• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2059-2065
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• 2013

This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

• Korean Journal of Adult Nursing
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• v.21 no.6
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• pp.580-592
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• 2009

Purpose: The purpose of this study was to investigate the factors related to Breast cancer Screening using Mammography and CBE of Korean women over 40 years of age. Methods: The participants for this study were 183 Korean women living in 3 urban cities and aged from 40 to 75. The data were collected using structured questionnaires which included sociodemographic factors (11 items), frequency and regularity of mammography and clinical breast examination (7 items), knowledge (16 items), health belief model scale (28 items), and family support (4 items) about breast cancer and breast cancer screening. Frequencies, Chronbach's alpha for reliability, Chi-square, t-test and logistic regression with the SPSS/WIN 12 program were used to analyze the data. Results: The percentages of Korean women who had a mammography and CBE for breast cancer screening were 60.1 and 31.1, respectively. Logistic regression analyses demonstrated that regular check ups and perceived barriers were significant predictors of mammography and CBE use for breast cancer screening. Conclusion: In order to increase the frequency of breast cancer screening practices, educational support and a health care delivery system is needed to improve the chance of regular health check ups.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5693-5697
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• 2013

Background: Changes in the attitudes and behavior of relatives of breast cancer patients concerning cancer prevention and screening after diagnosis in a loved one were evaluated. Materials and Methods: Forty-three questions were used to collect data from the relatives of the breast cancer patients who had been living with their relatives for at least one year. Results: The study group was composed of 171 female relatives (median age: 43, range: 17-82 yr). After the patients were diagnosed with breast cancer, changes in the attitudes and behavior of their relatives toward the prevention and screening of cancer were evident in 78 (45.6%) of the study participants (e.g. eating habits, quit or reduced smoking, exercise habits). In addition, it was noted that some characteristics of the relatives had different effects on different attitudes and behavior. Conclusions: Awareness on breast cancer among the relatives of breast cancer patients is useful for the management of health and social problems that can be seen in these individuals. At the same time, this information could help countries determine whether their actual level of healthcare for early cancer diagnosis, prevention, and screening are adequate.

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

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

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8095-8099
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• 2014

Background: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. Materials and Methods: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression. Results: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake. Conclusions: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.

• The Journal of the Korea Contents Association
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• v.12 no.11
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• pp.246-257
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• 2012

Objectives : This study was aimed to grasp the stages of change in breast cancer screening of the nurses and general women who were over 20 and under 50 and specify the factors which affected the stages of change in breast cancer screening, based on Precaution Adoption Process Model. Methods : This study was conducted for 158 people who consisted of the nurses and general women who were over 20 and under 50. Results : As a result of examining the factors of cues to action and the belief in cancer screening according to the stages of change in the breast cancer screening of the nurses and general women, there was not a statistically significant difference and the perceived barriers showed a statistically significant difference in the stage of behavioral decision, the fifth stage. Conclusion : It is necessary to approach the individuals with the recommendation of cancer screening through the people around them and differentiated strategies considering the stages of change in cancer screening in order to induce the behavioral change in breast cancer screening, and develop and apply the strategies to enhance the severity perceived on the breast cancer.

• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.109-116
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• 2009

Objectives : This study was performed to evaluate the relationships between psychosocial characteristics and changes in the stage of breast cancer screening behavior. Methods : The 474 study subjects were randomly sampled from 21,459 women(age range, 40-70 years) who were eligible for the Korean National Cancer Screening Program in 2006 in Jinju, Gyeongsangnam-do. The information, including behaviors and sociodemographic characteristics, attitudes, subjective norms and self-efficacy, was collected by trained interviewers via home visits. The breast cancer screening stages were grouped as precontemplation, contemplation, action, maintenance and relapse, according to Rakowski. Results : Of the 474 women, 18.8% were in the precontemplation stage, 23.3% were in the contemplation stage, 13.1% were in the action stage, 36.6% were in the maintenance stage, and 8.2% were in the relapse stage. The distribution of stages was associated with attitude, subjective norms and self-efficacy(p for trend<0.01). To investigate the overall relationship between the variables, we conducted a linear structural equation model analysis based on the theory of planned behavior. The subjective norms and self-efficacy influenced the stage of the women's screening behavior. Conclusions : We should target on self-efficacy about the screening behavior of women by performing timely, thoughtful interventions. The support from family members, friends and other people is crucial for women to undergo breast cancer screening and to improve the breast cancer screening rate.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1737-1742
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• 2013

Early diagnosis has a major role in improving prognosis of breast cancer. The purpose of this study was to assess the risk status of women 35-69 years of age using risk assessment models and the prevalence of mammography in a community setting. The sample of this cross sectional study consisted of 227 women, 35-69 years of age residing in Izmir, a city located in western region of Turkey. A questionnaire was used to collect data and the Gail and Cuzick-Tyrer models were applied to assess the risk of breast cancer. In this study, 52.7% of women had mammography at least once, and 41.3% of the women over the age of 40 had mammography screening in the last two years. The five years risk for breast cancer was high in 15.8% of women according to the Gail model and ten years risk was high in 21.7% with the Cuzick-Tyrer model. In the present study, the breast cancer risk levels were assessed in a population setting for the first time in Turkey using breast cancer risk level assessment models. Being in 60-69 age group, having low education and not being in menopause were significant risk factors for not having mammography according to logistic regression analysis. Mammography utilization rate was low. Women must be educated about breast cancer screening methods and early diagnosis. The women in the high risk group should be informed on their risk status which may increase their attendance at breast cancer screening.

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

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

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3965-3971
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• 2014

Background: In Iran, there are high rates of breast cancer. It is among the five most common cancers, the first among cancers diagnosed, and is the leading cause of cancer deaths among Iranian women. Objectives: The purpose of this qualitative study was to explore perception of breast cancer screening among Iranian women who have never had a mammograph. Materials and Methods: The current study was part of a qualitative research conducted by means of content analysis method and purposive sampling of 16 women over the age of 30 years who had not undergone mammography using individual semi-structured interviews. Interviews were recorded and transcribed verbatim. The data were under continuous consideration and comparative analysis in order to achieve data saturation. Results: After codification of data, three concept categories were achieved including: i) low awareness, ii) worries, and iii) lack of motivation. Conclusions: Although there is a tendency among Iranian women to participate in breast cancer screening, there is a powerful cultural belief that breasts are sexual organs that should not be discussed publicly. Due to the incidence of breast cancer in Iranian women, it is critical that breast awareness education be performed by health care experts to explore the concepts of breast cancer and breast cancer screening.