• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7657-7661
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• 2013

Background: This study concerns uptake and results of colorectal cancer (CRC) screening of government servant as part of the Health Screening Program that was conducted in Brunei Darussalam in 2009. Materials and Methods: Government servants above the age of 40 or with family history of CRC were screened with a single fecal occult blood test (FIT, immunohistochemistry). Among 11,576 eligible subjects, 7,360 (66.9%) returned their specimen. Subjects with positive family history of CRC (n=329) or polyps (n=135) were advised to attend clinics to arrange screening. All the subjects with positive FIT (n=142, 1.9%) were referred to the endoscopy unit for counselling for screening colonoscopy. Results: Overall only 17.7% of eligible subjects attended for screening; 54.9% (n=79/142) of positive FIT, 8.8% (n=29/329) of positive family history of CRC and none with history of polyps (n=0/135). Of these, only 54 patients (50.5%) agreed for colonoscopy, 52 (48.6%) declined as they were asymptomatic, and one was not offered (0.9%) due to his very young age. On screening colonoscopy, 12.9% (n=7) had advanced lesions including a sigmoid carcinoma in situ and six advanced polyps. The other findings included non advanced polyps (n=21), diverticular (n=11) and hemorrhoids (n=26). One patient who missed his screening colonoscopy appointment re-presented two years later and was diagnosed with advanced right sided CRC. All the advanced lesions were detected in patients with positive FIT, giving a yield of 20.5% for advanced lesions including cancers in the 5.1% FIT positive subjects. Conclusions: Our study showed screening for CRC even with a single FIT was effective. However, the uptake rate was poor with just over half of the patients agreeing to screening colonoscopy. Measures to increase public awareness are important. Since one limitation of our study was the relatively small sample size, larger studies should be conduced in future.

• Journal of Preventive Medicine and Public Health
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• 제35권2호
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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.

• 디지털융복합연구
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• 제12권12호
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• pp.457-467
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• 2014

본 연구는 의료기관 내 검진센터의 선택요인, 만족도, 재이용의사를 파악하여 이용자의 선호도를 이해하고 검진센터 이용자의 지속적인 검진센터 유도방안을 모색하기 위하여 2013년 2월 22일부터 2013년 4월 5일 까지 부산시 의료기관 내 검진센터를 운영하고 있는 10개소를 선정하여 구조화된 설문지를 이용하여 검진센터를 방문한 수검자들을 대상으로 하여 892부의 설문지를 이용하여 빈도, 비율, 평균의 차이분석, 로지스틱 회귀분석을 실시한 결과, 연구대상자들의 인구사회학적 특성은 여성, 50대 연령, 대졸 이상의 학력, 사무 전문직, 월평균 소득 200만원 미만, 직장인 일반 신검자, 신검센터의 방문이 처음이 아닌 사람, 질병이 없고, 건강하다고 생각하는 사람에서 높은 분포를 보였다. 검진센터 선택요인은 접근성, 직장과의 제휴, 주변권유 순의 결과를 보였다. 검진센터에 대한 만족도는 접근성(3.59), 검진내용(3.59), 브랜드인지도(3.58)시설 환경(3.50), 비용경제성(3.40) 순의 결과를 보였다. 질병이 없는 40~50대 연령층에서 검진센터를 재방문 할 의향이 높게 나타났다. 그러므로 이들 집단에 대한 적극적인 관리방안의 모색이 필요하다. 그리고 검진센터의 검진 종류 및 검진 항목을 다양화하여 이용자의 특성에 적합한 건강 검진이 이루어져야 할 것이다.

• 한국건강관리협회지
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• 제4권1호
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• pp.1-11
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• 2006

"본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함. Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.

• 보건교육건강증진학회지
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• 제28권2호
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• pp.63-73
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• 2011

Objectives: This study was conducted to investigate the relationships between trust and participation in cancer screening. Methods: Data from 2004 Busan Health Survey were analysed for the study. Multiple logistic regression was performed on participation in cancer screening by trust level with potential confounders(sex, age, education, monthly mean household income, subjective health status, smoking, alcohol intake, exercise, and daily eating habits). Results: In a total of 7,423 participants, 2,078(28.0%) were classified as cancer screening participants. High horizontal trust was associated with increased likelihood of cancer screening participation(OR(men) = 1.20, 95% CI 1.00-1.45) and (OR(women) = 1.19, 95% CI 1.02-1.39), after multiple adjustments. Respondents with high trust in health care system had significantly higher odds ratios for participation in cancer screening: 1.60(95% CI 1.27-2.02) among men and 1.18(95% CI 0.97-1.44) among women, after multiple adjustments. Conclusions: Trust was significantly associated with higher odds of cancer screening participation and could be a potent arena for increasing cancer screening participation.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4427-4430
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• 2012

Breast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia. Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancer screening rates are still low in the country. The community pharmacist, as one of the most accessible healthcare practitioners, could play a role in the provision of breast cancer health promotion services to the community. However, there are no documented data regarding the community pharmacists' involvement in breast cancer related health promotion activities. Hence, this study was conducted to examine self-reported knowledge, practice and perception of community pharmacists on provision of breast cancer health promotion services and to investigate the barriers that limit their involvement. This cross-sectional survey conducted between May to September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langat and Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scale questions was used to interview those pharmacists who gave their informed consent to participate in the study. The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on the knowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breast cancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancer health promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lack of training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the community pharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there is need to equip community pharmacists with necessary training and knowledge to enable them to contribute their share towards prevention and screening of breast cancer.

