• 보건교육건강증진학회지
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• 제23권4호
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• pp.29-45
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• 2006

Objectives: The aim of this study was to determine the distribution of stages of adoption in stomach cancer screening and elucidate differences among stages. Methods: A randomly selected sample of 712 Korean males and females aged 40 years or over were interviewed. Stomach cancer screening intention and behavior, sociodemographic characteristics, beliefs, self-efficacy and reinforcing characteristics were assessed. Results: The majority of participants were not on-schedule screening(unaware 3.2%, unengaged 20.8%, deciding about acting 24.0%, decided not to act 9.6%, decided to act 14.5%, acting 9.7%, maintenance 18.3%). Perceived susceptibility, perceived barriers, self-efficacy, other cancer screening experiences were significantly associated with higher compared to lower Precaution Adoption Process Model(PAPM) stages. Conclusions: This study appears to be applicable of the Precaution Adoption Process Model to understanding stomach cancer screening behavior. Our results suggest that it is needed to develop the tailored message for adherence of stomach cancer screening.

• 보건행정학회지
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• 제21권1호
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• pp.61-76
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• 2011

Limited research has investigated the satisfaction of patients with cancer. This study was performed to explore patients' satisfaction and the related factors. The data were collected by telephone survey for the participants who were beneficiaries on the national financial aid program for cancer patients between January and October in 2009. Student's t-tests and analysis of variance were performed first to determine if the mean satisfaction score differed by the characteristics of study objects, followed by stepwise multiple regression analyses to examine the factors affecting satisfaction. When comparing the relating factors with patients' satisfaction according to the sociodemographic characteristics, the male, old-aged, higher educated, lower cancer stage, lung cancer group showed a significantly higher level of recognition for satisfaction. A public health center, better public relations, recognized more helpful, don't have expectation, put a person to expense, and don't feel pressured for medical cost groups were showed a higher level of recognition for satisfaction. The result of the multiple regression analysis, short waiting time, well known program policy, recognized helping of policy and had the financial burden had significantly influence on the satisfaction of patients with cancer.

• Yonsei Medical Journal
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• 제59권9호
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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.

• Yonsei Medical Journal
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• 제59권9호
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• pp.1026-1033
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• 2018

Purpose: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprived women. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalities among Korean women from 2005 to 2015. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey, were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income status were estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percent changes (APCs), to show trends in cancer screening rates. Results: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to 61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of household income and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooled SII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening were shown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educational inequalities appeared to diminish over the study period for both cervical and breast cancer screening. Conclusion: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancer screening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these were constant from 2005 to 2015 for both cervical and breast cancer screening.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.150-154
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• 2007

Objectives : The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. Results : Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of \65,311 and an average benefit amount of \19million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. Conclusions : About half of Korean people have supple-mentary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.

• Journal of Korean Medical Science
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• 제33권47호
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• pp.302.1-303.10
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• 2018

Background: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. Methods: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. Results: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ${\geq}9$ correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ${\leq}4$ correct answers). Interestingly, among current smokers, only those who correctly responded to ${\geq}9$ of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. Conclusion: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.566-578
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• 2020

Objective : Radiation is known to induce autophagy in malignant glioma cells whether it is cytocidal or cytoprotective. Dexamethasone is frequently used to reduce tumor-associated brain edema, especially during radiation therapy. The purpose of the study was to determine whether and how dexamethasone affects autophagy in irradiated malignant glioma cells and to identify possible intervening molecular pathways. Methods : We prepared p53 mutant U373 and LN229 glioma cell lines, which varied by phosphatase and tensin homolog (PTEN) mutational status and were used to make U373 stable transfected cells expressing GFP-LC3 protein. After performing cell survival assay after irradiation, the IC₅₀ radiation dose was determined. Dexamethasone dose (10 μM) was determined from the literature and added to the glioma cells 24 hours before the irradiation. The effect of adding dexamethasone was evaluated by cell survival assay or clonogenic assay and cell cycle analysis. Measurement of autophagy was visualized by western blot of LC3-I/LC3-II and quantified by the GFP-LC3 punctuated pattern under fluorescence microscopy and acridine orange staining for acidic vesicle organelles by flow cytometry. Results : Dexamethasone increased cell survival in both U373 and LN229 cells after irradiation. It interfered with autophagy after irradiation differently depending on the PTEN mutational status : the autophagy decreased in U373 (PTEN-mutated) cells but increased in LN229 (PTEN wild-type) cells. Inhibition of protein kinase B (AKT) phosphorylation after irradiation by LY294002 reversed the dexamethasone-induced decrease of autophagy and cell death in U373 cells but provoked no effect on both autophagy and cell survival in LN229 cells. After ATG5 knockdown, radiation-induced autophagy decreased and the effect of dexamethasone also diminished in both cell lines. The diminished autophagy resulted in a partial reversal of dexamethasone protection from cell death after irradiation in U373 cells; however, no significant change was observed in surviving fraction LN229 cells. Conclusion : Dexamethasone increased cell survival in p53 mutated malignant glioma cells and increased autophagy in PTEN-mutant malignant glioma cell but not in PTEN-wildtype cell. The difference of autophagy response could be mediated though the phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin signaling pathway.

