• Korean Journal of Health Education and Promotion
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• v.26 no.2
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• pp.75-86
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• 2009

Objectives: To identify the factors associated with the intention to undergo mammography among Korean women without a prior screening experience. Methods: Among 1,039 women of the general population, we selected 145 women (mean age: 54.2 years, age range : 40-78 years) without any prior experience with mammography. They were recruited for the 'Cancer Information Needs Assessment Survey' by using the method of random multi-stage cluster sampling. Data on the socio-demographic characteristics, intention to undergo mammography based on the Precaution Adoption Process Model, level of self belief and self efficacy for breast cancer screening, motivation for decision to undergo breast cancer screening were obtained by conducting a household survey. Results: Of the study subjects, 49.7% were classified as "unengaged" and "decided not to act" regarding breast cancer screening. Women with the intention to undergo mammography were more likely to be younger (OR 0.11, 95%CI 0.04-0.36), to have been recommended to undergo screening by others (OR 3.27, 95%CI 1.36-7.87), to have a high level of perceived sensitivity (OR 3.15, 95%CI 1.27-7.82), and to have a high level of self efficacy (OR 1.09, 95%CI 0.97-1.23). Exposure to campaigns and information regarding breast cancer screening, whether cancer patients are or not in around, perceived severity, perceived benefit, and perceived cost were factors that were not significantly associated with the intention to undergo mammography. Conclusion: It is necessary to develop tailored intervention strategies for women who have never undergone breast cancer screening on the basis of their demographic characteristics and factors that positively influence the intention to undergo mammography.

• Health Policy and Management
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• v.25 no.3
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• pp.162-173
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• 2015

Background: The aim of the current study was to investigate the factors related to the non-practice of cancer screening in cancer survivors, who are at high risk of developing second cancers. Methods: This study is a cross-sectional analysis of 1,125 cancer survivors ${\geq}19$ years old who participated in the Korean National Health and Nutrition Examination Surveys IV and V (2007-2012). A Rao-scott chi-square test and a survey logistic regression analysis were employed respectively to analyze the difference of cancer survivors in cancer screening by each characteristic and the factors related to the non-practice of cancer screening in cancer survivors. Results: Among total subjects, 33.5% did not participate in cancer screening in the last two years. Results from a fully adjusted logistic model showed that the non-practice of cancer screening in cancer survivors was significantly associated with variables such as sex, age, marital status, education level, monthly income, and drinking a alcoholic beverage Specifically, the odds ratio of non-practice of cancer screening was higher in males than in females, in the younger group than in older group, in the group with no spouse than in the group with a spouse; in a group with a low level of education than in a group with a high level of education; in a group with the lowest income level than in a group with the other levels of income; or in non-drinkers than in drinkers. Conclusion: Health policies to reduce the non-practice rate of cancer screening in cancer survivors should be designed and implemented with close attention to cancer survivors' socio-economic characteristics such as sex, age, marital status, education, and income, along with a health behavioral characteristic as drinking.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5157-5163
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• 2013

The aim of the study was to evaluate of the knowledge, behavior and health beliefs of individuals over 50 regarding colorectal cancer screening, with a descriptive and cross-sectional design at Karabuk Life and Health Center in Turkey. A total of 160 people meeting set criteria were included in the study. The questionnaire consisted of two parts. The first part was composed of questions on characteristics of participants and the second part of questions derived from the Champion's Health Belief Model Scale. Only 15.0% of participants (n=24) had undergone a fecal occult blood test (FOBT), 11.3% (n=18) had had colonoscopy and 4.4% (n=7) had had sigmoidoscopy. Some 90.6% of the participants had low levels of risk awareness about the colorectal cancer. It was found that the average point of severity subscale of participants over 65 is higher than that of participants under 65 (p<0.05). In conclusion, because of the many barriers and health beliefs for the colorectal cancer screening program, the rate of participation in screening programs is not sufficient. Healthcare providers have important responsibilities for increasing rate of attendance in colorectal cancer screening programs.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.239-247
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• 2016

Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2607-2612
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• 2014

Background: Cancer screening rates in Japan are much lower than those in Western countries. This study evaluated the relationship between cancer screening rates and strategies used to improve screening rates, and determined which strategy is the most effective. Materials and Methods: All municipalities are responsible for conducting gastric, lung, colorectal, cervical, and breast cancer screenings in Japan. Of the 1,746 municipalities in total, 92-99% were included in the analyses for each cancer screening. Using national data in 2009, the correlations between cancer screening rates and strategies for improving screening rates of all municipalities, both large (populations of over 30,000) and small (populations of under 30,000), were determined. The strategies used were as follows: sending personal invitation letters, personal visits by community health workers, use of a clinical setting for screening, and free screening. Results: Of all four strategies used to improve cancer screening rates, sending personal invitation letters had the highest correlations with all screening rates, with the exception of breast cancer screening. The partial correlation coefficients linking this strategy with the screening rates in all municipalities were 0.28, 0.32, 0.30, and 0.26 for gastric, lung, colorectal, and cervical cancer screening, respectively. In large municipalities, the correlations between the number of examinees in a clinical setting and the screening rates were also relatively high, particularly for cervical cancer screening (r=0.41). Conclusions: Sending personal invitation letters appears to be particularly effective in improving cancer screening rates in all municipalities. All municipalities should implement a system that sends personal invitation letters for cancer screening. In large municipalities, increasing the availability of screening in a clinical setting is also effective in improving cancer screening rates.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6669-6671
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• 2014

Background: We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening wwere researched. Materials and Methods: This cross-sectional, descriptive study con cerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors. Results: The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was $30.9{\pm}6.41$ years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.

