• Asian Pacific Journal of Cancer Prevention
• /
• 제13권2호
• /
• pp.671-676
• /
• 2012

Objectives: Screening for second primary cancer (SPC) is one of the key components of cancer survivorship care. The aim of the present study was to explore oncologists' experience with promoting second primary cancer screening. Methods: Two focus group interviews were conducted with 12 oncologists of diverse backgrounds. Recurrent issues were identified and placed into thematic categories. Results: Most of the oncologists did not consider SPC screening promotion as their responsibility and did not cover it in routine care. All of the study participants had experience with unexpected SPC cases, and they were under emotional tress. There was no systematic manner of providing SPC screening. Oncologists usually prescribe SPC screening in response to patients' requests, and there was no active promotion of SPC screening. Short consultation time, limited knowledge about cancer screening, no established guideline for SPC screening, and disagreement with patients about oncologists' roles were major barriers to its promotion. An institution-based shared care model was suggested as a potential solution for promoting SPC screening given current oncology practices in Korea. Conclusion: Oncologists could not effectively deal with the occurrence of SPC, and they were not actively promoting SPC screening. Lack of knowledge, limited health care resources, and no established guidelines were major barriers for promoting SPC screening to cancer survivors. More active involvement of oncologists and a systematic approach such as shared-care models would be necessary for promoting SPC screening considering increasing number of cancer survivors who are vulnerable.

• 부모자녀건강학회지
• /
• 제11권1호
• /
• pp.49-60
• /
• 2008

This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.

• Journal of Preventive Medicine and Public Health
• /
• 제38권4호
• /
• pp.473-481
• /
• 2005

Objectives : We wanted to identify those factors associated with stomach, colon, breast and cervix cancer screening. Methods : A population-based telephone survey was conducted for 2 weeks (the 9th-23th of July, 2004) by trained interviewers with using a questionnaire. 2,598 respondents (females aged 30 years or over, and the males aged 40 years or over) were selected by random-digit dialing that was based on the 2000 Population and Housing Census. The data on socio-demographic, health behavior and enabling factors were collected. 2,571 respondents were included in analysis. The cancer screening rate was classified into 2 categories : the life time screening rate and the screening rate with recommendations. Results : For the 2,571 respondent s, the life time screening rate was as follows: 52.0% (Stomach), 25.3% (Colon), 55.9% (Breast) and 76.8% (Cervix). The screening rate with recommendation was as follows : 3 9.2% (Stomach), 20.6% (Colon), 42.5% (Breast) and 58.3% (Cervix). On a multiple logistic regression analysis of the life time screening, statistically significant relationships were observed for the screening intention, the health exam, the disease history, the age of the patients and the cancer screening rates. On a multiple logistic regression analysis of the screening with recommendation, statistically significant relationships were observed for the screening intention, the health exam, the age of the patients, the concern about the risk of cancer, the voluntary health insurance for cancer and the cancer screening rates. Conclusions : The results of this study suggest that the cancer screening intention, the health exam and the age of the patients are the most important factors to participate in life time cancer screening and also screening with recommendations. A positive association was also observed for the concern about the risk of cancer, the voluntary health insurance for cancer. It is hoped that this study will be a base line data for suggesting the representative cancer screening rate in Korea.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권11호
• /
• pp.4885-4892
• /
• 2016

Background: Chinese and Korean Americans have lower colorectal cancer (CRC) screening rates than other racial/ ethnic groups, which may be explained by a low level of CRC knowledge and a high level of misconceptions. This study explores the role of knowledge in CRC screening among these groups. Methods: Chinese (N=59) and Korean (N=61) Americans older than 50 were recruited from the Washington D.C. Metropolitan area. They completed a detailed survey and participated in focus groups to discuss their knowledge on CRC and CRC screening. Seventeen physicians, community leaders, and patient navigators participated in key informant interviews. Using a mixed methods approach, data were analyzed quantitatively and qualitatively. Results: Participants lacked knowledge about CRC and CRC screening. More than half did not know that screening begins at age 50 and there are several types of tests available. More than 30% thought CRC screening was not necessary if there were no symptoms or there was nothing they could do to prevent CRC. Focus group findings suggested understanding about CRC was limited by an inadequate source of linguistically and culturally relevant health information. For example, many participants considered CRC a western condition mainly caused by unhealthy diet. This led to under-estimations about their susceptibility to CRC. Knowledge was positively associated with self-reported screening. Participants who had higher knowledge scores were more likely to report ever having had a colonoscopy and confidence in ability to have CRC screening. Conclusions: Mixed-methods analysis provides multi-faceted perspectives on CRC knowledge and its influence on screening. Study findings can help inform interventions to increase CRC screening among Chinese and Korean Americans.

