• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.844-856
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• 1998

Globally, cancer research has been considered one of the most important field of biomedical researches. Recently, in Korea, there are increasing concerns about cancer research and the development of national cancer control programme. For the efficient investment in cancer research at the national level, strategic approach is needed based on the nationwide information about current status of research. However even the basic data on cancer research have not been systematically collected, and are not available when necessary. The aim of this study is to assess current status of cancer research. For this purpose, this study applied two round Delphi method in which fifteen experts in cancer research fields participated. They rated each items on the initial list at the first round, and modified their responses at the second round. Panels responded that pathogenesis of cancer, research & development of cancer drug, and oncogene, etc. are the most urgent and important research Holds. They assessed national level of cancer research as being 49.6% of the world highest level. Coefficient of variation tended to be lowered with the iteration. Predictive stability was evaluated to be lower in items of urgency than in items of importance and research level. Although this study shares the same limitations in the selection of the experts with many other Delphi studies, it provides a primary data that would be required to plan the national strategy of the cancer research.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.88-91
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• 2016

Pancreatic cancer is the lethal disease and the prognosis of pancreatic cancer has remained largely unchanged over the past years. Borderline advanced pancreatic cancer is a biological different from resectable pancreatic cancer due to higher risk of early recurrence because of artery/vein abutment. Therefore this unique subset of pancreatic cancer has a controversial issue with regard to their treatment policy. Some institutes managed borderline advanced pancreatic cancer by up-front neoadhuvant chemotherapy because neoadjuvant chemotherapy provide the opportunity to treat early micro-metastasis with unfavorable tumor biology. But, some institutes try aggressive up-front surgical procedures to provide a chance of long-term survival in highly selected patients. Therefore this unique subset of pancreatic cancer has a controversial issue with regard to their treatment policy. This review address recent treatment trend for patients with borderline advanced pancreatic cancer.

• Epidemiology and Health
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• v.39
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• pp.36.1-36.8
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• 2017

OBJECTIVES: To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS: Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS: Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). CONCLUSIONS: The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

• Health Policy and Management
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• v.24 no.3
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• pp.271-282
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• 2014

Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The purpose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy development in reducing cancer mortality. Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period between 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators. Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer except for pancreatic cancer. Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by selecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.183-187
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• 2012

The importance of palliative care for terminal cancer patients has been emphasized globally. Korea has formulated and implemented its policy for cancer control as it drew up a 10-year plan for cancer patient care. We examined Korea's National Cancer Act and the second 10-year plan for cancer patient care, which are legal grounds for palliative care projects for terminal cancer patients, to check the current status of Korea's efforts to establish a hospice and palliative care system. Institutionalization of hospice and palliative care has been developed within a framework of the national cancer project. Efforts such as expansion of hospice units, experts training and quality improvement should continue after the reimbursement of hospice and palliative care begins in 2013.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6177-6180
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• 2014

Background: Our study objectives were to evaluate the medical economics of cervical cancer prevention and thereby contribute to cancer care policy decisions in Japan. Methods: Model creation: we created presence-absence models for prevention by designating human papillomavirus (HPV) vaccination for primary prevention of cervical cancer. Cost classification and cost estimates: we divided the costs of cancer care into seven categories (prevention, mass-screening, curative treatment, palliative care, indirect, non-medical, and psychosocial cost) and estimated costs for each model. Cost-benefit analyses: we performed cost-benefit analyses for Japan as a whole. Results: HPV vaccination was estimated to cost $291.5 million, cervical cancer screening $76.0 million and curative treatment $12.0 million. The loss due to death was $251.0 million and the net benefit was -$128.5 million (negative). Conclusion: Cervical cancer prevention was not found to be cost-effective in Japan. While few cost-benefit analyses have been reported in the field of cancer care, these would be essential for Japanese policy determination.

