promoting SPC screening given current oncology practices in Korea. Conclusion: Oncologists could not effectively deal with the occurrence of SPC, and they were not actively promoting SPC screening. Lack of knowledge, limited health care resources, and no established guidelines were major barriers for promoting SPC screening to cancer survivors. More active involvement of oncologists and a systematic approach such as shared-care models would be necessary for promoting SPC screening considering increasing number of cancer survivors who are vulnerable.

Why Screening Rates Vary between Korea and Japan-Differences between Two National Healthcare Systems

Goto, Rei,Hamashima, Chisato,Mun, Sunghyun,Lee, Won-Chul Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.2

Both Japan and Korea provide population-based screening programs. However, screening rates are much higher in Korea than in Japan. To clarify the possible factors explaining the differences between these two countries, we analyzed the current status of the cancer screening and background healthcare systems. Population-based cancer screening in Korea is coordinated well with social health insurance under a unified insurer system. In Japan, there are over 3,000 insurers and coordinating a comprehensive strategy for cancer screening promotion has been very difficult. The public healthcare system also has influence over cancer screening. In Korea, public healthcare does not cover a wide range of services. Almost free cancer screening and subsidization for medical cost for cancers detected in population-screening provides high incentive to participation. In Japan, on the other hand, a larger coverage of medical services, low co-payment, and a lenient medical audit enables people to have cancer screening under public health insurance as well as the broad range of cancer screening. The implementation of evidence-based cancer screening programs may be largely dependent on the background healthcare system. It is important to understand the impacts of each healthcare system as a whole and to match the characteristics of a particular health system when designing an efficient cancer screening system.

Breast Screening and Breast Cancer Survival in Aboriginal and Torres Strait Islander Women of Australia

Roder, David,Webster, Fleur,Zorbas, Helen,Sinclair, Sue Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.1

Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. Results: After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing; were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment; had an elevated ductal carcinoma in situ but not invasive cancer detection rate; had larger breast cancers; and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Conclusions: Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.

암 검진 수검에 영향을 주는 요인

곽민선,박은철,방진영,성나영,이지영,최귀선,Kwak, Min-Son,Park, Eun-Chul,Bang, Jin-Young,Sung, Na-Young,Lee, Ji-Young,Choi, Kui-Son 대한예방의학회 2005 Journal of Preventive Medicine and Public Health Vol.38 No.4

Objectives : We wanted to identify those factors associated with stomach, colon, breast and cervix cancer screening. Methods : A population-based telephone survey was conducted for 2 weeks (the 9th-23th of July, 2004) by trained interviewers with using a questionnaire. 2,598 respondents (females aged 30 years or over, and the males aged 40 years or over) were selected by random-digit dialing that was based on the 2000 Population and Housing Census. The data on socio-demographic, health behavior and enabling factors were collected. 2,571 respondents were included in analysis. The cancer screening rate was classified into 2 categories : the life time screening rate and the screening rate with recommendations. Results : For the 2,571 respondent s, the life time screening rate was as follows: 52.0% (Stomach), 25.3% (Colon), 55.9% (Breast) and 76.8% (Cervix). The screening rate with recommendation was as follows : 3 9.2% (Stomach), 20.6% (Colon), 42.5% (Breast) and 58.3% (Cervix). On a multiple logistic regression analysis of the life time screening, statistically significant relationships were observed for the screening intention, the health exam, the disease history, the age of the patients and the cancer screening rates. On a multiple logistic regression analysis of the screening with recommendation, statistically significant relationships were observed for the screening intention, the health exam, the age of the patients, the concern about the risk of cancer, the voluntary health insurance for cancer and the cancer screening rates. Conclusions : The results of this study suggest that the cancer screening intention, the health exam and the age of the patients are the most important factors to participate in life time cancer screening and also screening with recommendations. A positive association was also observed for the concern about the risk of cancer, the voluntary health insurance for cancer. It is hoped that this study will be a base line data for suggesting the representative cancer screening rate in Korea.

