Cancer Research and Treatment

Original Articles

A Machine Learning Risk Prediction Model for Gastric Cancer with SHapley Additive exPlanations: Bomi Park, Chung Ho Kim, Jae Kwan Jun, Mina Suh, Kui Son Choi, Il Ju Choi, Hyun Jin Oh; Received August 29, 2024 Accepted December 15, 2024 Published online December 16, 2024; DOI: https://doi.org/10.4143/crt.2024.843 [Accepted]

Abstract PDF: Purpose
Gastric cancer (GC) prediction models hold potential for enhancing early detection by enabling the identification of high-risk individuals, facilitating personalized risk-based screening, and optimizing the allocation of healthcare resources.
Materials and Methods
In this study, we developed a machine learning-based GC prediction model utilizing data from the Korean National Health Insurance Service, encompassing 10,515,949 adults who had not been diagnosed with GC and underwent GC screening during 2013–2014, with a follow-up period of at least five years. The cohort was divided into training and test datasets at an 8:2 ratio, and class imbalance was mitigated through random oversampling.
Results
Among various models, logistic regression demonstrated the highest predictive performance, with an area under the receiver operating characteristic curve (AUC) of 0.708, which was consistent with the AUC obtained in external validation (0.669). Importantly, the outcomes were robust to missing data imputation and variable selection. The SHapley Additive exPlanations (SHAP) algorithm enhanced the explainability of the model, identifying advancing age, being male, Helicobacter pylori infection, current smoking, and a family history of GC as key predictors of elevated risk.
Conclusion
This predictive model could significantly contribute to the early identification of individuals at elevated risk for gastric cancer, thereby enabling the implementation of targeted preventive strategies. Furthermore, the integration of noninvasive and cost-effective predictors enhances the clinical utility of the model, supporting its potential application in routine healthcare settings.

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Determinants of Prostate Cancer Screening in Korean Men: A Nationwide Study Using the Korean National Cancer Screening Survey 2023: Giap Viet Nguyen, Kyeongmin Lee, Hyeon Ji Lee, EunKyo Kang, Mina Suh, Jae Kwan Jun, Kui Son Choi; Received September 8, 2024 Accepted October 28, 2024 Published online October 29, 2024; DOI: https://doi.org/10.4143/crt.2024.879 [Accepted]

Abstract PDF: Purpose
Research on the prevalence of prostate cancer (PCa) screening and reasons for undergoing screening is limited. We aimed to identify the factors influencing PCa screening behavior and explore the underlying motivations among Korean men.
Materials and Methods
This cross-sectional study used data from the 2023 Korean National Cancer Screening Survey, which employs a nationally representative random sampling method. This study included 1,784 men aged 40-74 years. The respondents reported their experiences with PCa screening. Multivariable logistic regression analysis was conducted to identify the factors associated with participation in PCa screening.
Results
The lifetime PCa screening rate was 18.6%. Among screening modalities, transrectal ultrasonography was the most frequently used (31.9%), followed by prostate-specific antigen tests (25.6%) and digital rectal examinations (21.5%). The multivariable analysis identified several factors that significantly increased the likelihood of screening participation, including older age, living with a spouse, poor self-reported health, and abstinence from alcohol consumption in the previous 12 months. Men who had undergone colorectal cancer screening were more likely to participate in PCa screening (adjusted odds ratio, 4.01; 95% confidence interval, 2.03–7.93) than those who had not. The primary motivations for screening were recommendations from family or social networks (31.9%) and inclusion in health examination packages (24.3%), whereas healthcare provider recommendations (18%) and symptomatic concerns (5.7%) were the least influential.
Conclusion
Our findings highlight the importance of providing evidence-based information for PCa screening recommendations and the need for improved communication and implementation of a shared decision-making approach for PCa screening in Korea.

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Special Article

Trends in Cancer-Screening Rates in Korea: Findings from the National Cancer Screening Survey, 2004-2023: EunKyo Kang, Kui Son Choi, Jae Kwan Jun, Yeol Kim, Hyeon Ji Lee, Chang Kyun Choi, Tae Hee Kim, Sun Hwa Lee, Mina Suh; Cancer Res Treat. 2025;57(1):28-38. Published online August 2, 2024; DOI: https://doi.org/10.4143/crt.2024.325

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to report the overall national trends in the rates of cancer screening based on recommendations and provide insights into the changing trends of these rates across different demographics.
Materials and Methods
This study used data from the Korean National Cancer Screening Survey (KNCSS), which surveys nationwide cancer-screening rates and includes 4,500 individuals meeting the Korean National Cancer Screening Program (NCSP) protocol age criteria. Cancer-screening rates were assessed using structured questionnaires; yearly trends were analyzed for both lifetime cancer-screening rates and rates of screening based on recommendations, and subgroup analyses were performed based on age and sex.
Results
The rates of cancer screening based on recommendations showed significant increments: the stomach cancer-screening rate increased from 39.2% in 2004 to 77.5% in 2023 (3.50% per year), the liver cancer-screening rate increased from 20.0% to 48.8% (4.30% per year), and the colorectal cancer, increased from 19.9% to 70.7% (5.15% per year). The breast cancer-screening rate increased from 33.2% to 72.7% (2.88% per year), and the cervical cancer, increased from 58.3% to 70.2% (1.08% per year). Despite some differences, particularly in relation to sociodemographic factors, screening rates increased significantly for all cancer types.
Conclusion
Cancer-screening rates in Korea increased consistently from 2004 to 2023, demonstrating the effectiveness of the national cancer-screening program. However, the increments in breast, cervical and lung cancer-screening rates were relatively lower, indicating the need for additional efforts and strategies.

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Original Articles

Gastrointestinal cancer

Association between Endoscopist Volume and Interval Cancers after Colonoscopy: Results from the National Colorectal Cancer Screening Program in Korea: Dong Jun Kim, Nan-He Yoon, Jae Kwan Jun, Mina Suh, Sunhwa Lee, Seongju Kim, Ji Eun Kim, Hooyeon Lee; Cancer Res Treat. 2024;56(4):1164-1170. Published online April 16, 2024; DOI: https://doi.org/10.4143/crt.2024.009

Abstract PDF Supplementary Material PubReader ePub: Purpose
The rate of interval colorectal cancer (iCRC) is now accepted as a key performance indicator of organized colorectal cancer (CRC) screening programs. We aimed to examine the association between endoscopist volumes and the rate of iCRC among individuals with a positive fecal immunochemical test (FIT) within a nationwide population-based CRC screening program.
Materials and Methods
Individuals aged ≥ 50 years who underwent colonoscopy after a positive FIT from January 1, 2019 until December 31, 2020 in the Korean National Cancer Screening Program (KNCSP) were enrolled. We converted the data into per-endoscopist screening results, calculated the iCRC rates per endoscopist, and compared them to the previous year’s annual volume that was divided into five groups (V1, 1-9; V2, 10-29; V3, 30-59; V4, 60-119; V5, ≥ 120).
Results
A total of 10,412 endoscopists performed 216,907 colonoscopies. Overall, the average rate of iCRC per endoscopist was 8.46 per 1,000 examinations. Compared with the group with the highest volume (V5 group), the rate of iCRC was 2.21 times higher in the V1 group. Similar trends were observed in the other groups (V2: relative risks [RR], 2.15; 95% confidence interval [CI], 1.57 to 2.94; V3: RR, 1.56; 95% CI, 1.15 to 2.13; V4: RR, 1.18; 95% CI, 0.83 to 1.67).
Conclusion
The findings emphasize that endoscopists with lower procedure volumes have higher risks of interval cancer being missed or undetected. To maximize the preventative impact of colonoscopy for CRC, this issue should be addressed by monitoring endoscopist volumes and variations in performances.

