• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.4081-4088
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• 2015

Background: Men and women who smoke tend to show less compliance to screening guidelines than non-smokers. However, a recent study in Korea showed that self-reported female smokers constituted less than half of cotinine-verified smokers. Therefore, the aim of this study was to identify hidden smokers using cotinine-verified method and examine cancer screening behavior according to biochemically verified smoking status. Materials and Methods: Among 5,584 women aged 30 years and older who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Survey (KNHANES), 372 (6.66%) hidden smokers were identified based on interview responses and verified by urinary cotinine levels. We compared cancer-screening behavior (cervical, breast, stomach, and colon cancer) of female hidden smokers to that of non-smokers and selfreported smokers by cross-sectional analysis. Results: Hidden female smokers had significantly lower adherence to breast cancer screening compared to non-smokers (aOR (adjusted odds ratio) [95% CI] = 0.71 [0.51-0.98]). Adherence to stomach cancer (aOR [95% CI] = 0.75 [0.54-1.03]) and cervical cancer (aOR [95% CI] = 0.85 [0.66-1.10]) screening was also lower among hidden female smokers compared to non-smokers. Self-reported (current) smokers showed lowest adherence to cervical cancer (aOR: 0.64, 95% CI0.47-0.87), breast cancer (0.47 [0.32-0.68]), stomach cancer (0.66[0.46-0.95]), and colon cancer (0.62 [0.38-1.01]) screening compared to non-smokers, followed by female hidden smokers, then non-smokers. These lower adherence rates of current smokers were attenuated after we incorporated hidden smokers into the current smoker group. Conclusions: Cancer screening adherence of female hidden smokers was lower than cotinine-verified non-smokers but higher than current smokers. Considering the risk of smoking-related cancer among women, identifying hidden smokers is important to encourage appropriate cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6459-6463
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• 2013

We investigated the cancer screening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri) using data from the Korean National Cancer Screening Survey (KNCSS), which is a nationwide, annual cross-sectional survey. The eligible study population included cancer-free men 40 years of age and older and women 30 years of age and older. The lifetime screening rate and screening rate with recommendation were calculated. The lifetime screening rates for gastric, liver, colorectal, breast, and cervical cancers were 77.9%, 69.9%, 65.8%, 82.9%, and 77.1%, respectively. The screening rates with recommendation were 70.9%, 21.5%, 44.7%, 70.9%, and 67.9%, respectively. The most common reason for all types of cancer was "no symptoms", followed by "lack of time" and "fear of the examination procedure". Efforts to facilitate participation in liver and colorectal cancer screening among Korean men and women are needed.

• Korean Journal of Health Education and Promotion
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• v.19 no.3
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• pp.135-152
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• 2002

Objectives: Cancer is the most frequent cause of death in Korea. Cancer screenings can save lives through early detection and their effect can be enhanced by regular repeat adherence rather than one-time screening. The aim of this study was to investigate major cancer screening rates and the reasons for not having screening for providing the basic data required. Materials and Methods: The study sample were recruited from the parents of students in 3 different middle and high schools in Pusan. 428 participants(l93 of males, 214 of females) completed a structured self-administered questionnaire from Dec. 21 to 31, 2001 and the response rate was 73.8%. Data were analyzed using descriptive statistics with SPSS Win 10.0. Results: The cancer screening rates of the subjects(male and female respectively) who have had one or more in their life-time were about 36.3% and 34.6% in gastroendoscopy for stomach cancer, about 11.1 % and 8.5% in stool hemocult test and colonoscopy for colon cancer, 13.5% and 9.3% in prostate-antigen test and rectal digit exam for prostate cancer, 36.4% in mammograpy for breast cancer, and 59.3% in Pap smear test for cervical cancer. And the higher proportions of having regular screening were 36.0% in Pap smear test for cervical cancer and 11.7% in mammograpy for breast cancer. The reasons related to not having screening tests were found that ‘seem to be healthy’ was 44.8%∼58.9% and the most common reason and the following was ‘not having opportunity for check-up’. The most common reason related to not having regular screening tests were ‘for the finding of previous check-up was normal’.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5869-5873
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• 2015

Background: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. Materials and Methods: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. Results: The mean age of the study group was $32.8{\pm}6.9$ years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". Conclusions: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2501-2505
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• 2015

