Cancer Research and Treatment

Original Articles

Disparities in the Participation Rate of Colorectal Cancer Screening by Fecal Occult Blood Test among People with Disabilities: A National Database Study in South Korea: Dong Wook Shin, Dongkyung Chang, Jin Hyung Jung, Kyungdo Han, So Young Kim, Kui Son Choi, Won Chul Lee, Jong Heon Park, Jong Hyock Park; Cancer Res Treat. 2020;52(1):60-73. Published online May 7, 2019; DOI: https://doi.org/10.4143/crt.2018.660

Abstract PDF Supplementary Material PubReader ePub

Purpose
Implementation of screening program may lead to increased health disparity within the population if participation differs by socioeconomic status. In Korea, colorectal cancer screening is provided at no or minimal cost to all people over 50 by National Cancer Screening Program. We investigated colorectal cancer screening participation rate and its trend over the last 10 years in relation to disabilities.
Materials and Methods
We linked national disability registration data with National Cancer Screening Program data. Age, sex-standardized participation rates were analyzed by type and severity of disability for each year, and factors associated with colorectal cancer screening participation were examined by multivariate logistic regression.
Results
Age, sex-standardized participation rate in people without disability increased from 16.2 to 33.9% (change, +17.7), but it increased from 12.7% to 27.2% (change, +14.5) among people with severe disability. People with severe disabilities showed a markedly lower colorectal cancer screening participation rate than people without disability (adjusted odds ratio [aOR], 0.714; 95% confidence interval, 0.713 to 0.720). People with autism (aOR, 0.468), renal failure (aOR, 0.498), brain injury (aOR, 0.581), ostomy (aOR, 0.602), and intellectual disability (aOR, 0.610) showed the lowest participation rates.
Conclusion
Despite the availability of a National Cancer Screening Program and overall increase of its usage in the Korean population, a significant disparity was found in colorectal cancer screening participation, especially in people with severe disabilities and or several specific types of disabilities. Greater effort is needed to identify the barriers faced by these particularly vulnerable groups and develop targeted interventions to reduce inequality.

