Cancer Research and Treatment

Original Articles

Associations of Financial Toxicity with Employment Concerns and Cancer-Related Distress: A Cross-Sectional Survey among Korean Working-Age Cancer Survivors: Hyun-Ju Seo, Dal-Lae Jin, Young Ae Kim, Su Jung Lee, Seok-Jun Yoon; Received January 24, 2024 Accepted December 2, 2024 Published online December 3, 2024; DOI: https://doi.org/10.4143/crt.2024.090 [Accepted]

Abstract PDF: Purpose
Although South Korea’s health insurance has a co-payment-decreasing policy for cancer survivors, information on the extent of financial toxicity and its related factors is limited. We assessed the level of financial toxicity and the association of high levels of financial toxicity with employment concerns after diagnosis and cancer-related distress in working-age cancer survivors.
Materials and Methods
A cross-sectional study was conducted. Study participants were recruited from the National Cancer Survivorship Center between November and December 2022. Financial burden was assessed using the Korean version of the Comprehensive Score for Financial Toxicity, and cancer-related distress was measured using the NCCN Distress Thermometer. Multivariate logistic regression analyses were used to explore the associations between high financial toxicity, cancer-related distress, and changes in employment status after cancer diagnosis.
Results
Of 1,403 working-age cancer survivors, approximately 62% reported high levels of financial distress. Survivors reporting early retirement and taking time off work with the intent to return were more likely to report high financial toxicity (adjusted OR 1.69, 95% CI 1.14-2.5; and adjusted OR 2.82, 95% CI 1.24-6.43, respectively) than those with a full-time or part-time job. Moreover, cancer survivors with high distress levels were more likely to report high financial toxicity than those with low distress levels (adjusted OR 4.36, 95% CI 3.17-5.99).
Conclusion
High financial toxicity is associated with adverse employment concerns and cancer-related distress among working-age cancer survivors. Therefore, developing cancer survivorship interventions within the healthcare system is necessary to ensure improvements in financial well-being.

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General

Validation of Cancer Diagnosis Based on the National Health Insurance Service Database versus the National Cancer Registry Database in Korea: Min Soo Yang, Minae Park, Joung Hwan Back, Gyeong Hyeon Lee, Ji Hye Shin, Kyuwoong Kim, Hwa Jeong Seo, Young Ae Kim; Cancer Res Treat. 2022;54(2):352-361. Published online August 2, 2021; DOI: https://doi.org/10.4143/crt.2021.044

Abstract PDF PubReader ePub

Purpose
This study aimed to assess the feasibility of operational definitions of cancer patients in conducting cancer-related studies using the claims data from the National Health Insurance Service (NHIS).
Materials and Methods
Cancer incidence data were obtained from the Korean Central Cancer Registry, the NHIS primary diagnosis, and from the rare and intractable disease (RID) registration program.
Results
The operational definition with higher sensitivity for cancer patient verification was different by cancer type. Using primary diagnosis, the lowest sensitivity was found in colorectal cancer (91.5%; 95% confidence interval [CI], 91.7 to 92.0) and the highest sensitivity was found in breast cancer (97.9%; 95% CI, 97.8 to 98.0). With RID, sensitivity was the lowest in liver cancer (91.9%; 95% CI, 91.7 to 92.0) and highest in breast cancer (98.1%; 95% CI, 98.0 to 98.2). In terms of the difference in the date of diagnosis in the cancer registration data, > 80% of the patients showed a < 31-day difference from the RID definition.
Conclusion
Based on the NHIS data, the operational definition of cancer incidence is more accurate when using the RID registration program claims compared to using the primary diagnosis despite the relatively lower concordance by cancer type requires additional definitions such as treatment.

Citations

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Socioeconomic Burden of Cancer in Korea from 2011 to 2015: Young Ae Kim, Ye-Rin Lee, Jeongjoo Park, In-Hwan Oh, Hoseob Kim, Seok-Jun Yoon, Keeho Park; Cancer Res Treat. 2020;52(3):896-906. Published online March 18, 2020; DOI: https://doi.org/10.4143/crt.2019.398

Abstract PDF PubReader ePub

Purpose
Though the socioeconomic burden of cancer on patients is increasing in South Korea, there is little research regarding the type of cancer that incurs the highest costs. This study analyzed the socioeconomic burden on cancer patients from 2011 to 2015 according to sex and age.
Materials and Methods
A prevalence-based approach was applied utilizing claim data of the National Health Insurance Service in Korea to estimate the socioeconomic burden of cancer on patients. Patients who received treatment for cancer from 2011 to 2015 were the study subjects. The total socioeconomic burden of their disease and treatment was divided into direct and indirect costs.
Results
There was an increase of 50.7% for 5 years, from 821,525 to 1,237,739 cancer patients. The cancer costs for men and women increased $8,268.4 million to $9,469.7 million and $3,626.5 million to $4,475.6 million, respectively. Furthermore, the 50-59-year-old age group accounted for a large portion of the total disease cost. Liver, lung, stomach, and colorectal cancers created the heaviest economic burdens on patients.
Conclusion
Overall, this study indicates new policies for cancer prevention, early detection, and postcancer treatment management are necessary to help limit the costs associatedwith cancer, especially in the elderly, and provides a foundation for establishing cancer-related health care policies, particularly by defining those cancers with heavier disease burdens.