Cervical screening among Chinese females in the era of HPV vaccination: a population-based survey on screening uptake and regular screening following an 18-year organized screening program

Horace CW Choi,Kathy Leung,Joseph T Wu 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.2

Objective: China has a substantial disease burden of cer vical cancer. To further understandpreventive measures for reducing cer vical cancer in China, this study aimed to correlatescreening attendance and regular screening with human papillomavirus (HPV) vaccinationamong Chinese females. Methods: This prospective questionnaire-based sur vey recruited Chinese females aged 25or above in Hong Kong by random digit dialing telephone inter views in 2022. The sur veystudied women’s practice of cer vical screening and adherence to regular screening. Variablesincluding HPV vaccination status and attendance of physical check-ups were involved inthe questionnaire. Screening uptake and screening adherence were the main outcomes,which were measured as the proportion of women who reported having attended a cer vicalscreening and screened regularly, respectively. Results: Out of 906 valid respondents, the reported cer vical screening uptake was over70% among females aged 30 or above and particularly over 80% among women aged 35–59;however, the uptake was only 46% among those aged 25–29. Adherence to regular screeningwas 50%–60% across ages 25–59 years and dropped to approximately 40% for women olderthan 60 years. Both screening uptake and adherence were associated with HPV vaccination,with adjusted odds ratios of 2.37 and 2.23, respectively. A large proportion of regularlyscreened women may be overscreened for screening more frequently than recommended. Conclusion: Responded Chinese females showed good cer vical screening uptake but weremoderately adherent to regular screening. Policymakers should emphasize the importance ofregular screening and the recommended screening frequency by HPV vaccination status forbetter healthcare resource use.

Cancer Screening Knowledge and Attitudes of Under- and Post-Graduate Students at Kasr Al Ainy School of Medicine, Cairo University, Egypt

Sedrak, Amal Samir,Galal, Yasmine Samir,Amin, Tarek Tawfik Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.8

Background: Increasing knowledge and awareness of cancer screening significantly influence health promotion behavior which could markedly reduce incidence rates. In many countries, health care providers are the principal source of information concerning cancer screening. This study was carried out to assess the level of knowledge concerning cancer screening among medical students, house officers and residents and to explore their attitude towards cancer screening practices. Materials and Methods: This cross-sectional study was conducted in Kasr Al Ainy Medical School at Cairo University in Egypt, with 300 undergraduate medical students and 150 postgraduates (interns and residents) enrolled. A pre-tested self-administered questionnaire was used to collect data from the study participants regarding personal and education-related information, knowledge about cancer screening and its sources, and attitude towards cancer screening. Results: More than 64% of participants had knowledge scores of ${\leq}10$ points (out of 24). The total knowledge score (out of 6 points) for breast cancer screening increased from $1.9{\pm}1.0$ to $2.3{\pm}1.2$ and $2.4{\pm}1.1$ for $4^{th}$, $5^{th}$ and $6^{th}$ year respectively, interns showed the highest score of $2.6{\pm}1.1$, P= 0.001. Year of enrollment at medical school was a significant positive predictor of acquiring knowledge about cancer screening (post graduate vs. undergraduate students) (OR= 1.30, C.I =1.01-1.63), lack of or none receiving of orientation/training about cancer screening was the sole negative significant predictor for proper knowledge about cancer screening (OR=0.50, C.I=0.31-0.82). Over 92% of students agreed that they had insufficient knowledge about cancer screening, 88.2% appraised the need to have enough knowledge in order to direct/advice patients, relatives and friends, and 93.7% required that the faculty should emphasize the importance of cancer screening in the delivered curricula at medical school. Conclusions: A relatively low to moderate level of knowledge about cancer screening was detected among the selected medical students regardless of their year of enrollment at medical school or their graduation status, which may implicate a negative impact on early cancer detection especially in a low resource country like Egypt.

Health Beliefs Associated with Cancer Screening Intentions in Korean Workers

Park, Kyoung-Ok,Kang, Jina Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7

Background: Cancer is a leading cause of death in Korea. To prevent cancer, it is essential to facilitate and promote appropriate cancer screening behavior in the adult population. The aim of this study was to examine health beliefs related to cancer screening intentions using the Health Belief Model (HBM). Materials and Methods: The research participants comprised 275 male health and safety managers at commercial companies in Korea. The self-administered survey explored demographic characteristics, cancer-related factors, beliefs about cancer/cancer screening (BCCS) (vulnerability to cancer, severity of cancer, benefits of screening, and barriers to screening), and cancer screening intention. Multivariate logistic regression analyses were used to identify factors associated with an intention to be screened for cancer. Results: Perceived health status and need for cancer prevention education were major factors associated with BCCS. Poorer health status was associated with greater perceived vulnerability, a perception of fewer benefits, and more barriers (p<0.05). A perceived greater need for cancer prevention education was associated with a higher perceived severity of cancer and more perceived barriers to screening (p<0.05). Marital status, cancer screening experience, and perceived vulnerability to cancer were significant influences on the cancer screening intention (p<0.05). Participants who had undergone cancer screening in the past 2 years were more likely to intend to be screened for cancer than were those who had not been screened; this was true across all degrees of intention and all types of cancer (p<0.01). Hesitant people considered themselves less vulnerable to gastric, lung, and liver cancer than did the poeple who intended to undergo cancer screening (p<0.05). Conclusions: Based on our findings, we recommend that workplace cancer prevention programs attempt to increase awareness about vulnerability to cancer among workers who hesitate to undergo cancer screening.