Citations

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Trends in uptake of cancer screening among people with severe mental illness before and after the COVID‐19 pandemic in Japan: A repeated cross‐sectional study
Yuto Yamada, Masaki Fujiwara, Naoki Nakaya, Koji Otsuki, Taichi Shimazu, Maiko Fujimori, Shiro Hinotsu, Kiwamu Nagoshi, Yosuke Uchitomi, Masatoshi Inagaki
Psychiatry and Clinical Neurosciences Reports.2025;[Epub] CrossRef
Health inequities among persons with disabilities: a global scoping review
Emre Umucu, Andrew A. Vernon, Deyu Pan, Sang Qin, Guillermina Solis, Rebecca Campa, Beatrice Lee
Frontiers in Public Health.2025;[Epub] CrossRef
Cancer screening participation and outcomes among people with an intellectual disability in the Netherlands: a cross-sectional population-based study
Amina Banda, Maarten Cuypers, Jenneken Naaldenberg, Aura Timen, Geraline Leusink
The Lancet Public Health.2025; 10(3): e237. CrossRef
Comparative analysis of genetic testing utilization rates among people with and without disabilities in South Korea from 2016 to 2019, focusing on malignant neoplasms: A national population‐based study
Gwanwook Bang, Minji Park, Jeong‐yeon Seon, So‐Youn Park
Cancer Medicine.2024;[Epub] CrossRef
Disparities in the diagnosis and treatment of colorectal cancer among patients with disabilities
Ki Bae Kim, Dong Wook Shin, Kyoung Eun Yeob, So Young Kim, Joung-Ho Han, Seon Mee Park, Jong Heon Park, Jong Hyock Park
World Journal of Gastrointestinal Oncology.2024; 16(7): 2925. CrossRef
The effect of the expansion of the Personal Assistance Service Program on the uptake of the National Health Screening in people with severe disability
Woorim Kim, Mingee Choi, Jaeyong Shin
Journal of Public Health.2024; 46(4): 537. CrossRef
Cervical Cancer Screening and Prevention Uptake in Females with Autism Spectrum Disorder
Yachin Chen, James Powers, Christopher J. McDougle, Nicole R. Zürcher, Robyn P. Thom
Journal of Autism and Developmental Disorders.2024;[Epub] CrossRef
Disability and Participation in Colorectal Cancer Screening: A Systematic Review and Meta-Analysis
Giovanni Emanuele Ricciardi, Rita Cuciniello, Emanuele De Ponti, Carlo Lunetti, Flavia Pennisi, Carlo Signorelli, Cristina Renzi
Current Oncology.2024; 31(11): 7023. CrossRef
Family physicians’ and trainees’ experiences regarding cancer screening with patients with intellectual disability: An interpretive description study
Genevieve Breau, Sally Thorne, Jennifer Baumbusch, T Greg Hislop, Arminee Kazanjian
Journal of Intellectual Disabilities.2023; 27(1): 250. CrossRef
Type and Severity of Mental Illness and Participation in Colorectal Cancer Screening
Benedicte Kirkøen, Paula Berstad, Geir Hoff, Tomm Bernklev, Kristin R. Randel, Øyvind Holme, Thomas de Lange, Kathryn A. Robb, Edoardo Botteri
American Journal of Preventive Medicine.2023; 64(1): 76. CrossRef
Spatial and temporal patterns of colorectal cancer in Asia, 1990–2019
Rajesh Sharma, Bijoy Rakshit
International Journal of Clinical Oncology.2023; 28(2): 255. CrossRef
Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020
Silvia Portero de la Cruz, Jesús Cebrino
Frontiers in Public Health.2023;[Epub] CrossRef
The Korea National Disability Registration System
Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin
Epidemiology and Health.2023; 45: e2023053. CrossRef
Assessing cancer in people with profound and multiple disabilities
Daniel Satgé, Motoi Nishi, Brigitte Trétarre
BMC Cancer.2023;[Epub] CrossRef
Cancer detection, diagnosis, and treatment for adults with disabilities
Lisa I Iezzoni
The Lancet Oncology.2022; 23(4): e164. CrossRef
Mental illness and participation in colorectal cancer screening: a scoping review
Marie D. Jørgensen, Ellen M. Mikkelsen, Rune Erichsen, Mette K. Thomsen
Scandinavian Journal of Gastroenterology.2022; 57(10): 1216. CrossRef
Patients’ acceptability and implementation outcomes of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia: a qualitative secondary analysis of a mixed-method randomised clinical trial
Yuto Yamada, Masaki Fujiwara, Taichi Shimazu, Tsuyoshi Etoh, Masafumi Kodama, Ryuhei So, Takanori Matsushita, Yusaku Yoshimura, Shigeo Horii, Maiko Fujimori, Hirokazu Takahashi, Naoki Nakaya, Tempei Miyaji, Shiro Hinotsu, Keita Harada, Hiroyuki Okada, Yos
BMJ Open.2022; 12(6): e060621. CrossRef
Disability and Participation in Breast and Cervical Cancer Screening: A Systematic Review and Meta-Analysis
Fahrin Ramadan Andiwijaya, Calum Davey, Khaoula Bessame, Abdourahmane Ndong, Hannah Kuper
International Journal of Environmental Research and Public Health.2022; 19(15): 9465. CrossRef
Inhibition of colorectal cancer tumorigenesis by ursolic acid and doxorubicin is mediated by targeting the Akt signaling pathway and activating the Hippo signaling pathway
Dan Hu, Ruo Meng, Thi Nguyen, Ok Chai, Byung Park, Ju-Seog Lee, Soo Kim
Molecular Medicine Reports.2022;[Epub] CrossRef
The Role of Disability Acceptance and Emotional Support in the Association between Negative Experiences and Depression in Disabled People with Cancer: A Moderated Mediation Model
Young Won Shin, Min Jin Jin, Myoung-Ho Hyun
STRESS.2022; 30(4): 244. CrossRef
Evaluation of health belief model-based educational intervention on colorectal cancer screening behavior at South Khorasan, Iran
Shahrbanoo Khazaei, Fatemeh Salmani, Mitra Moodi
Journal of Education and Health Promotion.2022; 11(1): 52. CrossRef
Time trends of colorectal cancer incidence and associated lifestyle factors in South Korea
Hayeong Khil, Sung Min Kim, SungEun Hong, Hyeon Min Gil, Eugene Cheon, Dong Hoon Lee, Young Ae Kim, NaNa Keum
Scientific Reports.2021;[Epub] CrossRef
Disparities in Liver Cancer Surveillance Among People With Disabilities
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
Journal of Clinical Gastroenterology.2021; 55(5): 439. CrossRef
Do cholesterol levels and continuity of statin use affect colorectal cancer incidence in older adults under 75 years of age?
Kyu-Tae Han, Seungju Kim, Antonio Palazón-Bru
PLOS ONE.2021; 16(4): e0250716. CrossRef
Disparities in prostate cancer diagnosis, treatment, and survival among men with disabilities: Retrospective cohort study in South Korea
Dong Wook Shin, Jinsung Park, Kyoung Eun Yeob, Seok Jung Yoon, Soong-nang Jang, So Young Kim, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
Disability and Health Journal.2021; 14(4): 101125. CrossRef
Encouraging participation in colorectal cancer screening for people with schizophrenia: A randomized controlled trial
Masaki Fujiwara, Yuto Yamada, Taichi Shimazu, Masafumi Kodama, Ryuhei So, Takanori Matsushita, Yusaku Yoshimura, Shigeo Horii, Maiko Fujimori, Hirokazu Takahashi, Naoki Nakaya, Kyoko Kakeda, Tempei Miyaji, Shiro Hinotsu, Keita Harada, Hiroyuki Okada, Yosu
Acta Psychiatrica Scandinavica.2021; 144(4): 318. CrossRef
Population-Based Data Reveal Factors Associated with Organised and Non-Organised Colorectal Cancer Screening: An Important Step towards Improving Coverage
Thuy Ngan Tran, Guido Van Hal, Marc Peeters, Svetlana Jidkova, Harlinde De Schutter, Sarah Hoeck
International Journal of Environmental Research and Public Health.2021; 18(16): 8373. CrossRef
Disparities in the Diagnosis, Treatment, and Survival Rate of Cervical Cancer among Women with and without Disabilities
Jin Young Choi, Kyoung Eun Yeob, Seung Hwa Hong, So Young Kim, Eun-Hwan Jeong, Dong Wook Shin, Jong Heon Park, Gil-won Kang, Hak Soon Kim, Jong Hyock Park, Ichiro Kawachi
Cancer Control.2021;[Epub] CrossRef
Disparities in gastric cancer screening among people with disabilities: a national registry-linkage study in South Korea
YoungJee Kim, Dong Wook Shin, Hyoung Woo Kim, Jin Hyung Jung, Kyungdo Han, In Young Cho, So Young Kim, Kui Son Choi, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
Gastric Cancer.2020; 23(3): 497. CrossRef
Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
Hyoung Woo Kim, Dong Wook Shin, Kyoung Eun Yeob, In Young Cho, So Young Kim, Seon Mee Park, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
Clinical and Translational Gastroenterology.2020; 11(10): e00242. CrossRef
Trends in cancer screening rates among individuals with serious psychological distress: an analysis of data from 2007 to 2016 Japanese national surveys
Masaki Fujiwara, Yuji Higuchi, Naoki Nakaya, Maiko Fujimori, Yuto Yamada, Riho Wada, Tsuyoshi Etoh, Kyoko Kakeda, Yosuke Uchitomi, Tomio Nakayama, Norihito Yamada, Masatoshi Inagaki
Journal of Psychosocial Oncology Research & Practice.2020; 2(3): e025. CrossRef