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Overview of the National Cancer Screening Program for Colorectal Cancer in Korea over 14 Years (2004-2017): Bomi Park, Eun Young Her, Kyeongmin Lee, Fatima Nari, Jae Kwan Jun, Kui Son Choi, Mina Suh; Cancer Res Treat. 2023;55(3):910-917. Published online March 8, 2023; DOI: https://doi.org/10.4143/crt.2022.1432

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the participation and follow-up test compliance rates and key performance indicators of the National Cancer Screening Program (NCSP) for colorectal cancer (CRC) from 2004 to 2017.
Materials and Methods
The overall outcomes of the NCSP for CRC were analyzed using the NCSP data collected from 2004 to 2017 and the Korean Central Cancer Registry for CRC from 2005 to 2017. We cross-sectionally analyzed the participation and follow-up test compliance rates and performance indicators for each year. The trend of participation rates as an annual percentage change was assessed, and other statistical analyses were performed.
Results
The screening participation rates increased from 7.3% in 2004 to 30.5% in 2017. Additionally, the screening rates were higher among individuals aged 60-69 years and National Health Insurance Service beneficiaries of low-income status. However, the adherence to the follow-up test decreased from 63% in 2004 to 32% in 2017. The follow-up tests using the double-contrast barium enema method decreased from 42.2% in 2004 to 0.3% in 2017. However, follow-up tests by colonoscopy increased from 21.0% in 2004 to 31.8% in 2017. Furthermore, the positivity, false-positive, and interval CRC rates decreased, whereas the specificity increased from 2004 to 2016, indicating improved performance of CRC.
Conclusion
The participation rates and performance of the NCSP for CRC have steadily improved, whereas adherence to follow-up tests has decreased. Additionally, there is a rapid growth in colonoscopy volume as a follow-up test. Continued efforts are required to improve the follow-up rates.

Citations

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Trends in Cancer-Screening Rates in Korea: Findings from the National Cancer Screening Survey, 2004-2023
EunKyo Kang, Kui Son Choi, Jae Kwan Jun, Yeol Kim, Hyeon Ji Lee, Chang Kyun Choi, Tae Hee Kim, Sun Hwa Lee, Mina Suh
Cancer Research and Treatment.2025; 57(1): 28. CrossRef
Serum bilirubin levels and risk of colorectal cancer in Korean adults: results from the Korean Genome and Epidemiology Study-Health Examinee (KoGES-HEXA) Cohort Study
Hwayoung Noh, Jeeyoo Lee, Nazlisadat Seyed Khoei, Laia Peruchet-Noray, Daehee Kang, Beatrice Fervers, Karl-Heinz Wagner, Aesun Shin, Heinz Freisling
British Journal of Cancer.2024; 131(10): 1635. CrossRef
Association between Endoscopist Volume and Interval Cancers after Colonoscopy: Results from the National Colorectal Cancer Screening Program in Korea
Dong Jun Kim, Nan-He Yoon, Jae Kwan Jun, Mina Suh, Sunhwa Lee, Seongju Kim, Ji Eun Kim, Hooyeon Lee
Cancer Research and Treatment.2024; 56(4): 1164. CrossRef
Effectiveness of the Korean National Cancer Screening Program in Reducing Colorectal Cancer Mortality
Hyeon Ji Lee, Kyeongmin Lee, Byung Chang Kim, Jae Kwan Jun, Kui Son Choi, Mina Suh
Cancers.2024; 16(24): 4278. CrossRef
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BMJ Open.2024; 14(12): e084628. CrossRef
National cancer screening program for colorectal cancer in Korea
Seung Min Baik, Ryung-Ah Lee
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Breast cancer

Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women: Eunji Choi, Mina Suh, So-Youn Jung, Kyu-Won Jung, Sohee Park, Jae Kwan Jun, Kui Son Choi; Cancer Res Treat. 2023;55(1):136-144. Published online April 4, 2022; DOI: https://doi.org/10.4143/crt.2021.962

Abstract PDF PubReader ePub

Purpose
High breast cancer incidence and dense breast prevalence among women in forties are specific to Asian. This study examined the natural history of breast cancer among Korean women.
Materials and Methods
We applied a three-state Markov model (i.e., healthy, preclinical, and clinical state) to fit the natural history of breast cancer to data in the Korean National Cancer Screening Program. Breast cancer was ascertained by linkage to the Korean Central Cancer Registry. Disease-progression rates (i.e., transition rates between three states), mean sojourn time (MST) and mammographic sensitivity were estimated across 10-year age groups and levels of breast density determined by the Breast Imaging, Reporting and Data System.
Results
Overall prevalence of dense breast was 53.9%. Transition rate from healthy to preclinical state, indicating the preclinical incidence of breast cancer, was higher among women in forties (0.0019; 95% confidence interval [CI], 0.0017 to 0.0021) and fifties (0.0020; 95% CI, 0.0017 to 0.0022), than women in sixties (0.0014; 95% CI, 0.0012 to 0.0017). The MSTs, in which the tumor is asymptomatic but detectable by screening, were also fastest among younger age groups, estimated as 1.98 years (95% CI, 1.67 to 2.33), 2.49 years (95% CI, 1.92 to 3.22), and 3.07 years (95% CI, 2.11 to 4.46) for women in forties, fifties, and sixties, respectively. Having dense breasts increased the likelihood of the preclinical cancer risk (1.96 to 2.35 times) and decreased the duration of MST (1.53 to 2.02 times).
Conclusion
This study estimated Korean-specific natural history parameters of breast cancer that would be utilized for establishing optimal screening strategies in countries with higher dense breast prevalence.

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Gastrointestinal cancer

Trends in the Performance of the Korean National Cancer Screening Program for Gastric Cancer from 2007 to 2016: Ji Eun Ryu, Eunji Choi, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu Won Jung, Kui Son Choi; Cancer Res Treat. 2022;54(3):842-849. Published online September 30, 2021; DOI: https://doi.org/10.4143/crt.2021.482

Abstract PDF Supplementary Material PubReader ePub

Purpose
The Korean National Cancer Screening Program (KNCSP) has implemented two screening methods for gastric cancer—upper gastrointestinal series (UGIS) and endoscopy—for Koreans aged ≥40 years. We aimed to assess performance trends for both screening methods.
Materials and Methods
The KNCSP database was used to evaluate individuals who underwent screening from 2007 to 2016. The final gastric cancer diagnosis was ascertained by linking with the Korean Central Cancer Registry. We conducted a prospective, cross-sectional analysis to estimate performance indicators of gastric cancer screening by UGIS and endoscopy, stratified by sociodemographic factors.
Results
We found that screening rates for gastric cancer increased from 28% to 51.7% between 2007 and 2016, and that the rate of endoscopy use for gastric cancer screening increased sharply. Cancer detection rates (CDR) of UGIS and endoscopy were 0.41 and 2.25 per 1,000 screens in 2007–2008 and 0.26 and 1.99 in 2015–2016, respectively. Interval cancer rates (ICR) per 1,000 negative screenings were 1.33 (2007–2008) and 1.21 (2015–2016) for UGIS and 1.14 (2007–2008) and 0.88 (2015–2016) for endoscopy. The sensitivity of UGIS decreased from 23.6% (2007–2008) to 17.6% (2015–2016), whereas that of endoscopy increased from 66.4% (2007–2008) to 69.3% (2015–2016). Specificity was maintained at >99% for both methods over the study period.
Conclusion
The use of endoscopy for gastric cancer screening within the KNCSP has increased. Endoscopy has higher CDR, sensitivity, and specificity, and lower ICR estimates than does UGIS.