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Public Attitudes towards Cancer Survivors among Korean Adults: Su Yeon Kye, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim; Cancer Res Treat. 2020;52(3):722-729. Published online February 6, 2020; DOI: https://doi.org/10.4143/crt.2019.265

Abstract PDF PubReader ePub

Purpose
We evaluated public attitudes towards cancer survivors and identified the characteristics associated with these attitudes in Korea.
Materials and Methods
We performed this cross-sectional study using proportionate quota random sampling of the 2015 Korean Census. In May 2017, investigators conducted face-to-face interviews with 1,500 Korean volunteers aged between 20 and 79 years. The questionnaire recorded sociodemographic factors, smoking and drinking habits, cancer history in family and acquaintances, interest in cancer survivors, cancer-survivor blame, and attitudes towards cancer survivors.
Results
Many participants had negative attitudes towards cancer survivors. People with a monthly household income above US $7,000 were less likely to have a negative attitude than those with monthly incomes below US $1,499. People in their 70s, without a religion, living in rural areas, smokers, or those who blame cancer survivors for their own cancer were more likely to have a negative attitude than people outside these categories. People interested in cancer survivors were less likely to have a negative attitude than those who were not interested.
Conclusion
To improve attitudes towards cancer survivors, it will be necessary to increase interest in cancer survivors through education, publicity, and advocacy using strategic messaging that focuses on social and institutional aspects and emphasizes that responsibility for cancer should not be attributed to cancer patients. Inducing the public to be interested in cancer survivors will be important for positive attitudes toward cancer survivors.

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Role performance and factors affecting quality of life in bladder cancer survivors with ileal orthotopic neobladder
So Hee Kim, Eunjung Ryu, Byong Chang Jeong
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Effects of stigma on quality of life of cancer survivors: Preliminary evidence from a survivorship programme in Kenya
Koech J. Maureen, Judy Mwangi, Benda Kithaka, Serah Kimaru, Ndinda Kusu, Lucy Munyi, Sidney Chahonyo, Francis Makokha
Heliyon.2024; 10(9): e30165. CrossRef
Perception of Korean healthy adolescents on cancer and adolescent cancer survivors: a cross-sectional survey
Min Kyung Hyun, Yeonseung Lee, Hyun Jeong Lee, Young Ae Kim
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Kisook Kim, Hyohyoen Yoon, Booyoung Oh
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How should the healthcare system support cancer survivors? Survivors’ and health professionals’ expectations and perception on comprehensive cancer survivorship care in Korea: a qualitative study
Su Jung Lee, Dal-Lae Jin, Young Ae Kim, Hyun-Ju Seo, Seok-Jun Yoon
BMC Cancer.2023;[Epub] CrossRef

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Outcomes of Pregnancy after Breast Cancer in Korean Women: A Large Cohort Study: Moo Hyun Lee, Young Ae Kim, Jin Hyuk Hong, So-Youn Jung, Sunmi Lee, Sun-Young Kong, Boyoung Park, Eun Sook Lee; Cancer Res Treat. 2020;52(2):426-437. Published online September 3, 2019; DOI: https://doi.org/10.4143/crt.2018.382

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to determine the rate and outcomes of pregnancies subsequent to breast cancer in Korea, and the effect of such pregnancies on the prognosis of women who survived breast cancer and subsequently conceived. Materials and Methods We followed a total of 31,761 Korean women 45 years of age or younger who were treated for primary breast cancer from 2002 to 2010. We also included follow-up surveys that were conducted through December 2011. We identified recurrence and mortality from breast cancer using data linked to the Korea National Health Insurance database. We used propensity score matching of the study cohort to analyze the risks of recurrence and mortality from breast cancer depending on pregnancy.
Results
Within our sample, 992 women (3.1%) became pregnant after receiving treatment for breast cancer. Of those, 622 (67.5%) successfully delivered; the remaining 370 (32.5%) failed to deliver. After propensity score matching, we found that the women who became pregnant after breast cancer did not have a different risk of recurrence (hazard ratio [HR], 0.503; 95% confidence interval [CI], 0.434 to 0.584) and death (HR, 0.520; 95% CI, 0.397 to 0.681), compared with those who did not conceive after breast cancer treatment. Conclusion Our study is the first to report outcomes for Korean women who survived breast cancer and subsequently conceived. Women who survived breast cancer and subsequently became pregnant did not show a poorer survival outcome, compared with those who did not become pregnant.