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The Effect of Disability on the Diagnosis and Treatment of Multiple Myeloma in Korea: A National Cohort Study: Jihyun Kwon, So Young Kim, Kyoung Eun Yeob, Hye Sook Han, Ki Hyeong Lee, Dong Wook Shin, Yeon-Yong Kim, Jong Heon Park, Jong Hyock Park; Cancer Res Treat. 2020;52(1):1-9. Published online April 22, 2019; DOI: https://doi.org/10.4143/crt.2018.702

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to determine whether the diagnosis, treatment approach, and prognosis of multiple myeloma (MM) vary according to the presence and type of disability.
Materials and Methods
Demographic, socioeconomic, and medical data were obtained from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. An age- and sex-matched cohort was established using a 1:3 ratio constituted with 2,776,450 people with disabilities and 8,329,350 people without disabilities. Adult patients diagnosed with MM were subsequently selected from this cohort. Disabilities were categorized as physical, communication, intellectual or psychological, and affecting the major internal organs.
Results
The cohort included 4,090 patients with MM, with a significantly lower rate per 100,000 persons among people with disabilities than among people without disabilities (29.1 vs. 39.4, p < 0.001). People with disabilities were more likely to undergo dialysis treatment at the time of diagnosis (16.3% vs. 10.0%, p < 0.001), but were less likely to undergo autologous stem cell transplantation (37.5% vs. 43.7%, p=0.072). This trend was more evident among patients with intellectual or psychological disabilities. The median overall survival among patients with disabilities was significantly shorter than that among patients without disabilities (36.8 months vs. 51.2 months, p < 0.001).
Conclusion
In Korea, people with disabilities generally have a lower rate of MM diagnosis, receive less intensive treatment, and have a lower survival rate than people without disabilities.

Citations

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Case report: IORT as an alternative treatment option for breast cancer patients with difficulty staying still
Fardeen Bhimani, Maureen McEvoy, Yu Chen, Anjuli Gupta, Jessica Pastoriza, Shani Fruchter, Zachary C. Bitan, Wolfgang A. Tomé, Keyur Mehta, Jana Fox, Sheldon Feldman
Frontiers in Oncology.2024;[Epub] CrossRef
The Korea National Disability Registration System
Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin
Epidemiology and Health.2023; 45: e2023053. CrossRef
Do people with disabilities experience disparities in cancer care? A systematic review
Irene Tosetti, Hannah Kuper, Sina Azadnajafabad
PLOS ONE.2023; 18(12): e0285146. CrossRef
Cancer detection, diagnosis, and treatment for adults with disabilities
Lisa I Iezzoni
The Lancet Oncology.2022; 23(4): e164. CrossRef
Disparities in All-Cause Mortality in Older Patients with Colorectal Cancer According to Disability Status: A Nationwide Analysis
Woo-Ri Lee, Kyu-Tae Han, Mingee Choi, Woorim Kim
Current Oncology.2022; 29(10): 7430. CrossRef
Disparities in prostate cancer diagnosis, treatment, and survival among men with disabilities: Retrospective cohort study in South Korea
Dong Wook Shin, Jinsung Park, Kyoung Eun Yeob, Seok Jung Yoon, Soong-nang Jang, So Young Kim, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
Disability and Health Journal.2021; 14(4): 101125. CrossRef
Disparities in the Diagnosis, Treatment, and Survival Rate of Cervical Cancer among Women with and without Disabilities
Jin Young Choi, Kyoung Eun Yeob, Seung Hwa Hong, So Young Kim, Eun-Hwan Jeong, Dong Wook Shin, Jong Heon Park, Gil-won Kang, Hak Soon Kim, Jong Hyock Park, Ichiro Kawachi
Cancer Control.2021;[Epub] CrossRef
Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
Hyoung Woo Kim, Dong Wook Shin, Kyoung Eun Yeob, In Young Cho, So Young Kim, Seon Mee Park, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
Clinical and Translational Gastroenterology.2020; 11(10): e00242. CrossRef

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Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul: Jae Heon Kim, So Young Kim, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee; Cancer Res Treat. 2019;51(1):53-64. Published online February 20, 2018; DOI: https://doi.org/10.4143/crt.2017.468