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General

Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004–2018: Seri Hong, Yun Yeong Lee, Jaeho Lee, Yeol Kim, Kui Son Choi, Jae Kwan Jun, Mina Suh; Cancer Res Treat. 2021;53(2):330-338. Published online October 20, 2020; DOI: https://doi.org/10.4143/crt.2020.263

Abstract PDF Supplementary Material PubReader ePub

Purpose
The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004–2018.
Materials and Methods
KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40–74 years and women aged 20–74 years with no cancer histories.
Results
Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively.
Conclusion
Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.

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Prevalence of Women with Dense Breasts in Korea: Results from a Nationwide Cross-sectional Study: Hye-Mi Jo, Eun Hye Lee, Kyungran Ko, Bong Joo Kang, Joo Hee Cha, Ann Yi, Hae Kyoung Jung, Jae Kwan Jun, on behalf of the Alliance for Breast Cancer Screening in Korea (ABCS-K); Cancer Res Treat. 2019;51(4):1295-1301. Published online January 29, 2019; DOI: https://doi.org/10.4143/crt.2018.297

Abstract PDF Supplementary Material PubReader ePub

Purpose
Women with dense breast are known to be at high risk for breast cancer, but their prevalence and number of Korean women are unknown. The current study was to investigate the distribution of mammographic breast density by age of women undergoing screening mammography, and to estimate the prevalence of Korean women with dense breasts, quantitatively.
Materials and Methods
For obtaining a nationwide representative sample, 6,481 mammograms were collected from 86 screening units participated in the National Cancer Screening Program for breast cancer. Based on the American College of Radiology Breast Imaging Reporting and Data System classification, breast density was evaluated by six breast radiologists, qualitatively. We applied these breast density distributions to age-specific counts of the Korean women population derived to mid-year 2017 to estimate the number of Korean women with dense breasts.
Results
Overall, 54.4% (95% confidence interval [CI], 52.9% to 55.8%) of women 40 to 69 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age. Based on the age distribution of Korean women, we estimated that 6,083,000 women (95% CI, 5,919,600 to 6,245,600) age 40-69 years in Korean have dense breasts. Women aged 40-49 years (n=3,450,000) accounted for 56.7% of this group.
Conclusion
More than half of Korean women aged 40 and over have dense breasts. To prevent breast cancer effectively and efficiently, it is necessary to develop a new personalized prevention strategy considering her status of breast density.

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Risky Lifestyle Behaviors among Gastric Cancer Survivors Compared with Matched Non-cancer Controls: Results from Baseline Result of Community Based Cohort Study: Minkyung Kim, Kui Son Choi, Mina Suh, Jae Kwan Jun, Kumban Walter Chuck, Boyoung Park; Cancer Res Treat. 2018;50(3):738-747. Published online July 24, 2017; DOI: https://doi.org/10.4143/crt.2017.129

Abstract PDF PubReader ePub

Purpose
This study investigated the prevalence of smoking, drinking, and physical inactivity and the associated factors of these behaviors in gastric cancer survivors.
Materials and Methods
The baseline data from the nationwide cohort study was used. Four hundred thirty-seven gastric cancer survivors who survived ≥ 2 years from diagnosis and reported completion of treatment were matched with 4,370 controls according to age, sex, education, and household income.
Results
The prevalence rates of current smoking and drinking among gastric cancer survivors were 8.7% and 38.3%, which were significantly lower than those among matched controls (p ≤ 0.001), but the prevalence rates of physical inactivity were not significantly different (55.8% vs. 59.9%, p=0.248). In gastric cancer survivors, ≥ 5 years since cancer diagnosis and current drinking contributed to more current smoking; otherwise, age increment and femalewere associatedwith lower current smoking. Thosewith household income ≥ $2,000 and current smokers were more likely to drink and female showed less drinking. Female, currently employed state, and self-rated health status were associated with more physical inactivity.
Conclusion
Although gastric cancer survivors showed better health behaviors than controls, suggesting that the diagnosis of cancer may motivate individuals towards healthy behaviors, their current prevalence rates of smoking and drinking were still high, and more than 50% of them were physically inactive. Tailored interventions to improve their health behaviors considering associated factors for the gastric cancer survivors are necessary.

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Sunghye Choo, Sanghee Kim, Yong Chan Lee, Eunsung Kim
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Daniel N Tollosa, Meredith Tavener, Alexis Hure, Erica L James
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Lung Cancer Screening with Low-Dose CT in Female Never Smokers: Retrospective Cohort Study with Long-term National Data Follow-up: Hyae Young Kim, Kyu-Won Jung, Kun Young Lim, Soo-Hyun Lee, Jae Kwan Jun, Jeongseon Kim, Bin Hwangbo, Jin Soo Lee; Cancer Res Treat. 2018;50(3):748-756. Published online July 17, 2017; DOI: https://doi.org/10.4143/crt.2017.312

Abstract PDF Supplementary Material PubReader ePub

Purpose
Because of growing concerns about lung cancer in female never smokers, chest low-dose computed tomography (LDCT) screening is often performed although it has never shown clinical benefits. We examinewhether or not female never smokers really need annual LDCT screening when the initial LDCT showed negative findings.
Materials and Methods
This retrospective cohort study included 4,365 female never smokers aged 40 to 79 years who performed initial LDCT from Aug 2002 to Dec 2007. Lung cancer diagnosis was identified from the Korea Central Cancer Registry Database registered until December 31, 2013. We calculated the incidence, cumulative probability, and standardized incidence ratio (SIR) of lung cancer by Lung Imaging Reporting and Data System (Lung-RADS) categories showed on initial LDCT.
Results
After median follow-up of 9.69 years, 22 (0.5%) had lung cancer. Lung cancer incidence for Lung-RADS category 4 was 1,848.4 (95% confidence interval [CI], 1,132.4 to 3,017.2) per 100,000 person-years and 16.4 (95% CI, 7.4 to 36.4) for categories 1, 2, and 3 combined. The cumulative probability of lung cancer for category 4 was 10.6% at 5 years and 14.8% at 10 years while they were 0.07% and 0.17% when categories 1, 2, and 3 were combined. The SIR for subjects with category 4 was 43.80 (95% CI, 25.03 to 71.14), which was much higher than 0.47 (95% CI, 0.17 to 1.02) for categories 1, 2, and 3 combined.
Conclusion
Considering the low risk of lung cancer development in female never smokers, it seems unnecessary to repeat annual LDCT screening for at least 5 years or even longer unless the initial LDCT showed Lung-RADS category 4 findings.