• 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.

• 한국건강관리협회지
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• 제2권1호
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• pp.27-37
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• 2004

Background 'For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although cervical cytology screening programmes have result in the reduction of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. So cervicography is introduced. Cervicography is an adjunct method of cervical cancer screening intended to complement Papanicolaou smear. Cervicography involve obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the efficacy of Papanicolaou smear and cervicography in cervical cancer screening. Materials & Methods : This study population was of 74 women, who visited department of obstetrics & Gynecology, Korea association of Health Promotion Chung-nam branch from January, 20O2 to October, 2003. All patients were taken Pap smear before cervicography, and then two cervicography was obtained with applying5% acetic acid. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen. Results : 1. The sensitivity and the specificity of Papanicolaou smear was 92.1% and 72.7%respectively.2. The sensitivity and the specificity of cervicography was 88.9% and 54.5% respectively. The false negative rate, and false positive rate of Papanicolaou smear were 7.9%, 27.2% respectively. The false negative rate, and false positive rate of cervicography were 11.1%,45.5% respectively. Conclusions . Papanicolaou smear is a useful method and an important tool for detecting cervical cancer. However when Papanicolaou smear and Cervicograpy is used together, the sensitivity is higher than for Papanicolaou smear used alone.

• 보건교육건강증진학회지
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• 제30권4호
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• pp.99-110
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• 2013

Objectives: This study aimed to investigate factors related to prostate disease and follow-up procedure on health examination program in Gangwon-do. Methods: The studied population was 16,501 male aged 40 or more, who underwent screening tests for prostatic disease in 2011 health examination program designed for the low income residents in Gangwon-do. The screening tests included prostate specific antigen (PSA), international symptom score (IPSS), and maximal flow rate (Qmax). We conducted chi-square test for trend, two independent samples t-test, and binary logistic regression to find out the relationship between prostate cancer or benign prostatic hyperplasia and risk factors such as age, PSA level, and IPSS. Results: The number of subjects who turned out positive for PSA level (> 3.8ng/ml) was 971 men accounting for 5.9%. The result of post survey on them showed that 511 subjects (52.6%) got the urology check-up: 156 (30.5%) were diagnosed as normal, 286 (56.0%) as benign prostatic hyperplasia, and 69 (13.5%) as prostate cancer. The detection rate for prostate cancer was 8.8% when PSA level was between 3.81 and 9.99g/ml, and was 30.6% when PSA level was more than 10.00ng/ml. The rates of further testing varied depending on the communities from 26.7% to 68.2%, which was mainly affected by the role of local health center. Conclusions: Our findings indicate that enhanced quality control of local health center and empowerment of screening agency would increase the effort of coupled institutions between public and private sectors.

• 보건교육건강증진학회지
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• 제20권1호
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• pp.91-109
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• 2003

The importance of repeat screening for stomach cancer is well known to decrease deaths from stomach cancer. This study was aimed at assessing practice behaviors and to identify related factors in the aspects of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to stomach cancer screening in an urban area. Data was collected through self-administered questionnaires from 403 people aged 40 to 69 years from April 23th to May 15th, 2002. Practice behaviors were classified as : "ever" or "never", and "repeat" or "not repeat" grouped based on a recent 5 year screening history. The results were as follows: 1. Among the 403 subjects: "the ever group" was 23.8% and "the repeat group" was 4.0%, The rates of screening were 20.5% for men, 27.8% for those women, and 27.3% for aged 40-49, 24.5% for those aged 50-59, 19.0% for those aged 60-69. The rates of repeat screening were 4.0% for men, 4.1% for women, and 2.9% for those aged 40-49, 6.3% for aged 50-59, 2.5% for those aged 60-69. 2. The main factors associated with adherence to gastric cancer screening were education(post high school vs below : OR=2.44), previous cancer screening(yes vs no : OR=2.61), belief in personal health(no vs yes : OR=2.72), health status(unhealthy vs healthy : OR=3.40), possibility of cancer compared to others(low vs not low : OR=2.56), and regular exercise(yes vs no : OR=2.94). The main factor associated with adherence to gastric cancer repeat screening was other cancer screening(yes vs no : OR=6.33). Consequently, there is a need to change the recognition of the importance and necessity of stomach cancer screening in healthy conditions through health education, and to perform multiple screening tests each visit.