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aims to investigate the trend in medical travel by non-Seoul residents to Seoul for treatment of prostate cancer and also to investigate the possible factors affecting the trend.
Materials and Methods
This study represents a retrospective cohort study using data from theKoreanNationalHealth Insurance System from 2002 to 2015. Annual trends were produced for proportions of patients who traveled according to the age group, economic status and types of treatment. Multiple logistic analysiswas used to determine factors affecting surgeries at medical facilities in Seoul among the non-Seoul residents.
Results
A total of 68,543 patients were defined as newly diagnosed prostate cancer cohorts from 2005 to 2014. The proportion of patients who traveled to Seoul for treatment, estimated from cases with prostate cancer-related claims, decreased slightly over 9 years (28.0 at 2005 and 27.0 at 2014, p=0.02). The average proportion of medical travelers seeking radical prostatectomy increased slightly but the increase was not statistically significant (43.1 at 2005 and 45.4 at 2014, p=0.26). Income level and performance ofrobot-assisted radical prostatectomy were significant positive factors for medical travel to medical facilities in Seoul. Combined comorbidity diseases and year undergoing surgery were significant negative factors for medical travel to medical facilities in Seoul.
Conclusion
The general trend of patients travelling from outside Seoul for prostate cancer treatment decreased from 2005 to 2014. However, a large proportion of traveling remained irrespective of direct distance from Seoul.

Citations

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Relationship between patient outcomes and patterns of fragmented cancer care in older adults with gastric cancer: A nationwide cohort study in South Korea
Dong-Woo Choi, Seungju Kim, Sun Jung Kim, Dong Wook Kim, Kwang Sun Ryu, Jae Ho Kim, Yoon-Jung Chang, Kyu-Tae Han
Journal of Geriatric Oncology.2024; 15(2): 101685. CrossRef
Analysis of trend in the role of national and regional hubs in prostatectomy after prostate cancer diagnosis in the past 5 years: A nationwide population-based study
Seong Cheol Kim, Seungbong Han, Ji Hyung Yoon, Sungchan Park, Kyung Hyun Moon, Sang Hyeon Cheon, Gyung-Min Park, Taekmin Kwon
Investigative and Clinical Urology.2024; 65(2): 124. CrossRef
Domestic medical travel from non-Seoul regions to Seoul for initial breast cancer treatment: a nationwide cohort study
Jae Ho Jeong, Jinhong Jung, Hee Jeong Kim, Jong Won Lee, Beom-Seok Ko, Byung Ho Son, Kyung Hae Jung, Il Yong Chung
Annals of Surgical Treatment and Research.2023; 104(2): 71. CrossRef
Symptom Experiences before Medical Help-Seeking and Psychosocial Responses of Patients with Esophageal Cancer: A Qualitative Study
Hui Ge, Liang Zhang, Xuanxuan Ma, Wen Li, Shuwen Li, Pranshu Sahgal
European Journal of Cancer Care.2023; 2023: 1. CrossRef
Cancer care patterns in South Korea: Types of hospital where patients receive care and outcomes using national health insurance claims data
Dong‐Woo Choi, Sun Jung Kim, Seungju Kim, Dong Wook Kim, Wonjeong Jeong, Kyu‐Tae Han
Cancer Medicine.2023; 12(13): 14707. CrossRef
Regional disparities in the availability of cancer clinical trials in Korea
Jieun Jang, Wonyoung Choi, Sung Hoon Sim, Sokbom Kang
Epidemiology and Health.2023; 46: e2024006. CrossRef
Do Patients Residing in Provincial Areas Transport and Spend More on Cancer Treatment in Korea?
Woorim Kim, Kyu-Tae Han, Seungju Kim
International Journal of Environmental Research and Public Health.2021; 18(17): 9247. CrossRef
Time Trends for Prostate Cancer Incidence from 2003 to 2013 in South Korea: An Age-Period-Cohort Analysis
Hyun Young Lee, Do Kyoung Kim, Seung Whan Doo, Won Jae Yang, Yun Seob Song, Bora Lee, Jae Heon Kim
Cancer Research and Treatment.2020; 52(1): 301. CrossRef
Trends in Prostate Cancer Prevalence and Radical Prostatectomy Rate according to Age Structural Changes in South Korea between 2005 and 2015
Hyun Young Lee, Suyeon Park, Seung Whan Doo, Won Jae Yang, Yun Seob Song, Jae Heon Kim
Yonsei Medical Journal.2019; 60(3): 257. CrossRef
Why is Life Expectancy in Busan Shorter than in Seoul? Age and Cause-Specific Contributions to the Difference in Life Expectancy between Two Cities
Young-Ho Khang, Jinwook Bahk
Yonsei Medical Journal.2019; 60(7): 687. CrossRef

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Trend Analysis for the Choice and Cost of Lung Cancer Treatment in South Korea, 2003-2013: Dohun Kim, So Young Kim, Beomseok Suh, Jong Hyock Park; Cancer Res Treat. 2018;50(3):757-767. Published online September 4, 2017; DOI: https://doi.org/10.4143/crt.2017.050

