• 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.

• The Journal of Korean Academic Society of Nursing Education
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• v.27 no.2
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• pp.95-106
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• 2021

Purpose: The purpose of this study was to examine the effects of a smart-care services program for breast cancer survivors on cognitive function and physical health. Methods: A quasi-experimental control group pretest posttest design was used. Subjects were recruited in D city, and data were collected from July 2017 to February 2018. The experimental group (n=24) participated in the smart-care services program, whereas the control group (n=26) received conventional management. The smart-care services program consisted of addressing cognitive function problems arising from chemotherapy, diet, exercise, head/neck massage and self-monitoring using smartphone applications and smart bands. All participants underwent assessments at baseline, at 6 weeks, and at 12 weeks. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation), a chi-squared test, t-test, and repeated measures ANOVA. Results: After the smart-care services program, significant differences were found between the groups in cognitive function (F=18.91, p<.001) and sleep time (F=9.25, p<.001). No significant differences were found between the groups in caloric consumption after the program. Conclusion: The smart-care services program significantly improved the level of cognitive function and sleep time for breast cancer survivors. The use of this smart-care services program for breast cancer survivors might be an effective nursing intervention tool for improving cognitive function and health behaviors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8461-8467
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• 2014

Background: In this study we investigated factors influencing cancer screening intention and behavior to develop measures to increase the rate of cancer screening in the Korean elderly. Materials and Methods: Participants included 425 elderly subjects 65 years of age or older from D city, South Korea. The health behavior characteristics and cancer screening-related and theory of planned behavior (TPB) factors influencing the participant attitudes on cancer screening were examined to identify determinants significantly affecting cancer screening intentions and behavior. Results: Predictive factors influencing cancer screening behavior included smoking, exercise, cancer concerns, preference for the type of cancer screening, prior experience with the National Cancer Screening Program, perception of the National Cancer Screening Program, behavioral control with respect to cancer screening and cancer screening intentions. The factors influencing cancer screening behavior were different from those for cancer screening intentions. Conclusions: Increasing the cancer screening intentions of the elderly is necessary to raise the rates of cancer screening. Additionally, identifying the inhibitory factors that serve as obstacles to cancer screening in the elderly and changing screening intentions into actual screening behavior is necessary. This study provides a reference for developing and applying policy measures and intervention strategies to increase the cancer screening rates of the elderly in Korea.

• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.395-404
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• 2006

Purpose: This study investigated the effect of a structured group intervention on knowledge about lung cancer, self efficacy and quality of life for family caregivers of patients with lung cancer using a nonequivalent control groupquasi-experimental design. Methods: Subjects were 11 family caregivers for both the control and the experimental group. The experimental group participated in once a week for 2-hour session for 4 weeks. Four topics of educational program were lung cancer and treatment, side effects of treatments, symptoms management, and health management. Every session consisted of lecture, sharing experiences, and meditating time. Quality of life was measured using Jang(1996)'s tool. The tools for knowledge and self-efficacy were developed by the authors. Results: After the intervention, the experimental group showed higher self-efficacy in caring for the patients than did the controls. However, there were no significant differences in knowledge about lung cancer and quality of life between the two groups. Conclusion: Findings indicate that the group intervention would be effective for family caregivers of lung cancer patients.

• Korean Journal of Adult Nursing
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• v.25 no.5
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• pp.494-503
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• 2013

Purpose: The purpose of this study was to examine the effects of a simulation-based educational program on anxiety and discomfort in patients with early stage of stomach cancer or stomach adenoma undergoing gastroendoscopic surgery. Methods: The study employed a non-equivalence control group and non-synchronized design to prevent diffusion of treatment. Data were collected from 110 patients (experimental group=55, control group=55) admitted to a department of gastroenterology to undergo gastroendoscopic surgery for early stage of stomach cancer or stomach adenoma. The program was conducted as a 30-minute simulation-based education including 12 processes which patients would experience. Outcome variables were state anxiety, objective discomfort, and subjective discomfort. Results: The scores of state anxiety in the experimental group significantly decreased over time compared to those in the control group. The scores of objective and subjective discomfort after surgery in the experimental group were significantly lower than those in the control group. Conclusion: The study findings suggested that the simulation-based educational program making a person feel sense of real experiences could reduce anxiety and discomfort in gastroendoscopic surgery patients.

• Health Policy and Management
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• v.31 no.1
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• pp.91-99
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• 2021

Background: The Korean government introduced National Cancer Control Program and strengthening national health insurance coverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancer management such as patient concentration or time-to-treatment. Thus, we investigated the association between the time-to-treatment and survival of cancer patients, and compared regional differences by time trend. Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancer and received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for the association between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences for time-to-treatment by time trend. Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30 days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30 days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, but it was generally reduced after 2010. Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improve cancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity and types of cancer.

• Women's Health Nursing
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• v.12 no.1
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• pp.37-46
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• 2006

Purpose: The purpose of this study was to investigate the effects of an exercise program on physical function and quality of life of mastectomy patients. Method: This study was conducted from October, 2004 to June, 2005. The subjects consisted of 60 patients with breast cancer(30 each in the experimental and control groups). The subjects in the experimental group participated in an exercise program for 16 weeks. Evaluation was performed four times in both the experimental and control group. Results: The results revealed an increase in physical function in the experimental group including wrist circumstance, function of shoulder joint, stretching, and upper endurance. Also, an increase in function scales in quality of life were significantly higher in the experimental group than the control group. In addition subjective comments on how they felt after participating in the exercise program were good in the experimental group. Conclusion: The 16-week exercise program showed a large positive effect on physical function and quality of life of breast cancer patients after a mastectomy.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6227-6231
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• 2013

In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1034-1040
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• 2018

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.401-406
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• 2015

Background: This study was planned as comparative and descriptive in order to measure and evaluate the knowledge and attitudes regarding early diagnosis of women with and without a family history of cervical cancer. Materials and Methods: The study sample consisted of the relatives of female patients (N=253) who were admitted to Istanbul University of Medicine. Women with a family history of cervical cancer formed the case group, while those without family history of cervical cancer constituted the control group. Two distinct data collection tools, a questionnaire and the Miller Behavioral Style Scale (MBSS), were used in order to obtain data for evaluation with SPSS for Windows 20.0 statistics package program. Results: It was found that 61.0% of the case group with family history of cervical cancer and 19.0% of the control group without family history of cervical cancer were using early diagnostic methods. Thus the presence of an individual with cervical cancer in the family affected the attitudes towards early diagnosis. It was further found that the level of knowledge on cervical cancer and PAP smear test was higher in the case group, which was more sensitive with regard to being informed about cervical cancer as compared to general society. However, the average MBSS scores were not significantly different compared to the control group. Conclusions: It was noted that, women participating this study knowledgeable, but this did not necessarily transform into better behavior.