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Conception and pregnancy among women with a live birth after breast cancer treatment: A survey study of young breast cancer survivors
Kimia Sorouri, Tal Sella, Shoshana M. Rosenberg, Maggie Loucks, Gregory Kirkner, Craig Snow, Kathryn J. Ruddy, Shari I. Gelber, Rulla M. Tamimi, Jeffrey M. Peppercorn, Lidia Schapira, Virginia F. Borges, Steven E. Come, Ellen Warner, Ann H. Partridge
Cancer.2024; 130(4): 517. CrossRef
Safe and successful pregnancy following breast cancer treatment in young patients 35 years old or under without invasive fertility preservation: a retrospective study
Ji Hye Kim, Yong Yeup Kim, Jai Hyun Chung, Woo Young Kim, Jae Bok Lee, Sang Uk Woo
Annals of Surgical Treatment and Research.2024; 106(4): 189. CrossRef
Female reproductive health in pediatric, adolescent, and young adult cancer survivors
Holly R. Hoefgen, Janie Benoit, Serena Chan, Yasmin Jayasinghe, Maryam Lustberg, Victoria Pohl, Amanda Saraf, Deb Schmidt, Leslie Coker Appiah
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Pregnancy rate, maternal and neonatal outcomes among breast cancer survivors: A systematic review
Marzieh Azizi, Elham Ebrahimi, Zahra Behboodi Moghadam, Zohreh Shahhosseini, Maryam Modarres
Nursing Open.2023; 10(10): 6690. CrossRef
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Natalie Levey, Iris Krishna
Obstetrics and Gynecology Clinics of North America.2022; 49(1): 181. CrossRef
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Soo Youn Bae, Jihyoun Lee, Ji Sung Lee, Jae Sun Yoon, Ku Sang Kim, Yoo Seok Kim, Zisun Kim, Jun Won Min, Eun-Jung Shim, Ilkyun Lee, Min Hyuk Lee, Sungmin Park
The Breast.2022; 63: 46. CrossRef
Update on Pregnancy Following Breast Cancer Diagnosis and Treatment
Marta Perachino, Francesca Poggio, Luca Arecco, Eva Blondeaux, Stefano Spinaci, Camilla Marrocco, Alessia Levaggi, Matteo Lambertini
The Cancer Journal.2022; 28(3): 176. CrossRef
Survival outcomes following pregnancy or assisted reproductive technologies after breast cancer: A population‐based study
J. Alejandro Rauh‐Hain, Jose Zubizarreta, Roni Nitecki, Alexander Melamed, Shuangshuang Fu, Kirsten Jorgensen, Paula C. Brady, Valerie L. Baker, Mariana Chavez‐MacGregor, Sharon H. Giordano, Nancy L. Keating
Cancer.2022; 128(17): 3243. CrossRef
Survival after breast cancer in women with a subsequent live birth: Influence of age at diagnosis and interval to subsequent pregnancy
Richard A. Anderson, Matteo Lambertini, Peter S. Hall, W. Hamish Wallace, David S. Morrison, Tom W. Kelsey
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Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis
Matteo Lambertini, Eva Blondeaux, Marco Bruzzone, Marta Perachino, Richard A. Anderson, Evandro de Azambuja, Philip D. Poorvu, Hee Jeong Kim, Cynthia Villarreal-Garza, Barbara Pistilli, Ines Vaz-Luis, Cristina Saura, Kathryn J. Ruddy, Maria Alice Franzoi,
Journal of Clinical Oncology.2021; 39(29): 3293. CrossRef

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The Economic Burden of Breast Cancer in Korea from 2007-2010: Young Ae Kim, In-Hwan Oh, Seok-Jun Yoon, Hyun-Jin Kim, Hye-Young Seo, Eun-Jung Kim, Yo Han Lee, Jae Hun Jung; Cancer Res Treat. 2015;47(4):583-590. Published online February 13, 2015; DOI: https://doi.org/10.4143/crt.2014.143

Abstract PDF PubReader ePub

Purpose
This study estimates the socioeconomic cost and burden for breast cancer patients in Korea between 2007 and 2010. Materials and Methods This study used a prevalence-based approach to estimate the cost of breast cancer. Breast cancer patients were defined as those who were hospitalized or have visited an outpatient clinic during the period from 2007 to 2010. The socioeconomic costs of breast cancer were subdivided into two costs: direct and indirect.
Results
From 2007 to 2010, the prevalence of treated breast cancer increased from 7.9% to 20.4%. The total socioeconomic costs incurred by breast cancer increased by approximately 40.7% from US $668.49 million in 2007 to US $940.75 million in 2010. The direct medical care costs for 2010 were 1.4 times greater (US $399.22 million) than for 2007 (US $278.71 million). The direct non-medical costs rose from US $50.69 million in 2007 to US $75.83 million in 2010, a 49.6% increase. Regarding the economic burden of breast cancer, the total indirect costs were US $339.09 million in 2007 and increased by 37.3% to US $465.70 million in 2010. In the sensitivity analysis, with the annual discount rate for each year ranging from 0%-5%, the costs increased 1.1-1.2 times. Conclusion Due to the growing incidence of breast cancer, the annual prevalence and related costs are increasing. We must strive to reduce the socioeconomic burden of breast cancer through preventive measures and early screening.

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