Abstract PDF PubReader ePub

Purpose
Our study aimed to report the annual changes in lung cancer statistics and analyze trends in sociodemographic, medical, and financial factors from 2003 to 2013 in the national database from the Korean National Health Insurance (KNHI).
Materials and Methods
Among 7,489 patients with code C34 in KNHI database, only lung cancer patients newly diagnosed after 2003 were included in the study population, for a total of 4,582 patients. Descriptive statistics were used to characterize treatment patterns and medical costs according to sociodemographic factors.
Results
Approximately 70% of subjects were male, and the mean age was 67 years. Around 46% of patients were over 70 years old, and 12% were over 80 years old. The medical costs were highest for patients younger than 60 and lowest for those over 80 years old. Surgery was more common in younger patients, while “no treatment” increased greatly with age. In trend analysis, the proportions of aging (p for trend < 0.001), female (p for trend=0.003), metropolitan/urban (p for trend=0.041), and lowest or highest-income patients (p for trend=0.004) increased over time, along with the prevalence of surgery as the primary treatment (p for trend < 0.001). There was also a trend with regard to change in medical costs (p for trend < 0.001), in that those of surgery and radiotherapy increased.
Conclusion
Surgery as a curative treatment has increased over the past decade. However, the elderly, suburban/rural residents, and low-income patients were more likely to be untreated. Therefore, active measures are required for these increasingly vulnerable groups.

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Effect of Perioperative Factors on Short-Term Outcomes in Patients with Non-Small Cell Lung Cancer Over 60 Years of Age
Wenzhi Zhu, Jiaonan Yang, Xiaoyi Wang, Xinqiang Ji, Hongyu Tan
International Journal of General Medicine.2024; Volume 17: 5453. CrossRef
Trend of lung cancer surgery, hospital selection, and survival between 2005 and 2016 in South Korea
Dohun Kim, Gil‐Won Kang, Hoyeon Jang, Jun Yeun Cho, Bumhee Yang, Hee Chul Yang, Jinwook Hwang
Thoracic Cancer.2022; 13(2): 210. CrossRef
Current Status of Lung Cancer and Surgery Based on Studies Using a Nationwide Database
Dohun Kim, Jung-Won Lee
Journal of Chest Surgery.2022; 55(1): 1. CrossRef
Association of institutional transition of cancer care with mortality in elderly patients with lung cancer: a retrospective cohort study using national claim data
Kyu-Tae Han, Jongwha Chang, Dong-Woo Choi, Seungju Kim, Dong Jun Kim, Yoon-Jung Chang, Sun Jung Kim
BMC Cancer.2022;[Epub] CrossRef
Is time-to-treatment associated with higher mortality in Korean elderly lung cancer patients?
Kyu-Tae Han, Woorim Kim, Areum Song, Yeong Jun Ju, Dong-Woo Choi, Seungju Kim
Health Policy.2021; 125(8): 1047. CrossRef
Estimating the disease burden of lung cancer attributable to residential radon exposure in Korea during 2006–2015: A socio-economic approach
Juhwan Noh, Heeseon Jang, Jaelim Cho, Dae Ryong Kang, Tae Hyun Kim, Dong Chun Shin, Changsoo Kim
Science of The Total Environment.2020; 749: 141573. CrossRef

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Patient’s Cognitive Function and Attitudes towards Family Involvement in Cancer Treatment Decision Making: A Patient-Family Caregiver Dyadic Analysis: Dong Wook Shin, Juhee Cho, Debra L. Roter, So Young Kim, Jong Hyock Park, Hyung Kook Yang, Hyun Woo Lee, Sun-Seog Kweon, Yune Sik Kang, Keeho Park; Cancer Res Treat. 2018;50(3):681-690. Published online July 4, 2017; DOI: https://doi.org/10.4143/crt.2017.201

Abstract PDF PubReader ePub

Purpose
Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and family caregivers preferences for family involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and family members agree on preferences.
Materials and Methods
A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forfamily involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment).
Results
Both patients and family caregivers preferred greater family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment.
Conclusion
Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing family involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.

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Semra Ozdemir, Sean Ng, Isha Chaudhry, Chetna Malhotra, Eric Andrew Finkelstein
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Samar J. Melhem, Shereen Nabhani-Gebara, Reem Kayyali
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Laura M.L. Tielemans, Kirsten D. van Heugten, Marije E. Hamaker, Inez C. van Walree
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Factors Affecting Patient and Caregiver Preferences for Treatment of Myeloma and Indolent Lymphoma
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Ansuk Jeong, Dongwook Shin, Jong Hyock Park, Keeho Park
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Experience with age discrimination and attitudes toward ageism in older patients with cancer and their caregivers: A nationwide Korean survey
Dong Wook Shin, Keeho Park, Ansuk Jeong, Hyung Kook Yang, So Young Kim, Mihee Cho, Jong Hyock Park
Journal of Geriatric Oncology.2019; 10(3): 459. CrossRef
How family caregivers of persons with advanced cancer assist with upstream healthcare decision-making: A qualitative study
J. Nicholas Dionne-Odom, Deborah Ejem, Rachel Wells, Amber E. Barnato, Richard A. Taylor, Gabrielle B. Rocque, Yasemin E. Turkman, Matthew Kenny, Nataliya V. Ivankova, Marie A. Bakitas, Michelle Y. Martin, Mojtaba Vaismoradi
PLOS ONE.2019; 14(3): e0212967. CrossRef

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Terminal Versus Advanced Cancer: Do the General Population and Health Care Professionals Share a Common Language?: Sang Hyuck Kim, Dong Wook Shin, So Young Kim, Hyung Kook Yang, Eunjoo Nam, Hyun Jung Jho, Eunmi Ahn, Be Long Cho, Keeho Park, Jong-Hyock Park; Cancer Res Treat. 2016;48(2):759-767. Published online August 10, 2015; DOI: https://doi.org/10.4143/crt.2015.124