Purpose: The present study was carried out to measure knowledge level and behavior of family health personnel (FHP) in Izmir on early diagnosis of breast and cervical cancers. Materials and Methods: The study population of this cross-sectional study was not selected. A questionnaire was applied to all FHP to measure knowledge level and behavior about cancer. The participation rate was 88%. Breast examination, mammography analysis, Papanicolaou smear applications were determined as dependent variables, and knowledge level about breast and cervical cancer, age, professional time as FHP as independent variables. Data were evaluated using definitive statistics, chi-square and logistic regression tests in SPSS software package for Windows 15.0. Results: A total of 970 family health personnel participated in the research. The age range was 20-45 years (82.4%). Mean age was $37.9{\pm}7.4$. Response rate was 87.3%. Of the participants, 88.4% performed breast self-examination. Rate of performing mammography at least once was 24.1%. Rate of performing Pap-smear examination at least once was 61.0%. In logistic regression analyses, it was determined that people with knowledge on breast and cervical cancer were those performing breast self-examination, mammography and Pap-smear examinations (p<0.05. Conclusions: It is essential that the knowledge, behavior and manners of health providers on early diagnosis for cancer increases awareness in the general population and provides information on execution ofthe most effective methods for generating a healthy society.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.10003-10008
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• 2014

Background: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. Objectives: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. Materials and Methods: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. Results: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. Conclusions: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.143-147
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• 2016

Breast and cervical cancers are among leading causes of morbidity and mortality in women worldwide. Regular screening is very important for early detection of these cancers, but studies indicate low rates of screening participation. In this survey we studied the rate of screening participation among women 18-64 years old referred to urban health centers in Kerman, Iran in 2015. A cross-sectional study was carried out on 240 women who were selected using a multistage sampling method. Data collected using a questionnaire covered demographics and questions about common cancer screening status in women. Analysis was by SPSS 19. The mean age of participants was $31.7{\pm}7$. Most (97.1%) were married, housewives (83.3%), had high school diploma (43.8%) and a monthly income more than ten million Rls. The frequency of the Pap test performance was higher in women who were employed and with a university degree (p<0.05). The frequency of mammography performance in women over 40 years was also higher in women with university degree (p<0.05). There was no statistically significant difference in the frequency of pelvic examination, and self and clinical breast examinations based on education, household income and employment (p>0.05). Our study found that the rate of screening participation among women is low. Investigation of the barriers, increasing the awareness of women about the importance and advantages of screening and also more incentives for health personnel especially family physicians to pay more attention to preventive programs could be effective.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6691-6695
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• 2014

Background: A population-based cervical cancer screening program using visual inspection with acetic acid was launched in Maldives in 2014. Our study aimed to assess the knowledge, attitude and practices of women in relation to risk factors of cervical cancer, early detection of the disease and its prevention. Materials and Methods: The questionnaire based survey was conducted among 20 to 50 year old women, systematically sampled to represent three regions of Maldives. Trained investigators interviewed a total of 2,845 women at home. Results: The prevalence of the risk factors of cervical cancer like early age at marriage and childbirth, multiple marriages, multiple marriages of the husbands, and multiple pregnancies was high. More women knew about breast cancer than cervical cancer. Even among the small number of women who knew of cervical cancer, only 34.6% had the knowledge of at least one early symptom. Very few women knew that the cancer could be prevented by any test. Only 6.2% of the women reported having ever undergone a Pap smear. Many women had the misconception that cervical cancer was infectious. In Maldives the younger women have high literacy rate due to the policy of universal free education and those with higher levels of education had improved knowledge of cervical cancer and its risk factors. The prevalence of risk factors also reduced with improved literacy. Conclusions: Awareness about risk factors and prevention of cervical cancer is limited among Maldivian women in spite of having high exposure to some of the risk factors. A universal literacy program in the country has helped to improve the knowledge of cervical cancer prevention and to reduce the exposure to various risk factors in the younger population.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3101-3103
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• 2013

In Easter Island, population is composed by original habitants, the Rapa Nui culture and introduced people, mainly from continental Chile, who have a different ethnic origin. The aim of this research was to describe cancer frequency in resident population in Easter Island, and secondarily compare the findings with other islands of Polynesia and continental Chile. We reviewed the statistics of patients treated in Hanga Roa Hospital during the period 2006-2010, finding a total of 49 patients with cancer during the study. The most frequent cancers in Easter Island's people were breast cancer (8 cases), skin (8 cases), cervical (8 cases), lung (5 cases) and gastric (4 cases). According to gender, in females the most frequent cancer was breast, followed by skin and cervical, while in men, lung, prostate and hematopoietic cancers were the most frequent. Most cases of cervical cancer occurred in women of Rapa Nui ethnicity, while most skin cancers were found in non-Rapa Nui people. In case of the most common cancer in Easter Island, education (e.g. Papanicolaou and mammography screening) and prevention in the community (e.g. use sun block, avoid cigarettes) should be useful tools to reduce incidence.