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Stages of Adoption for Fecal Occult Blood Test and Colonoscopy Tests for Colorectal Cancer Screening in Korea: Nhung Cam Bui, Ha Na Cho, Yoon Young Lee, Mina Suh, Boyoung Park, Jae Kwan Jun, Yeol Kim, Kui Son Choi; Cancer Res Treat. 2018;50(2):416-427. Published online May 10, 2017; DOI: https://doi.org/10.4143/crt.2017.075

Abstract PDF PubReader ePub

Purpose
While colorectal cancer (CRC) is common in Asian countries, screening for CRC is not. Moreover, CRC screening behaviors in Asian populations remain largely unknown. The present study aimed to investigate the stages of adopting CRC screening in Korea according to screening modality.
Materials and Methods
Data were obtained from the 2014 Korean National Cancer Screening Survey, a cross-sectional survey that utilized nationally representative random sampling to investigate cancer screening rates. A total of 2,066 participants aged 50-74 years were included in this study. Chi-square test and multinomial logistic regressionwere applied to determine stages of adoption for fecal occult blood test (FOBT) and colonoscopy and factors associated with each stage.
Results
Of 1,593 participants included in an analysis of stage of adoption for FOBT, 36% were in action/maintenance stages, while 18%, 40%, and 6% were in precontemplation, contemplation, and relapse/relapse risk stages, respectively. Of 1,371 subjects included in an analysis of stage of adoption for colonoscopy, 48% were in action/maintenance stages, with 21% in precontemplation, 21% in contemplation, and 11% in relapse/relapse risk stages. Multinomial logistic regression highlighted sex, household income, place of residency, family history of cancer, having private cancer insurance, smoking status, alcohol use, and regular exercise as being associated with stages of adoption for FOBT and colonoscopy.
Conclusion
This study outlines the distributions of stages of adoption for CRC screening by screening modality. Interventions to improve screening rates should be tailored to individuals in particular stages of adoption for CRC screening by modality.

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Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
A new TGF‐β risk score predicts clinical and immune landscape in colorectal cancer patients
Bing Tang, Binggang Liu, Zhiyao Zeng
Annals of Gastroenterological Surgery.2024; 8(5): 927. CrossRef
Utilization of colorectal cancer screening tests: a systematic review and time trend analysis of nationally representative data
Idris Ola, Rafael Cardoso, Michael Hoffmeister, Hermann Brenner
eClinicalMedicine.2024; 75: 102783. CrossRef
Role of breast cancer screening in the overdiagnosis of thyroid cancer: results from a cross-sectional nationwide survey
Eunhye Lee, Sung Hoon Jeong, Chung Mo Nam, Jae Kwan Jun, Eun-Cheol Park
BMC Women's Health.2023;[Epub] CrossRef
Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kui Son Choi
Epidemiology and Health.2023; 45: e2023086. CrossRef
The risk of developing colorectal cancer in individuals aged 50-70 years and behavioral changes in high-risk individuals regarding a fecal occult blood test
Renginar ÖZTÜRK DÖNMEZ, Süheyla ÖZSOY, Melek ARDAHAN
Journal of Surgery and Medicine.2022; 6(1): 14. CrossRef
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Dongmei Ai, Hongfei Pan, Rongbao Han, Xiaoxin Li, Gang Liu, Li C. Xia
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Colonoscopy and Sigmoidoscopy Use among the Average-Risk Population for Colorectal Cancer: A Systematic Review and Trend Analysis
Rafael Cardoso, Tobias Niedermaier, Chen Chen, Michael Hoffmeister, Hermann Brenner
Cancer Prevention Research.2019; 12(9): 617. CrossRef
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Hye Young Shin, Mina Suh, Boyoung Park, Jae Kwan Jun, Kui Son Choi
BMC Cancer.2017;[Epub] CrossRef

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Risk and Characteristics of Postcolonoscopy Interval Colorectal Cancer after a Positive Fecal Test: A Nationwide Population-Based Study in Korea: Chang Kyun Lee, Kui Son Choi, Chang Soo Eun, Dong-Il Park, Dong Soo Han, Minjoo Yoon, Mina Suh, Jae Kwan Jun; Cancer Res Treat. 2018;50(1):50-59. Published online February 24, 2017; DOI: https://doi.org/10.4143/crt.2017.027

Abstract PDF Supplementary Material PubReader ePub

Purpose
Fecal tests remain a mainstay of population-based colorectal cancer (CRC) screening programs worldwide. However, data on interval CRC (iCRC) arising after follow-up colonoscopy of a positive fecal test are scarce. We conducted a nationwide population-based study to reveal the risk and characteristics of iCRC in this setting.
Materials and Methods
We searched the National Cancer Screening Program for CRC database in Korea (2005-2010). Incidence of iCRC within the program was estimated, then Cox proportional-hazards regression analysis was performed to determine the independent predictors of iCRC. The clinical characteristics of iCRC were compared with screen-detected CRC (sCRC).
Results
We identified 280 iCRC among 150,660 negative colonoscopies as a follow-up exam to a positive fecal immunochemical test (FIT), and 2,427 sCRC. The overall incidence of iCRC was 0.49/1,000 person-years (95% confidence interval [CI], 0.48 to 0.51). iCRC was more likely to occur in men (adjusted hazard ratio [aHR], 1.79; 95% CI, 1.39 to 2.30) and elderly patients (aHR, 1.77; 95% CI, 1.38 to 2.28 in 65-74 years; aHR, 3.13, 95% CI, 2.13-4.60 in ≥ 75 years). The National Quality Improvement Program for colonoscopy reduced a short-term risk of iCRC (aHR, 0.48; 95% CI, 0.27 to 0.87). Compared with sCRC, iCRC was more likely to occur in the proximal colon, be diagnosed at the localized stage, and have a lower CRC mortality (32.7 vs. 17.4%, 56.8 vs. 34.1%, 12.5 vs. 17.7%, respectively; all p < 0.05).
Conclusion
In a population-based CRC screening program with FIT, the burden of iCRC after follow-up colonoscopy was substantial. Men and elderly patients possess a significantly higher risk of iCRC.

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Overall and Annual Postcolonoscopy Colorectal Cancer Rates in a Large Integrated Healthcare Setting: A Cross-Sectional Study
Jeffrey K. Lee, James H-E. Kang, Sophie A. Merchant, Christopher D. Jensen, Nicholas E. Burr, Douglas A. Corley
Clinical Gastroenterology and Hepatology.2024; 22(1): 188. CrossRef
Post-colonoscopy colorectal cancer: A population-based cohort study of fecal occult blood test-positive colonoscopies
Bernard Denis, Alice Bertolaso, Isabelle Gendre, Philippe Perrin, Karima Hammas
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Post-colonoscopy colorectal cancers in a national fecal immunochemical test-based colorectal cancer screening program
Pieter H. A. Wisse, Sybrand Y. de Boer, Marco Oudkerk Pool, Jochim S Terhaar sive Droste, Claudia Verveer, Gerrit A. Meijer, Evelien Dekker, Manon C. W. Spaander
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Association between Endoscopist Volume and Interval Cancers after Colonoscopy: Results from the National Colorectal Cancer Screening Program in Korea
Dong Jun Kim, Nan-He Yoon, Jae Kwan Jun, Mina Suh, Sunhwa Lee, Seongju Kim, Ji Eun Kim, Hooyeon Lee
Cancer Research and Treatment.2024; 56(4): 1164. CrossRef
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Efrat L. Amitay, Katarina Cuk, Tobias Niedermaier, Korbinian Weigl, Hermann Brenner
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Frequency and Characteristics of Interval Colorectal Cancer in Actual Clinical Practice: A KASID Multicenter Study
Kyeong Ok Kim, Kyu Chan Huh, Sung Pil Hong, Won Hee Kim, Hyuk Yoon, Sang Wook Kim, Yeon Soo Kim, Jong Ha Park, Jun Lee, Bum Jae Lee, Young Sook Park
Gut and Liver.2018; 12(5): 537. CrossRef