• Journal of Korean Academy of Nursing
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• v.33 no.8
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• pp.1119-1126
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• 2003

Background. Breast cancer is the most common form of cancer among Korean women. Only 14 % of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999). Purpose. The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea. Methods. First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n=494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection. Results. After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2 % of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup2
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• pp.1-5
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• 2016

To reduce tobacco use and related harm in Korea, telephone based cessation services (Quitlines) began full operation to provide regular behavioral counseling for smoking cessation in 2006. After registration in the cessation program, at least 21 calls per year are given to each client to help quit and encourage maintenance. Tailored programs for males, females, and adolescent smokers have been offered taking into account smokers' characteristics and smoking behavior. Mailing self-help quit packs and e-mail and SMS services are allowable as additional services.A total of 23,201 smokers were registered on the Quitline program from 2006 to 2014. In 2014, an average of 13,343 calls per month have been received by 28 coaches, the 1 year abstinence rate of clients is 26%, and clients' satisfaction rate is 81.6%. After introduction of the call system in 2007, client convenience and effective operations have been achieved with high technology support of a computer-based telephone system. Systematic education and evaluation programs for quit coaches have contributed to quality assurance of the services. Currently, research into development of new programs and evaluation of Quitline performance is being undertaken. A Comprehensive Multi-channel Cessation Center (CMCC) has been suggested and is now planned as a next step in the national program for smoking cessation.

• Health Policy and Management
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• v.26 no.4
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• pp.382-389
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• 2016

Background: National cancer screening reduces mortality from stomach, colon, breast, and cervical cancer. However, cancer screening rates remain lower than 50% in Korea. This research was designed to make effective guidelines for cancer screening promotion to increase participation rate in cancer screening. Methods: Data was collected from Incheon regional cancer center's telephone survey 'Recognition of cancer prevention and control' of 861 Incheon citizens over age 40. Logistic regression was used to analyse a relationships between cancer screening rates and promotional methods. PASW SPSS ver. 18.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Results: About 27.4% of respondents (236 of 861 respondents) have recognized the promotional program of Incheon regional cancer center for cancer screening participation. Cancer screening rate was associated with age group, educational level for stomach cancer, age group, bus advertisement (odds ratio, 1.19 to 2.75) for colon cancer, educational level, residential area for breast cancer, and age group for cervical cancer. Conclusion: There was relationship between stomach cancer screening rates and promotional methods. Therefore, cancer screening promotion guidelines to increase participation rate should be considered.

• BMB Reports
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• v.51 no.11
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• pp.584-589
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• 2018

Secondary prevention via earlier detection would afford the greatest chance for a cure in premalignant lesions. We investigated the exomic profiles of non-malignant and malignant changes in head and neck squamous cell carcinoma (HNSCC) and the genomic blueprint of human papillomavirus (HPV)-driven carcinogenesis in oropharyngeal squamous cell carcinoma (OPSCC). Whole-exome (WES) and whole-genome (WGS) sequencing were performed on peripheral blood and adjacent non-tumor and tumor specimens obtained from eight Korean HNSCC patients from 2013 to 2015. Next-generation sequencing yielded an average coverage of $94.3{\times}$ for WES and $35.3{\times}$ for WGS. In comparative genomic analysis of non-tumor and tumor tissue pairs, we were unable to identify common cancer-associated early mutations and copy number alterations (CNA) except in one pair. Interestingly, in this case, we observed that non-tumor tonsillar crypts adjacent to HPV-positive OPSCC appeared normal under a microscope; however, this tissue also showed weak p16 expression. WGS revealed the infection and integration of high-risk type HPV16 in this tissue as well as in the matched tumor. Furthermore, WES identified shared and tumor-specific genomic alterations for this pair. Clonal analysis enabled us to infer the process by which this transitional crypt epithelium (TrCE) evolved into a tumor; this evolution was accompanied by the subsequent accumulation of genomic alterations, including an ERBB3 mutation and large-scale CNAs, such as 3q27-qter amplification and 9p deletion. We suggest that HPV16-driven OPSCC carcinogenesis is a stepwise evolutionary process that is consistent with a multistep carcinogenesis model. Our results highlight the carcinogenic changes driven by HPV16 infection and provide a basis for the secondary prevention of OPSCC.