Strategies to Improve Smoking Cessation for Participants in Lung Cancer Screening Program: Analysis of Factors Associated with Smoking Cessation in Korean Lung Cancer Screening Project (K-LUCAS)

김열,이재호,이은주,임준태,김용현,이춘택,장승훈,백유진,이원철,이찬화,김혜영,구진모,최귀선,박보영,이덕형,서홍관 대한암학회 2024 Cancer Research and Treatment Vol.56 No.1

Purpose Smoking cessation intervention is one of the key components of successful lung cancer screening program. We investigated the effectiveness and related factors of smoking cessation services provided to the participants in a population-based lung cancer screening trial. Materials and Methods The Korean Lung Cancer Screening Project (K-LUCAS) is a nationwide, multi-center lung cancer screening trial that evaluates the feasibility of implementing population-based lung cancer screening. All 5,144 current smokers who participated in the K-LUCAS received a mandatory smoking cessation counseling. Changes in smoking status were followed up using a telephone survey in 6 months after lung cancer screening participation. The lung cancer screening’s impact on smoking cessation is analyzed by variations in the smoking cessation interventions provided in screening units. Results Among 4,136 survey responders, participant’s motivation to quit smoking increased by 9.4% on average after lung cancer screening. After 6 months from the initial screening, 24.3% of participants stopped smoking, and 10.6% of participants had not smoked continuously for at least 6 months after screening. Over 80% of quitters stated that participation in lung cancer screening motivated them to quit smoking. Low-cost public smoking cessation program combined with lung cancer screening increased the abstinence rates. The smokers were three times more likely to quit smoking when the smoking cessation counseling was provided simultaneously with low-dose computed tomography screening results than when provided separately. Conclusion A mandatory smoking cessation intervention integrated with screening result counselling by a physician after participation in lung cancer screening could be effective for increasing smoking cessation attempts.

지역사회 여성 주민의 건강보험제도를 활용한 건강검진 및 암검사 수검 특성

김영복,이원철,노운녕,조선진,백희정,손혜현,이순영,맹광호 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1

This study, performed to analyze the factors associated with health and cancer screening using preventive programs from health insurance among the women of a community, through a survey of about 923 women in Euijungbu-city. The subjects of the study were selected by a proportional cluster sampling method. The self-reported questionnaire was intended to find factors associated with health screening and cancer screening. The results of this study were as follows: 1. In the case of health screening using health insurance, 14.1% of the subjects turned out to have been screened once or more in their respective life-time. Reasons given for non-participation in the screening were : 'lacking screening information', a belief that'it's not useful' and a belief that they' weren't sick'. 2. The factors associated with health screening behavior were age, educational level, number of doctor visits, BMI and health promotion behavior(p<01, p<05). Also, the factor associated with health screening behavior were cue to action and health status, and the predictors on health screening behavior were age and health promotion behavior(p<01, p<05). 3. In the case of cancer screening through the health insurance, 7.4% of the subjects turned out to have been screened once or more respectively in their life-times. Reasons given for non-participation in the screening were : 'lacking screening information',a belief they 'weren't sick' and that' it's not useful'. 4. The factors associated with cancer screening behavior were age, educational level, income, alcholol intake, excercise, number of doctor visits and BMI(p<01, p<05). Aditional factors associated with cancer screening behavior were cue to action, health belief score and health status. Predictors for cancer screening behavior were: age, health belief score, screening attitude and health status(p<01,p<05). As indicated by the above results, a lack of information was an important factor for a lack of participation in screening. Age and cue to action were also important factors in promoting the cancer screening rate. Therefore, a dissemination of information about cancer screening contributes to the promotion of a screening rate, and cooperation between health insurance and local health center facilitates to be public the community-based cancer screening program.