Abstract PDF PubReader ePub

Purpose
Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients’ cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general population and determined associated socio-demographic factors. Materials and Methods A total of 2,000 persons from the general population were systematically recruited. We used a clinical vignette of a hypothetical advanced breast cancer patient, but whose cancer was not considered terminal. After presenting the brief history of the case, we asked respondents to choose the correct cancer stage from a choice of early, advanced, terminal stage, and don’t know. Multinomial logistic regression analysis was performed to determine sociodemographic factors associated with the correct response, as defined in terms of medical context.
Results
Only 411 respondents (20.6%) chose “advanced,“ while most respondents (74.5%) chose “terminal stage” as the stage of the hypothetical patient, and a small proportion of respondents chose “early stage” (0.7%) or “don’t know” (4.4%). Multinomial logistic regression analysis found no consistent or strong predictor.
Conclusion
A large proportion of the general population could not differentiate advanced cancer from terminal cancer. Continuous effort is required in order to establish common and shared definitions of the different cancer stages and to increase understanding of cancer staging for the general population.

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AmrallahA Mohammed, Omar Al-Zahrani, FifiMostafa Elsayed
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Metastatic Breast Cancer as a Chronic Condition
Patti Rager Zuzelo
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Experiences and Opinions Related to End-of-Life Discussion: From Oncologists' and Resident Physicians' Perspectives
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Geriatrics & Gerontology International.2017; 17(4): 672. CrossRef

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Long-Term Low-Dose Aspirin Use Reduces Gastric Cancer Incidence: A Nationwide Cohort Study: Young-Il Kim, So Young Kim, Ji Hyun Kim, Jun Ho Lee, Young-Woo Kim, Keun Won Ryu, Jong-Hyock Park, Il Ju Choi; Cancer Res Treat. 2016;48(2):798-805. Published online July 14, 2015; DOI: https://doi.org/10.4143/crt.2015.117

Abstract PDF PubReader ePub

Purpose
The aim of this study was to investigate whether aspirin use can reduce the incidence of gastric cancer in patients with hypertension or type 2 diabetes. Materials and Methods A total of 200,000 patients with hypertension or type 2 diabetes were randomly selected from the Korean National Health Insurance claim database. Of these, 3,907 patients who used 100 mg of aspirin regularly (regular aspirin users) and 7,808 patients who did not use aspirin regularly (aspirin non-users) were selected at a frequency of 1:2, matched by age, sex, comorbid illnesses (type 2 diabetes and hypertension), and observation periods. The incidence of gastric cancer in this cohort was then assessed during the observation period of 2004 to 2010.
Results
In the matched cohort, the incidence rates of gastric cancer were 0.8% (31/3,907) for regular aspirin users and 1.1% (86/7,808) for aspirin non-users, but the cumulative incidence rates were not significantly different between groups (p=0.116, log-rank test). However, in multivariate analysis, regular aspirin users had a reduced risk of gastric cancer (adjusted hazard ratio [aHR], 0.71; 95% confidential interval [CI], 0.47 to 1.08; p=0.107). Duration of aspirin use showed significant association with reduction of gastric cancer risk (aHR for each year of aspirin use, 0.85; 95% CI, 0.73 to 0.99; p=0.044), particularly in patients who used aspirin for more than 3 years (aHR, 0.40; 95% CI, 0.16 to 0.98; p=0.045). Conclusion Long-term low-dose aspirin use was associated with reduced gastric cancer risk in patients with hypertension or type 2 diabetes.

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Monica Susan, Ioana Macasoi, Iulia Pinzaru, Cristina Dehelean, Iosif Ilia, Razvan Susan, Ioana Ionita
Current Oncology.2023; 30(7): 6197. CrossRef
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Safety and effectiveness of low-dose aspirin for the prevention of gastrointestinal cancer in adults without atherosclerotic cardiovascular disease: a population-based cohort study
Jessica J P Shami, Jiaxi Zhao, Swathi Pathadka, Eric Yuk Fai Wan, Joseph Edgar Blais, Pareen Vora, Montse Soriano-Gabarró, Ka Shing Cheung, W K Leung, Ian C K Wong, Esther W Chan
BMJ Open.2022; 12(2): e050510. CrossRef
Association Between Aspirin Use and Gastric Adenocarcinoma: A Prospective Cohort Study
Sohee Kwon, Wenjie Ma, David A. Drew, Samuel J. Klempner, Brianna M. Leonardo, Jacqueline J. Flynn, Yin Cao, Edward L. Giovannucci, Ying Bao, Charles S. Fuchs, Mingyang Song, Andrew T. Chan
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Ryota Niikura, Yoshihiro Hirata, Yoku Hayakawa, Takuya Kawahara, Atsuo Yamada, Kazuhiko Koike
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Ying Liang, Haoyan Jiao, Lingbo Qu, Hao Liu
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Cumulative Dose Threshold for the Chemopreventive Effect of Aspirin Against Gastric Cancer
Min-hyung Kim, Jooyoung Chang, Warrick Junsuk Kim, Samprit Banerjee, Sang Min Park
American Journal of Gastroenterology.2018; 113(6): 845. CrossRef
Chemoprevention of Gastric Cancer: Non-steroidal Anti-inflammatory Drugs Including Aspirin
Kee Don Choi
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Effects of long-term aspirin use on molecular alterations in precancerous gastric mucosa in patients with and without gastric cancer
Yuki Michigami, Jiro Watari, Chiyomi Ito, Ken Hara, Takahisa Yamasaki, Takashi Kondo, Tomoaki Kono, Katsuyuki Tozawa, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Takeshi Morimoto, Kiron M. Das, Hiroto Miwa
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Aspirin enhances the cytotoxic activity of bortezomib against myeloma cells via suppression of Bcl-2, survivin and phosphorylation of AKT
Jiang-Hua Ding, Li-Ya Yuan, Guo-An Chen
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Aspirin and non-steroidal anti-inflammatory drugs use reduce gastric cancer risk: A dose-response meta-analysis
Xuan-zhang Huang, You Chen, Jian Wu, Xi Zhang, Cong-cong Wu, Chao-ying Zhang, Shuang-shuang Sun, Wen-jun Chen
Oncotarget.2017; 8(3): 4781. CrossRef
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Dietary inflammatory index and the risk of gastric cancer in a Korean population
Sunghee Lee, Jeonghee Lee, Il Ju Choi, Young-Woo Kim, Keun Won Ryu, Young-Il Kim, Jin-Kyoung Oh, Binh Thang Tran, Jeongseon Kim
Oncotarget.2017; 8(49): 85452. CrossRef