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Trends in Participation Rates for the National Cancer Screening Program in Korea, 2002-2012: Mina Suh, Seolhee Song, Ha Na Cho, Boyoung Park, Jae Kwan Jun, Eunji Choi, Yeol Kim, Kui Son Choi; Cancer Res Treat. 2017;49(3):798-806. Published online November 11, 2016; DOI: https://doi.org/10.4143/crt.2016.186

Abstract PDF Supplementary Material PubReader ePub

Purpose
The National Cancer Screening Program (NCSP) in Korea supports cancer screening for stomach, liver, colorectal, breast, and cervical cancer. This study was conducted to assess trends in participation rates among Korean men and women invited to undergo screening via the NCSP as part of an effort to guide future implementation of the program in Korea.
Materials and Methods
Data from the NCSP for 2002 to 2012 were used to calculate annual participation rates with 95% confidence intervals (CI) by sex, insurance status, and age group for stomach, liver, colorectal, breast, and cervical cancer screening.
Results
In 2012, participation rates for stomach, liver, colorectal, breast, and cervical cancer screening were 47.3%, 25.0%, 39.5%, 51.9%, and 40.9%, respectively. The participation rates increased annually by 4.3% (95% CI, 4.0 to 4.6) for stomach cancer, 3.3% (95% CI, 2.5 to 4.1) for liver cancer, 4.1% (95% CI, 3.2 to 5.0) for colorectal cancer, 4.6% (95% CI, 4.1 to 5.0) for breast cancer, and 0.9% (95% CI, –0.7 to 2.5) for cervical cancer from 2002 to 2012.
Conclusion
Participant rates for the NCSP for the five above-mentioned cancers increased annually from 2002 to 2012.

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Trends and Age-Period-Cohort Effects on the Incidence and Mortality Rate of Cervical Cancer in Korea: Eun-Kyeong Moon, Chang-Mo Oh, Young-Joo Won, Jong-Keun Lee, Kyu-Won Jung, Hyunsoon Cho, Jae Kwan Jun, Myong Cheol Lim, Moran Ki; Cancer Res Treat. 2017;49(2):526-533. Published online September 1, 2016; DOI: https://doi.org/10.4143/crt.2016.316

Abstract PDF PubReader ePub

Purpose
This study was conducted to describe the trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea.
Materials and Methods
The incidence and mortality rate of cervical cancer among ≥ 20-year-old women from 1993 to 2012 were obtained from the Korea Central Cancer Registry and the Korean Statistical Information Service. Age-standardized rates were calculated and Joinpoint regression was used to evaluate the trends in the incidence and mortality rate. Age-period-cohort analysis was performed to investigate the independent effects of age, period and cohort.
Results
The incidence of cervical cancer decreased from 32.8 per 100,000 in 1993 to 15.9 per 100,000 in 2012 (annual percent change [APC], –3.9%; 95% confidence interval [CI], –4.2% to –3.6%). The mortality rate decreased from 5.2 per 100,000 in 1993 to 2.1 per 100,000 in 2012 (APC, –4.8%; 95% CI, –5.1% to –4.4%); however, the incidence and mortality rates among young women (< 30 years old) increased. An age-period-cohort model of the incidence and mortality rate showed decreasing period effects between 1993 and 2008 and decreasing cohort effects between 1928 and 1973, while birth cohorts after 1973 exhibited slight increases in the incidence and mortality rate of cervical cancer.
Conclusion
Recent decreases in the incidence and mortality rate of cervical cancer were due to decreases in the period and cohort effects, which reflect the implementation of a cancer screening program and changes in lifestyle. However, our findings also highlighted an increase in cohort effects on the incidence and mortality rate among young women born after 1973.

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Responses to Overdiagnosis in Thyroid Cancer Screening among Korean Women: Sangeun Lee, Yoon Young Lee, Hyo Joong Yoon, Eunji Choi, Mina Suh, Boyoung Park, Jae Kwan Jun, Yeol Kim, Kui Son Choi; Cancer Res Treat. 2016;48(3):883-891. Published online December 28, 2015; DOI: https://doi.org/10.4143/crt.2015.218

Abstract PDF PubReader ePub

Purpose
Communicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon.
Materials and Methods
Data were acquired from subjects included in the 2013 Korean National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey. Of the 4,100 respondents in the 2013 KNCSS, women were randomly subsampled and an additional face-to-face interview was conducted. Finally, a total of 586 female subjects were included in this study. Intention to undergo thyroid cancer screening was assessed before and after receiving information on overdiagnosis.
Results
Prior awareness of overdiagnosis in thyroid cancer screening was 27.8%. The majority of subjects intended to undergo thyroid cancer screening before and after receiving information on overdiagnosis (87% and 74%, respectively). Only a small number of subjects changed their intention to undergo thyroid cancer screening from positive to negative after receiving information on overdiagnosis. Women of higher education level and Medical Aid Program recipients reported being significantly more likely to change their intention to undergo thyroid cancer screening afterreceiving information on overdiagnosis,whilewomen with stronger beliefs on the efficacy of cancer screening were less likely to change their intention.
Conclusion
Women in Korea appeared to be less concerned about overdiagnosis when deciding whether or not to undergo thyroid cancer screening.

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Role of breast cancer screening in the overdiagnosis of thyroid cancer: results from a cross-sectional nationwide survey
Eunhye Lee, Sung Hoon Jeong, Chung Mo Nam, Jae Kwan Jun, Eun-Cheol Park
BMC Women's Health.2023;[Epub] CrossRef
Communication-based strategies to curb the overuse of low-value cancer screening
Soela Kim, Jennifer L Monahan, Young Kyung Do
Journal of Communication.2023; 73(5): 399. CrossRef
The learning curve on robot-assisted transaxillary thyroidectomy performed by a single endocrine surgeon in a third-level institution in Europe: a cumulative sum (CUSUM) analysis
Gabriele Materazzi, Piermarco Papini, Lorenzo Fregoli, Riccardo Morganti, Andrea De Palma, Carlo Enrico Ambrosini, Leonardo Rossi
Updates in Surgery.2023; 75(6): 1653. CrossRef
Recent Changes in the Incidence of Thyroid Cancer in Korea between 2005 and 2018: Analysis of Korean National Data
Yun Mi Choi, Jiwoo Lee, Mi Kyung Kwak, Min Ji Jeon, Tae Yong Kim, Eun-Gyoung Hong, Won Bae Kim, Won Gu Kim
Endocrinology and Metabolism.2022; 37(5): 791. CrossRef
How do people understand overtesting and overdiagnosis? Systematic review and meta-synthesis of qualitative research
Tomas Rozbroj, Romi Haas, Denise O'Connor, Stacy M. Carter, Kirsten McCaffery, Rae Thomas, Jan Donovan, Rachelle Buchbinder
Social Science & Medicine.2021; 285: 114255. CrossRef
Association of Screening by Thyroid Ultrasonography with Mortality in Thyroid Cancer: A Case–Control Study Using Data from Two National Surveys
Jae Kwan Jun, Soon-Young Hwang, Seri Hong, Mina Suh, Kui Son Choi, Kyu-Won Jung
Thyroid.2020; 30(3): 396. CrossRef
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Brooke Nickel, Ray Moynihan, Alexandra Barratt, Juan P Brito, Kirsten McCaffery
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Total thyroidectomy's association with survival in papillary thyroid cancers and the high proportion of total thyroidectomy in low-risk patients: Analysis of Korean nationwide data
Hyun-Soo Zhang, Eun-Kyung Lee, Yuh-Seog Jung, Byung-Ho Nam, Kyu-Won Jung, Hyun-Joo Kong, Young-Joo Won, Boyoung Park
Surgery.2019; 165(3): 629. CrossRef
Public perceptions of changing the terminology for low-risk thyroid cancer: a qualitative focus group study
Brooke Nickel, Caitlin Semsarian, Ray Moynihan, Alexandra Barratt, Susan Jordan, Donald McLeod, Juan P Brito, Kirsten McCaffery
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Proteomic Biomarkers for Bisphenol A–Early Exposure and Women’s Thyroid Cancer
Ho-Sun Lee, Yunkyeong Kang, Kyung Tae, Gyu-Un Bae, Jong Y. Park, Yoon Hee Cho, Mihi Yang
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Defining, Estimating, and Communicating Overdiagnosis in Cancer Screening
Louise Davies, Diana B. Petitti, Lynn Martin, Meghan Woo, Jennifer S. Lin
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Relationship between Salt Preference and Gastric Cancer Screening: An Analysis of a Nationwide Survey in Korea: Ji-Yeon Shin, Jeongseon Kim, Kui Son Choi, Mina Suh, Boyoung Park, Jae Kwan Jun; Cancer Res Treat. 2016;48(3):1037-1044. Published online December 11, 2015; DOI: https://doi.org/10.4143/crt.2015.333

