• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6411-6414
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• 2014

Background: A dense breast not only reduces the sensitivity of mammography but also is a moderate independent risk factor for breast cancer. The percentage of Western women with fat breast tissue is higher aged 40 years or older. To a certain extent, mammography as a first choice of screening imaging method for Western women of this group is reasonable. Hitherto, the frequency and age distribution of mammographic breast density patterns among Chinese women had not been characterized. The purpose of this study was to investigate the frequency and age distribution of mammographic breast density patterns among a group of Chinese screening women and breast cancer patients in order to provide useful information for age-specific guidelines for breast cancer screening in Chinese women. Methods: A retrospective review of a total of 3,394 screening women between August and December 2009 and 2,527 breast cancer patients between July 2011 and June 2012 was conducted. Descriptive analyses were used to examine the association between age and breast density. The significance of differences of breast density between the screening women and the breast cancer patients was examined using nonparametric tests. Results: There was a significant inverse relationship between age and breast density overall (r=-0.37, p< 0.01). Breast density of the breast cancer patients in the subgroups of 40-49 years old was greater compared with that of the screening women, the same in those aged 50-54 years and in those 55 years old or older, less than in the screening group. Conclusions: With regard to the Chinese women younger than 55 years old, the diagnostic efficiency of breast cancer screening imaging examinations may be potentially improved by combining screening mammography with ultrasound.

• Nutrition Research and Practice
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• v.14 no.1
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• pp.20-24
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• 2020

BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

• Journal of agricultural medicine and community health
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• v.34 no.2
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• pp.214-222
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• 2009

Objectives: This study was performed to evaluate the effect of navigator education program for cancer screening, which is designed for improvement in knowledge of cancer, perceived self efficacy and communication skill of the breast and cervical cancer screening for middle-aged and aged women in urban areas. Cancer screening navigator is lay health advisor who are educated for providing information, emotional support about cancer screening at the community. Methods: The subjects were 33 women at the age of 40-69 and educated for 12 hours through the education program. The control group subjects were 30 women. For statistical analysis, descriptive statistics and paired t-test were used with SPSS WIN 14.0. Results: Contents of education program were case of cancer early detection, benefit of breast cancer screening, benefit of cervical cancer screening, health care system for cancer screening, role of cancer screening navigator, communication skill, transtheoretical model and role play. Knowledge of cancer(t=4.267, p=0.000) and communication skill(t=4.947, p=0.000) of the women increased significantly after implementing the 12 hours education program. Conclusion: The results suggest that navigator education for cancer screening has an effect in increasing knowledge of cancer, and communication skill scores.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.99-106
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• 2002

Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.331-338
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• 2006

Objectives: The goal of this study is to measure women's willingness to pay for cancer screening and to identify those factors associated with this willingness to pay. Methods: A population-based telephone survey was performed on 1,562 women (aged 30 years or over) for 2 weeks (9-23th, July, 2004). Data about sociodemographic characteristics, health behaviors, the intention of the cancer screenings and willingness to pay for cancer screening were collected. 1,400 respondents were included in the analysis. The women's willingness to pay for cancer screening and the factors associated with this willingness to pay were evaluated. Results: The results show that 76% of all respondents have a willingness to pay for cancer screening. Among those who are willing to pay, the average and median amount of money for which the respondents are willing to pay are 126,636 (s.d.: 58,414) and 120,000 won, respectively. As the status of education & the income are higher, the average amount that women are willing to pay becomes much more. The amount of money women are willing to pay is the highest during the 'contemplation' stage. Being willing to payor not is associated with a change of behavior (transtheoretical model), the income, the concern about the cancer risk, the family cancer history, the marital status, the general health exam, age and the place of residence. Income is associated with a greater willingness to pay. Old age was associated with a lower willingness to pay. Conclusions: According to the two-part model, income and TTM are the most important variables associated with the willingness to pay for cancer screening. The cancer screening participation rate is low compared with the willingness to pay for cancer screening. It is thought that we have to consider the participants' behavior that's associated with cancer screening and their willingness to pay in order to organize and manage cancer screening program.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.346-352
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• 2006

Objectives: The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. Methods: The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. Results: For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. Conclusions: The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.4
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• pp.385-395
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• 2023

The purpose of this study was to analyze the screening rates and examination results of the national dental screening program for infants and children since its initiation. Data for this study were obtained from the annual health screening statistical yearbook of the National Health Insurance Service. The investigation focused on the screening rate according to year, age, and region, as well as examination results from 2008 to 2021. The study revealed a general increase in screening rates over the years, with a simultaneous decrease observed as the age of the subjects increased. Regional variations in screening rates were observed, with the highest and lowest rates in Sejong and Jeonbuk, respectively. Analysis of examination results revealed an increasing proportion of subjects requiring treatment as they aged. From 2008 to 2013, less than 15% of subjects aged 18 - 24 and 18 - 29 months required treatment, whereas over 30% required treatment in the remaining age groups. Between 2014 and 2021, the proportion of subjects in the 18 - 29 month age group requiring treatment remained under 15%, but it exceeded 40% in the other age groups. In conclusion, active participation in national dental screening for infants and children is crucial to improving oral health outcomes.

• Journal of Digital Convergence
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• v.10 no.9
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• pp.397-407
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• 2012

This study aims to develop the methods for effective managing national health screening patients in the health examination center using digital data from national health screening in Dae-Jeon health examination center. To achieve this, we collected about national health screening for 10 years from 2002 to 2011 in Dae-Jeon health examination center and developed re-examination predictive model, private examination predictive model and stomach cancer examination predictive model for national health screening patients by using this data. According to the predictive model results, age, residence, group or individual health examination and the previous number of national health screening were statistically associated with re-examination, private examination, stomach cancer examination. We came up with a plan for health examination center system based on the predictive model and logic in Dae-Jeon. Customized service based on patient management system for national health screening will contribute to efficiency in health examination center.

• Journal of the Korean Data and Information Science Society
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• v.21 no.1
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• pp.129-138
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• 2010

The purpose of this study was to investigate the most cost-effectiveness screening strategies for cervical cancer in Korea. We calculated the age-specific cervical cancer incidence rate from Korea Central Cancer Registry (2003), and then estimated the schedule sensitivity, detection probability, and screening and confirmative costs of each screening strategy based on the stochastic process (Lee and Zelen, 1998). The efficiency of the screening strategy was evaluated by incremental cost-effectiveness analysis. The most effective strategy was every 3 years pap smear test between the age of 35 and 65 years in the cervical cancer screening. The findings of this study will be helpful to evaluate efficiency of cancer screening strategies, and to provide the theoretical background of development and assessment of early detection of cancer in Korea.

• Journal of Preventive Medicine and Public Health
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• v.44 no.3
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.