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Public Perceptions on Cancer Incidence and Survival: A Nation-wide Survey in Korea: Soyeun Kim, Dong Wook Shin, Hyung Kook Yang, So Young Kim, Young-Jin Ko, BeLong Cho, Young Sung Lee, Dukhyoung Lee, Keeho Park, Jong Hyock Park; Cancer Res Treat. 2016;48(2):775-788. Published online May 26, 2015; DOI: https://doi.org/10.4143/crt.2014.369

Abstract PDF PubReader ePub

Purpose
The aim of this study was to compare the public perceptions of the incidence rates and survival rates for common cancers with the actual rates from epidemiologic data.
Materials and Methods
We conducted a survey of Korean adults without history of cancer (n=2,000). The survey consisted of questions about their perceptions regarding lifetime incidence rates and 5-year survival rates for total cancer, as well as those of eight site-specific cancers. To investigate associated factors, we included questions about cancer worry (Lerman’s Cancer Worry Scale) or cared for a family member or friend with cancer as a caregiver.
Results
Only 19% of Korean adults had an accurate perception of incidence rates compared with the epidemiologic data on total cancer. For specific cancers, most of the respondents overestimated the incidence rates and 10%-30% of men and 6%-18% of women had an accurate perception. A high score in “cancer worry” was associated with higher estimates of incidence rates in total and specific cancers. In cancers with high actual 5-year survival rates (e.g., breast and thyroid), the majority of respondents underestimated survival rates. However, about 50% of respondents overestimated survival rates in cancers with low actual survival rates (e.g., lung and liver). There was no factor consistently associated with perceived survival rates.
Conclusion
Widespread discrepancies were observed between perceived probability and actual epidemiological data. In order to reduce cancer worry and to increase health literacy, communication and patient education on appropriate risk is needed.

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Family Avoidance of Communication about Cancer: A Dyadic Examination: Dong Wook Shin, Jooyeon Shin, So Young Kim, Hyung-Kook Yang, Juhee Cho, Jung Ho Youm, Gyu Seog Choi, Nam Soo Hong, BeLong Cho, Jong-Hyock Park; Cancer Res Treat. 2016;48(1):384-392. Published online March 13, 2015; DOI: https://doi.org/10.4143/crt.2014.280

Abstract PDF PubReader ePub

Purpose
This study aimed to examine the following questions: to what extent do patients and caregivers perceive their family members to be avoidant of communication regarding patient’s cancer, and to what extent do these perceptions interrelate; and how do such perceptions influence their own and each other’s communication behaviors, communication outcome, mental health, and quality of life. Materials and Methods A national survey was performed with 990 patient-caregiver dyads (participation rate, 76.2%). To examine the dyadic interaction, we developed linked patient and family member questionnaires, including the Family Avoidance of Communication about Cancer (FACC) scale. Results The mean scores (standard deviations) of patient- and caregiver-perceived FACC were low at 10.9 (15.5) and 15.5 (17.5), respectively (p < 0.001), and concordance was low, a well (Spearman’s rho, 0.23). Patient-perceived FACC was associated with lower levels of disclosure and behaviors of holding back communication, as well as lower levels of mental health outcome and quality of life. The same was true for caregivers (all p < 0.05). Patient-perceived FACC was associated with caregiver holding back, caregiver’s depression level, and caregiver quality of life (all p < 0.05). Both patient- and caregiver-perceived FACC were independently associated with communication difficulty within the family. Conclusion Future research would benefit from the measurement of FACC from both patients and caregivers, and promote family intervention to enhance openness to communication, which would be helpful for improving mental health and quality of life for both patients and caregivers.