Abstract PDF PubReader ePub

Purpose
Epidemiological studies have demonstrated an association between excessive salt intake and gastric cancer risk, and this potential risk increases the need for adequate gastric cancer screening in individuals with high salt intake. However, the association between salt intake and gastric cancer screening in the general population has rarely been investigated. We explored the association between salt preference and participation in gastric cancer screening among a nationally representative Korean population.
Materials and Methods
The study population was derived from the Korean National Cancer Screening Survey (KNCSS) 2006-2007, an annual nationwide interview survey investigating cancer screening rates. Of 4,055 individuals who participated in the KNCSS 2006-2007, 3,336 individuals aged over 40 years were included in our analysis. The odds ratio (OR) and 95% confidence interval (CI) were estimated using polytomous logistic regression.
Results
Individuals with higher salt preference were less likely to participate in regular gastric cancer screening. After adjusting for age, sex, monthly household income, education, family history of cancer, and self-rated health status, ORs for undergoing regular gastric cancer screening were 1.00, 0.82 (95% CI, 0.61 to 1.12), 0.74 (95% CI, 0.54 to 1.00), 0.77 (95% CI, 0.56 to 1.05), and 0.38 (95% CI, 0.16 to 0.92) according to the level of salt preference (p for trend=0.048).
Conclusion
Individuals with higher salt preference showed suboptimal gastric cancer screening adherence compared to those with a lower salt preference. These findings highlight the need for better delivery of educational messages to change risk perceptions regarding gastric cancer screening practice.

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Socio-economic factors and medical conditions affecting regular stomach cancer screening in Korea: a retrospective longitudinal study using national public health data for 11 years
J.-Y. Kim, J.Y. Hong, S.M. Kim, K.H. Ryu, D.S. Kim, S.H. Lee, J.H. Na, H.H. Cho, J. Yu, J. Lee
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Martin C. S. Wong, Eman Yee‐man Leung, Sarah T. Y. Yau, Sze Chai Chan, Shaohua Xie, Wanghong Xu, Junjie Huang
Cancer Medicine.2023; 12(21): 20544. CrossRef
Adherence to the World Cancer Research Fund/American Institute for Cancer Research and Korean Cancer Prevention Guidelines and cancer risk: a prospective cohort study from the Health Examinees-Gem study
Jeeyoo Lee, Aesun Shin, Woo-Kyoung Shin, Ji-Yeob Choi, Daehee Kang, Jong-Koo Lee
Epidemiology and Health.2023; 45: e2023070. CrossRef
Dietary Salt Intake and Gastric Cancer Risk: A Systematic Review and Meta-Analysis
Bo Wu, Dehua Yang, Shuhan Yang, Guangzhe Zhang
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Briar McKenzie, Joseph Alvin Santos, Kathy Trieu, Sudhir Raj Thout, Claire Johnson, JoAnne Arcand, Jacqui Webster, Rachael McLean
The Journal of Clinical Hypertension.2018; 20(5): 850. CrossRef

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Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004-2013: Mina Suh, Kui Son Choi, Boyoung Park, Yoon Young Lee, Jae Kwan Jun, Duk-Hyoung Lee, Yeol Kim; Cancer Res Treat. 2016;48(1):1-10. Published online April 15, 2015; DOI: https://doi.org/10.4143/crt.2014.204

Abstract PDF PubReader ePub

Purpose
The Korean National Cancer Screening Survey (KNCSS), a nationwide cross-sectional survey, has been conducted annually since 2004. The current study was conducted to report on the trends in screening rates among Korean men and women, and to evaluate policies regarding cancer screening programs implemented to reduce the burden of cancer.
Materials and Methods
The current study used KNCSS data. The eligible study population included men aged 40-74 years and women aged 30-74 years with no cancer history. The lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated for five major cancers (i.e., stomach, liver, colorectal, breast, and cervix uteri).
Results
The screening rates with recommendation increased by 4.2% (95% confidence interval [CI], 3.7% to 4.8%) annually for stomach cancer, 1.2% (95% CI, 0.1% to 2.4%) for liver cancer, 3.0% (95% CI, 1.8% to 4.1%) for colorectal cancer, 3.7% (95% CI, 2.7% to 4.8%) for breast cancer, and 1.3% (95% CI, 0.8% to 1.8%) for cervical cancer. In 2013, the screening rates with recommendation for stomach, liver, colorectal, breast, and cervical cancers were 73.6%, 33.6%, 55.6%, 59.7%, and 67.0%, respectively.
Conclusion
Both the lifetime screening rates and screening rates with recommendation for the five above-mentioned cancers increased annually from 2004 to 2013.

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Cost-Effectiveness of Liver Cancer Screening in Adults at High Risk for Liver Cancer in the Republic of Korea: Young Hwa Lee, Kui Son Choi, Jae Kwan Jun, Mina Suh, Hoo-Yeon Lee, Youn Nam Kim, Chung Mo Nam, Eun-Cheol Park, Woo-Hyun Cho; Cancer Res Treat. 2014;46(3):223-233. Published online July 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.3.223

Abstract PDF PubReader ePub

Purpose
This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, forliver cancer screening in the high-risk population of Korea. Materials and Methods A stochastic modelwas used to simulate the cost-effectiveness ofliver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and costwas based on the direct cost ofthe screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio. Results Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years. Conclusion In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as qualityadjusted life-years or disability-adjusted life-years.