• Safety and Health at Work
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• 제8권1호
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• pp.29-35
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• 2017

Background: Despite our knowledge of the causes of cancer, millions of workers are involuntarily exposed to a wide range of known and suspected carcinogens in the workplace. To address this issue from a policy perspective, we developed a policy framework based on a prospective health policy analysis. Use of the framework was demonstrated for developing policies to prevent cancers associated with diesel engine exhaust (DEE), asbestos, and shift work, three occupational carcinogens with global reach and large cancer impact. Methods: An environmental scan of existing prospective health policy analyses was conducted to select and describe our framework parameters. These parameters were augmented by considerations unique to occupational cancer. Policy-related resources, predominantly from Canada, were used to demonstrate how the framework can be applied to cancers associated with DEE, asbestos, and shift work. Results: The parameters of the framework were: problem statement, context, jurisdictional evidence, primary prevention policy options, and key policy players and their attributes. Applying the framework to the three selected carcinogens illustrated multiple avenues for primary prevention, including establishing an occupational exposure limit for DEE, banning asbestos, and improving shift schedules. The framework emphasized the need for leadership by employers and government. Conclusion: To our knowledge, this is the first proposal for a comprehensive policy framework dedicated to the primary prevention of occupational cancer. The framework can be adapted and applied by key policy players in Canada and other countries as a guide of what parameters to consider when developing policies to protect workers' health.

• 동의생리병리학회지
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• 제23권3호
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• pp.528-533
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• 2009

Gastric cancer is common cancer generating about 20% incidence in Korea. But Oriental medical doctor (OMD) often can't measure therapy on gastric cancer positively because that the prognosis on it is not good. It is impossible the results on all of diseases not only gastric cancer always to have to be good. It is required to find out the causes of diseases and therapy method to conquest the diseases for the medical therapy. But because the results on medical therapy are not always good, it is necessary for the doctor who want to treat the diseases like gastric cancer having the prognosis to be death to protect himself, like as the legal system, a medical policy. And consequently, this protecting legal system lead the medical therapy principle or method on some special diseases to therapy completion on it. As a results of policy, medical therapy have to be developed. It is studied the literature referencing gastric cancer, experimental articles to insist the effects of Oriental medicine planet to gastric cancer and the clinical cases on gastric cancer to be treated as Oriental medicine therapy to have effects. Recently, there have been many other development in oriental medical therapy. This development can be grouped as two type. One type is clinical part and the other is experimental research part. Specially the experimental research and clinical research on gastric cancer in oriental medical therapy have been developed. So the present day is the time to make medical policy on liver cancer for OMD to measure oriental medical therapy and develop oriental medical theory. As a above results, we propose that the name of gastric cancer have to use in Korean medicine security clinical name (한방의료보험상병명) to make oriental medical policy.

• Molecules and Cells
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• 제43권5호
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• pp.459-468
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• 2020

Nuclear receptor subfamily group H member 4 (NR1H4), also known as farnesoid X receptor, has been implicated in several cellular processes in the liver and intestine. Preclinical and clinical studies have suggested a role of NR1H4 in colon cancer development; however, how NR1H4 regulates colon cancer cell growth and survival remains unclear. We generated NR1H4 knockout (KO) colon cancer cells using clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein-9 nuclease (CAS9) technology and explored the effects of NR1H4 KO in colon cancer cell proliferation, survival, and apoptosis. Interestingly, NR1H4 KO cells showed impaired cell proliferation, reduced colony formation, and increased apoptotic cell death compared to control colon cancer cells. We identified MYC as an important mediator of the signaling pathway alterations induced by NR1H4 KO. NR1H4 silencing in colon cancer cells resulted in reduced MYC protein levels, while NR1H4 activation using an NR1H4 ligand, chenodeoxycholic acid, resulted in time- and dose-dependent MYC induction. Moreover, NR1H4 KO enhanced the anti-cancer effects of doxorubicin and cisplatin, supporting the role of MYC in the enhanced apoptosis observed in NR1H4 KO cells. Taken together, our findings suggest that modulating NR1H4 activity in colon cancer cells might be a promising alternative approach to treat cancer using MYC-targeting agents.