• 보건의료산업학회지
• /
• 제5권4호
• /
• pp.1-13
• /
• 2011

The purpose of this study is to analyze the medical care utilization behavior of patients to whom treatment (surgery) is recommended after they are diagnosed with abnormal findings on health screening and factors affecting the selection of the medical institute for treatment. The data was collected from 291 patients who need treatment or surgery, according to the abnormal findings on the additional examination such as cardiac CT, brain MRI, Gastroscopy and Colonoscopy since four diseases are suspected among of 2,752 people who receive health screening. The results are as follows. First, the most common disease of patients who have abnormal findings by the diagnosis through the results of first testing is colon disease based on through the additional examination. The most common disease of patients who will get treatment (surgery) based on final diagnosis by a doctor who determines the result of health screening on the basis of diagnosis from the first testing is cardiovascular disease. Second, in terms of diseases, patients with cardiovascular disease select the medical institute where they get the health screenings as a place for treatment. Patients with cerebrovascular disease select another medical institute for treatment. Finally, the affective factors of selectivity treatment facility on health screening satisfaction were human, facility, health screening and revisit factors.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권4호
• /
• pp.1565-1570
• /
• 2015

Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권2호
• /
• pp.395-400
• /
• 2015

Both Japan and Korea provide population-based screening programs. However, screening rates are much higher in Korea than in Japan. To clarify the possible factors explaining the differences between these two countries, we analyzed the current status of the cancer screening and background healthcare systems. Population-based cancer screening in Korea is coordinated well with social health insurance under a unified insurer system. In Japan, there are over 3,000 insurers and coordinating a comprehensive strategy for cancer screening promotion has been very difficult. The public healthcare system also has influence over cancer screening. In Korea, public healthcare does not cover a wide range of services. Almost free cancer screening and subsidization for medical cost for cancers detected in population-screening provides high incentive to participation. In Japan, on the other hand, a larger coverage of medical services, low co-payment, and a lenient medical audit enables people to have cancer screening under public health insurance as well as the broad range of cancer screening. The implementation of evidence-based cancer screening programs may be largely dependent on the background healthcare system. It is important to understand the impacts of each healthcare system as a whole and to match the characteristics of a particular health system when designing an efficient cancer screening system.

• Journal of Preventive Medicine and Public Health
• /
• 제34권3호
• /
• pp.237-243
• /
• 2001

Objectives : To examine the screening rate of cervical cancer in women and to find out the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. Methods : The data was based on self-reported questionnaires from 1,613 women whose ages ranged from 26 to 60 years; this survey was peformed between December 1999 and January 2000. This study analyzed the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. A logistic regression analysis was performed in order to derive the significant variables from the predisposing factors(demographic factor, health promotion behavior, reproductive factor), intervention factors(information channel, relation with medical stan, and proximal factors(attitude, social influence, self-efficacy). All analyses were peformed by the PC-SAS 6.12. Results : Our analyses showed that the screening rate for the women who received a cervical cancer screening(Pap smear) more than once within their life-time was 56.1% while those who had received one within the last two years was 34.5%. The significant factors for participation in cervical cancer screening program within their life-time were their income, married age, health promotion score, relation with medical staffs, social influence, and self-efficacy. On the other hand, age, number of pregnancies, menarche age, relation with medical staffs, social influences, and self-efficacy were significant factors for those being screened within the last two years. The predictive power of the logit model within their life-time was 68.8% and that within the last two years was 66.6%. Conclusion : The predictive factors for participation in cervical cancer screening program within their life-time are different from those for within the last two years. and that women's relations with medical staffs and social influences were the critical factors impacting on cervical cancer screening rates.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권18호
• /
• pp.8541-8551
• /
• 2016

Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

• 보건행정학회지
• /
• 제29권3호
• /
• pp.357-367
• /
• 2019

Background: This study evaluated the cost-effectiveness of 21 different national dyslipidemia screening strategies according to total cholesterol (TC) cutoff and screening interval among 40 years or more for the primary prevention of coronary heart disease over a lifetime in Korea, from a societal perspective. Methods: A decision tree was used to estimate disease detection with the 21 different screening strategies, while a Markov model was used to model disease progression until death, quality-adjusted life years (QALYs) and costs from a Korea societal perspective. Results: The results showed that the strategy with TC 200 mg/dL and 4-year interval cost \4,625,446 for 16.65105 QALYs per person and strategy with TC 200 mg/dL and 3-year interval cost \4,691,771 for 16.65164 QALYs compared with \3,061,371 for 16.59877 QALYs for strategy with no screening. The incremental cost-effectiveness ratio of strategy with TC 200 mg/dL and 4-year interval versus strategy with no screening was \29,916,271/QALY. At a Korea willingness-to-pay threshold of \30,500,000/QALY, strategy with TC 200 mg/dL and 4-year interval is cost-effective compared with strategy with no screening. Sensitivity analyses showed that results were robust to reasonable variations in model parameters. Conclusion: In this study, revised national dyslipidemia screening strategy with TC 200 mg/dL and 4-year interval could be a cost-effective option. A better understanding of the Korean dyslipidemia population may be necessary to aid in future efforts to improve dyslipidemia diagnosis and management.