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Medical Costs and Healthcare Utilization among Cancer Decedents in the Last Year of Life in 2009: Inuk Hwang, Dong Wook Shin, Kyoung Hee Kang, Hyung Kook Yang, So Young Kim, Jong-Hyock Park; Cancer Res Treat. 2016;48(1):365-375. Published online March 2, 2015; DOI: https://doi.org/10.4143/crt.2014.088

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate the cancer care cost during the last year of life of patients in Korea. Materials and Methods We studied the breakdown of spending on the components of cancer care. Cancer decedents in 2009 were identified from the Korean Central Cancer Registry and linked with the Korean National Health Insurance Claims Database. The final number of patients included in the study was 70,558.
Results
In 2009, the average cancer care cost during the last year of life was US $15,720. Patients under age 20 spent US $53,890 while those 70 or over spent US $11,801. Those with leukemia incurred the highest costs (US $43,219) while bladder cancer patients spent the least (US $13,155). General costs, drugs other than analgesics, and test fees were relatively high (29.7%, 23.8%, and 20.7% of total medical costs, respectively). Analgesic drugs, rehabilitation, and psychotherapy were still relatively low (4.3%, 0.7%, and 0.1%, respectively). Among the results of multiple regression analysis, few were notable. Age was found to be negatively related to cancer care costs while income level was positively associated. Those classified under distant Surveillance, Epidemiology, and End Results stages of cancer and higher comorbidity level also incurred higher cancer care costs. Conclusion Average cancer care costs varied significantly by patient characteristics. However, the study results suggest an underutilization of support services likely due to lack of alternative accommodations for terminal cancer patients. Further examination of utilization patterns of healthcare resources will help provide tailored evidence for policymakers in efforts to reduce the burdens of cancer care.

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Seonhwa Lee, Byungmi Kim, Jin Young Choi, So-Jung Park, Jun Ah Lee, Chung Ho Kim, Bomi Park, Bohyun Park
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Oncologists’ Experience with Patients with Second Primary Cancer and the Attitudes toward Second Primary Cancer Screening: A Nationwide Survey: Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Boram Park, BeLong Cho, Hyung Jin Kim, Young Jun Lee, Deog-Yeon Jo, Jong Hyock Park; Cancer Res Treat. 2015;47(4):600-606. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.162

Abstract PDF PubReader ePub

Purpose
Screening for second primary cancer (SPC) is one of the key components to survivorship care. We aim to evaluate the oncologists’ experience with SPCs and assess the current practice, perceived barriers, and recommendations related to SPC screening. Materials and Methods A nationwide survey was conducted with a representative sample of 496 Korean oncologists. A questionnaire based on the findings from our previous qualitative study was administered. Results More than three-fourths of oncologists (76.3%), who participated in the study, had experience with SPC patients. Over half of them (51.9%) stated that it was an embarrassing experience. While the current management practice for SPC varies, most oncologists (80.2%) agreed on the necessity in proactively providing information on SPC screening. A short consultation time (52.3%), lack of guidelines and evidence on SPC screening (47.7%), and patients’ lack of knowledge about SPCs (45.1%) or SPC screening (41.4%) were most frequently reported as barriers to providing appropriate care for managing SPC. Oncologists recommended the development of specific screening programs or guidelines in accordance to the type of primary cancer (65.9%), the development of an internal system for SPC screening within the hospital (59.7%) or systematic connection with the national cancer screening program (44.3%), and education of oncologists (41.4%) as well as patients (48.9%) regarding SPC screening. Conclusion Many oncologists reported the occurrence of SPC as an embarrassing experience. Given the variations in current practice and the lack of consensus, further studies are warranted to develop the optimal clinical strategy to provide SPC screening for cancer survivors.

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Physicians’ attitudes towards the media and peer-review selection of the ‘best cancer doctor’: comparison of two different selection methods
Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Soohyeon Lee, Eun Joo Nam, Joo Seop Chung, Jeong-Soo Im, Keeho Park, Jong Hyock Park
BMJ Open.2018; 8(5): e019067. CrossRef

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Oncologist Perspectives on Rare Cancer Care: A Nationwide Survey: Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Su Hyun Lee, Beomseok Suh, Hee-Young Shin, Hyun Joo Lee, Dae Ghon Kim, Jong Hyock Park; Cancer Res Treat. 2015;47(4):591-599. Published online January 5, 2015; DOI: https://doi.org/10.4143/crt.2014.086

Abstract PDF PubReader ePub

Purpose
In response to the challenges and difficulties imposed by rare cancers, multi-stakeholder initiatives dedicated to improving rare cancer care was launched, and several recommendations were made by professional societies. However, these primarily reflect the view of the advocates and supporters, and may not represent the views of the “average” clinician or researcher. In this study, we sought to investigate perceived difficulties with regard to rare cancer care and potential solutions endorsed by oncologists.
Materials and Methods
A representative sample of 420 oncologists recruited in 13 cancer centers participated in a nationwide survey.
Results
Oncologists faced various difficulties in treatment of patients with rare cancers, including the lack of clinical practice guidelines (65.7%) and personal experience (65.2%), lack of approved treatment options (39.8%), and reimbursement issues (44.5%). They were generally supportive of recent recommendations by multi-stakeholder initiatives as well as professional societies for development of clear clinical practice guidelines (66.0%), flexible reimbursement guidelines (52.9%), and a national rare cancer registry (47.4%). However, there was only moderate endorsement for referrals to high-volume centers (35.5%) and encouragement of off-label treatments (21.0%).
Conclusion
Insights into the general attitudes of oncologists gained through our nationwide survey of representative samples would be helpful in development of clinical practices and public health policies in rare cancer treatment and research.

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Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Soohyeon Lee, Eun Joo Nam, Joo Seop Chung, Jeong-Soo Im, Keeho Park, Jong Hyock Park
BMJ Open.2018; 8(5): e019067. CrossRef
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The Lancet Oncology.2017; 18(8): 1022. CrossRef

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