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Thi Phuong Thao Tran, Minji Han, Ngoc Minh Luu, Jin‐Kyoung Oh
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Jae Youn Seo, Dong Wook Shin, Su Jong Yu, Jin Hyung Jung, Kyungdo Han, In Young Cho, So Young Kim, Kui Son Choi, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
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Jin Won Kwon, Ha Jin Tchoe, Jayoun Lee, Jae Kyung Suh, Jeong-Hoon Lee, Sangjin Shin
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Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey, 2004-2012: Mina Suh, Kui Son Choi, Yoon Young Lee, Jae Kwan Jun; Cancer Res Treat. 2013;45(2):86-94. Published online June 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.2.86

Abstract PDF PubReader ePub

PURPOSE
The Korean National Cancer Screening Survey (KNCSS), a nationwide, annual cross-sectional survey, has been conducted since 2004. The current study was conducted in order to report on trends in cancer screening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri).
MATERIALS AND METHODS
KNCSS data were collected between 2004 and 2012. The eligible study population included cancer-free men who were 40 years of age and older and women who were 30 years of age and older. The lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated.
RESULTS
Lifetime screening rates and screening rates with recommendation for the five types of cancer rose steadily until 2010, showed a slight drop or were stable in 2011, and increased again in 2012. On average, screening rates with recommendation have shown annual increases of 4.3% (95% confidence interval [CI], 3.6 to 5.0%) for stomach cancer, 0.8% (95% CI, -0.5 to 2.1%) for liver cancer, 2.4% (95% CI, 1.3 to 3.5%) for colorectal cancer, 4.5% (95% CI, 3.9 to 5.1%) for breast cancer, and 1.3% (95% CI, 0.6 to 2.0%) for cervical cancer. Disparities in age groups and household incomes have been decreasing since 2004.
CONCLUSION
Cancer screening rates in Korea showed a significant increase from 2004 to 2012, and screening rates for gastric and breast cancer are now approaching 70%. The 10-Year Plan for Cancer Control target for screening rates was met or nearly met for all cancer types examined, with the exception of liver and colorectal cancer.

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Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2011: Boyoung Park, Kui Son Choi, Yoon Young Lee, Jae Kwan Jun, Hong Gwan Seo; Cancer Res Treat. 2012;44(2):113-120. Published online June 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.2.113

Abstract PDF PubReader ePub

PURPOSE
The Korean National Cancer Screening Survey (KNCSS) is a nationwide survey conducted annually, since 2004. This study was conducted in order to report on trends in rates of cancer screening for five major cancers-stomach, liver, colorectal, breast, and cervix uteri in Korea.
MATERIALS AND METHODS
Data collected by the KNCSS between 2004 and 2011 were used in this study. The eligible study population included cancer-free men who were 40 years old and over, and women who were 30 years old and over. Lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated.
RESULTS
Both lifetime screening rates and screening rates with recommendation have increased since 2004. On average, screening rates with recommendation have shown an annual increase of 4.2% (95% CI, 3.3 to 5.2%) for stomach cancer, 1.1% (95% CI, -0.5 to 2.7%) for liver cancer, 2.2% (95% CI, 0.8 to 3.6%) for colorectal cancer, 4.0% (95% CI, 3.0 to 4.9%) for breast cancer, and 0.2% (95% CI, -0.9 to 1.3%) for cervical cancer. Increases in rates of cancer screening, with the exception of liver and cervical cancers, were significant, and screening rates for stomach and breast cancer in particular showed a marked increase.
CONCLUSION
Cancer screening rates among Koreans showed a consistent increase from 2004 to 2011 and rates of screening for gastric, breast, and cervical cancer are approaching 70%.

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Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2010: Eun-Ha Lee, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Eun-Cheol Park, Jin Soo Lee; Cancer Res Treat. 2011;43(3):141-147. Published online September 30, 2011; DOI: https://doi.org/10.4143/crt.2011.43.3.141

Abstract PDF PubReader ePub

PURPOSE
The Korean National Cancer Screening Survey (KNCSS) is a continuous nationwide survey implemented by the National Cancer Center in Korea since 2004. The purpose of the present study was to report trends in cancer screening rates for the five major cancers (stomach, liver, colorectal, breast, and cervix uteri) in Korean men and women.
MATERIALS AND METHODS
The study used KNCSS data collected between 2004 and 2010. The survey was conducted on Korean men aged 40-74 years and Korean women aged 30-74 years with no history of cancer diagnosis. The annual percentage change and corresponding 95% confidence intervals were used to examine changes in annual screening rates.
RESULTS
Screening rates with recommendation increased by 4.4% annually for stomach cancer, 1.5% for liver cancer, 2.8% per year for colorectal cancer, 4.5% for breast cancer, and 1.2% for cervix uteri cancer. The increasing trend in cancer screening rates, with the exception of liver cancer, was significant.
CONCLUSION
Cancer screening rates have increased consistently from 2004 to 2010 among Korean men and women. Stomach and breast cancer screening rates in particular have increased markedly.

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Cancer Nursing.2019; 42(2): E20. CrossRef
Effects of Screening on Gastric Cancer Management: Comparative Analysis of the Results in 2006 and in 2011
Yun Gyoung Kim, Seong-Ho Kong, Seung-Young Oh, Kyung-Goo Lee, Yun-Suhk Suh, Jun-Young Yang, Jeongmin Choi, Sang Gyun Kim, Joo-Sung Kim, Woo Ho Kim, Hyuk-Joon Lee, Han-Kwang Yang
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Radiation Oncology.2013;[Epub] CrossRef
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Ja Sung Choi, Jin Yi Choi, Hyeon Geun Cho, Ki Jun Han, Hee Man Kim, Jae Hee Cho, Yu Jin Kim
Scandinavian Journal of Gastroenterology.2013; 48(6): 657. CrossRef
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Moon Hae Kang, Eun-Cheol Park, Kui Son Choi, MiNa Suh, Jae Kwan Jun, Eun Cho
Asian Pacific Journal of Cancer Prevention.2013; 14(3): 2059. CrossRef
Cancer Screening in Korea, 2012: Results from the Korean National Cancer Screening Survey
Mina Suh, Kui Son Choi, Yoon Young Lee, Boyoung Park, Jae Kwan Jun
Asian Pacific Journal of Cancer Prevention.2013; 14(11): 6459. CrossRef
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Hye Seung Lee, Sang Mee Hwang, Taek Soo Kim, Duck-Woo Kim, Do Joong Park, Sung-Bum Kang, Hyung-Ho Kim, Kyoung Un Park
Translational Oncology.2013; 6(3): 290. CrossRef
A Prospective Study on the Incidence of Postoperative Venous Thromboembolism in Korean Gastric Cancer Patients: An Inquiry into the Application of Western Guidelines to Asian Cancer Patients
Jin Won Kim, Eun Ju Chun, Sang Il Choi, Do Joong Park, Hyung-Ho Kim, Soo-Mee Bang, Min Jeong Kim, Ju-Hee Lee, Moon-Soo Lee, Jeong-Ok Lee, Yu Jung Kim, Jee Hyun Kim, Jong Seok Lee, Keun-Wook Lee, Ju-Seog Lee
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Jin Kyun Park, Hyun Ah Park, Jin Joo Park, Young Gyu Cho
Asian Pacific Journal of Cancer Prevention.2012; 13(7): 3271. CrossRef
Increasing Trend of Colorectal Cancer Incidence in Korea, 1999-2009
Aesun Shin, Kyee-Zu Kim, Kyu-Won Jung, Sohee Park, Young-Joo Won, Jeongseon Kim, Dae Yong Kim, Jae Hwan Oh
Cancer Research and Treatment.2012; 44(4): 219. CrossRef
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Bit-Na Yoo, Kui-Son Choi, Kyu-Won Jung, Jae-Kwan Jun
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Time to follow up after an abnormal finding in organized gastric cancer screening in Korea
Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Myung-Il Hahm, Eun-Cheol Park
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Current status of the National Cancer Screening Program for cervical cancer in Korea, 2009
Young Hwa Lee, Kui Son Choi, Hoo-Yeon Lee, Jae Kwan Jun
Journal of Gynecologic Oncology.2012; 23(1): 16. CrossRef

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Gastric Cancer Screening in Korea: Report on the National Cancer Screening Program in 2008: Kyung Sook Lee, Dong Kwan Oh, Mi Ah Han, Hoo-Yeon Lee, Jae Kwan Jun, Kui Son Choi, Eun-Cheol Park; Cancer Res Treat. 2011;43(2):83-88. Published online June 30, 2011; DOI: https://doi.org/10.4143/crt.2011.43.2.83

Abstract PDF PubReader ePub

PURPOSE
The National Cancer Screening Program (NCSP) began in 1999. The objective of this report is to evaluate the results of the NCSP in 2008 and provide essential evidence associated with the gastric cancer screening program in Korea.
MATERIALS AND METHODS
Data was obtained from the National Cancer Screening Information System; participation rates in gastric cancer screening were calculated. According to screening modalities, recall rates were estimated with 95% confidence intervals (CIs).
RESULTS
The target population of the gastric cancer screening program in 2008 was 7,132,820 Korean men and women aged 40 and over, 2,076,544 of whom underwent upper endoscopy or upper gastrointestinal (UGI) series as screening tools (participation rate, 29.1%). Disparities in participation rates were observed relating to gender and health insurance type. Overall, recall rates of upper endoscopy and UGI series were 3.1% (95% CI, 3.0 to 3.1) and 33.3% (95% CI, 33.3 to 33.4), respectively.
CONCLUSION
According to our research, efforts to facilitate participation and to reduce disparities in gastric cancer screening among Korean men and women are needed. These results will provide essential data for evidence-based strategies in gastric cancer control in Korea.

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Reproductive and Hormonal Factors Associated with Fatty or Dense Breast Patterns among Korean Women: Jei-Hun Jeon, Jung-Hyun Kang, Yeonju Kim, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Dong-Kwan Oh, Chang Yoon Lee, Kyungran Ko, Eun-Cheol Park; Cancer Res Treat. 2011;43(1):42-48. Published online March 31, 2011; DOI: https://doi.org/10.4143/crt.2011.43.1.42

Abstract PDF PubReader ePub

PURPOSE
Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women.
MATERIALS AND METHODS
Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis.
RESULTS
In univariate logistic regression, older age, higher body mass index, older age at menarche, and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend <0.01, respectively), whereas nulliparous and premenopausal status were positively associated. Compared to women who had > or =2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend <0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32).
CONCLUSION
Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.

Citations

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Survival Rates of Breast Cancer Patients Aged 40 to 49 Years according to Detection Modality in Korea: Screening Ultrasound versus Mammography
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Zoe Quandt, Julie D Flom, Parisa Tehranifar, Diane Reynolds, Mary Beth Terry, Jasmine A McDonald
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Trends of Mammography Use in a National Breast Cancer Screening Program, 2004-2008: Sun Mi Lim, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Eun-Cheol Park, Yeonju Kim, Mi Ah Han, Dong Kwan Oh, Jung Im Shim; Cancer Res Treat. 2010;42(4):199-202. Published online December 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.4.199

Abstract PDF PubReader ePub

Purpose

Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program.

Materials and Methods

The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence.

Results

Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group.

Conclusion

The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups.

Citations

Citations to this article as recorded by

Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis
Rebecca Mottram, Wendy Lynn Knerr, Daniel Gallacher, Hannah Fraser, Lena Al-Khudairy, Abimbola Ayorinde, Sian Williamson, Chidozie Nduka, Olalekan A Uthman, Samantha Johnson, Alexander Tsertsvadze, Christopher Stinton, Sian Taylor-Phillips, Aileen Clarke
BMJ Open.2021; 11(11): e046660. CrossRef
Spectrum of very early breast cancer in a setting without organised screening
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British Journal of Cancer.2014; 110(9): 2187. CrossRef
Factors Associated with Organized and Opportunistic Cancer Screening: Results of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2011
Minsun Kang, Ki-Bong Yoo, Eun-Cheol Park, Kisung Kwon, Gaeun Kim, Doo Ree Kim, Jeoung A Kwon
Asian Pacific Journal of Cancer Prevention.2014; 15(7): 3279. CrossRef
Attendance of the fourth (2008–2009) screening round of the Hungarian organized, nationwide breast cancer screening program
Imre Boncz, Lajos Döbrőssy, Zoltán Péntek, Attila Kovács, András Budai, László Imre, Réka Vajda, Andor Sebestyén
Orvosi Hetilap.2013; 154(50): 1975. CrossRef
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Jiyoung Kim, SeKyung Lee, SooYoun Bae, Min-Young Choi, Jeonghui Lee, Seung Pil Jung, Sangmin Kim, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim, Jeong Eon Lee, Seok Jin Nam, Jung-Hyun Yang
Breast Cancer Research and Treatment.2012; 131(2): 527. CrossRef
Satisfaction in the National Cancer Screening Program for Breast Cancer with and without Clinical Breast Examination
Mi-Ah Han, Jae-Kwan Jun, Kui-Son Choi, Eun-Cheol Park, Hoo-Yeon Lee
Asian Pacific Journal of Cancer Prevention.2012; 13(1): 63. CrossRef
Time to follow up after an abnormal finding in organized gastric cancer screening in Korea
Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Myung-Il Hahm, Eun-Cheol Park
BMC Cancer.2012;[Epub] CrossRef
Risk Factors and Control Strategies for the Rapidly Rising Rate of Breast Cancer in Korea
Sue K. Park, Yeonju Kim, Daehee Kang, En-Joo Jung, Keun-Young Yoo
Journal of Breast Cancer.2011; 14(2): 79. CrossRef

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Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008: Jung Im Shim, Yeonju Kim, Mi Ah Han, Hoo-Yeon Lee, Kui Sun Choi, Jae Kwan Jun, Eun-Cheol Park; Cancer Res Treat. 2010;42(4):191-198. Published online December 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.4.191

Abstract PDF PubReader ePub

Purpose

This study aims to investigate the current situation of national colorectal cancer screening by analyzing participation rates, positive rates of screening methods and screening rate of secondary screening tests in colorectal screening of the national cancer screening program in 2008.

Materials and Methods

With database about target population and screened individuals of the national cancer screening program, the results of target population and participants of colorectal cancer screening in 2008 were analyzed. Among adults aged over 50 years of medical aid and beneficiaries of national health insurance paying lower 50% premiums in the total subscribers, 4,640,365 were target population of colorectal cancer screening and the data of 984,915 undergoing fecal occult blood test (FOBT) as a primary screening were analyzed.

Results

The colorectal cancer screening rate was 21.2% and the rates of national health insurance subscribers, females and the elderly aged 60-64 years were higher than those of others. The recipients with a positive result in FOBT recorded approximately 7.5%. Medical aid beneficiaries (7.9%), males (8.8%) and seniors aged over 75 years (9.1%) showed higher positive rates than the average one. Out of the FOBT positive recipients, 43.0% took a secondary screening and the rate undergoing colonoscopy (31.4%) was higher than that of doing double-contrast barium enema test (11.6%).

Conclusion

Colorectal cancer screening rate of medical aid beneficiaries and people paying lower 50% premiums among national health insurance subscribers, was different according to demographic characters (gender, age and types of health insurance). This finding meant that screening for the vulnerable needed to be encouraged by considering socio-demographic characters. Additionally, more efforts were necessary to increase the secondary screening rate of people with a positive result in primary one.

Citations

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