• Korean Journal of Health Education and Promotion
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• v.30 no.4
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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.

• The Korean Journal of Health Service Management
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• v.7 no.3
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• pp.95-109
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• 2013

The objective of this study is to assess the utilization and satisfactions about public health centers in Korea. For the analysis, the study utilize the nationwide data of 229,229 person on '2010 Community Health Survey' of Ministry of Health & Welfare. The statistical methodology used in the study is ${\chi}^2$, ANOVA, logistic regression model and multiple regression model. This study have four major findings. First, the significant affecting socio-demographic factors in utilizing public health center were gender, age, region, national basic living secured, married, income, education, job, state of health, chronic disease, unmet medical needs and utilization reason. Second, the most serviced category of health center user was vaccination both city and rural area and the next was certificate, primary care, health screening, other use, the mother and child in city area, primary care, health screening, certificate, home visiting health in rural area. Third, the significant affecting socio-demographic factors in satisfaction degree on health center service were age, region, national basic living secured, income, education, job, state of health, utilization degree and reason. Fourth, the most satisfied service of health service center was home visiting health in city area and mental health service in rural area and the next was nutritive control and the lowest satisfied service was user of certificate. The utilization and satisfaction on health center service were identified as different with residental area and user's characteristics. The politic effort are needed to support socially disadvantaged class and to narrow regional gap.

• Journal of Korean Academy of Nursing
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• v.29 no.2
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• pp.258-270
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• 1999

This study was carried out to offer the basic data for more qualitative lives of the middle-aged women through their health maintenance and control. So, the researcher reviewed and analyzed the health problems of the middle-aged women, the differences of main symptoms in each subject, positive ratcs in screening tests, the difference of screening tests with age and the correlation of obesity and blood pressure with screening tests. All subjects were 218 women(40-59years) who had a check-up at a comprehensive health check-up center in K University Hospital in Seoul from July 1, 1998 to August 31. 1998. Questionaires were developed to get subjects, general characteristics. main symptoms, medical examination and diagnosed disease by the researcher referring through the questionaires of comprehensive health check-up center and the medical recorders were used as a tool of study. The researcher analyzed the data with SPSS PC+ ; the distribution of the subjects, general characteristics and main symptoms with percentage : the difference between main symptoms and screening tests with X$^2$-test, ANOVA. The results are as follows. 1) Among the age distribution, most were 40-45 years old and unemployed. 2) The most common complaints were indigestion in digestive system, cough in respiratory system, heart beat in cardiovascular system, general sweat in endocrine system. edema in urinary system, easy bruise in hematologic system, backache in musculoskeletal system, headache in psychoneurologic system, lochia in gynecology, itch in dermatology system, eye ball pain in visual system and tinnitus in auditory system. 3) In main symptoms according to age, the 40-45 age group had a higher rate of complaints in digestive system and gynecology than other age group ; the 46-49 age group in endocrine system. 4) The main symptoms according to diagnosis had no difference statistically. 5) The screening tests which showed high rates of abnormality were mammography(the highest), abdominal ultrasonography, upper gastrointestinal series/gastrofiberscopy, PFT. In all age group the highest rate of abnormality was seen in mammography. 6) In screening tests according to age. the 46-49 age group showed higher positive rates of pap smear, blood sugar test, urine test than any other age group ; the 50-55 age group showerd higher positive rates of obesity, BP, chest X-ray, abdominal ultrasonography, ESR, SGOT, CRP and urine micro. 7) In correlation of obesity with screening test, the obesity group showed higher positive rates of blood pressure, chest X-ray, abdominal ultrasonography, HCT and CRP than the normal weight group. 8) In correlation of blood pressure with screening test, the hypertension group showed higher positive rate of obesity, chest X-ray, abdominal ultrasonography, pap smear and blood sugar than the normal blood pressure group. In conculusion, the middle-aged women have various physical symptoms and affected by age. The obesity and BP have an important effect on the health of the middle aged women. Therefore, this study is considered significant as data for qualitative lives of the middle-aged women playing an important part of family health care by catching of their health problem complaints for prevention of disease and promotion of health.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4329-4334
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• 2013

Background: Cervical cancer, which is common in developing countries, is also a major health issue in Korea. Our aim was to evaluate the cost-effectiveness of Korea's National Cancer Screening Program (NCSP), implemented in 1999. Materials and Methods: The target population was Korean women 30 years or over who were invited to take part in the NCSP in 2002-2007. By merging NCSP records with Korean Central Cancer Registry data, patients diagnosed with cervical cancer who had been screened were assigned to a "screened group," while patients diagnosed elsewhere were assigned to a "non-screened group." Clinical outcomes were measured in terms of life-years saved (LYS), derived from 5-year mortality rates supplied by the Korean National Health Insurance Corporation and National Statistical Office. Direct and travel costs associated with screening were evaluated from the perspective of the payer, the NCSP. Results: A diagnosis via screening was associated with 2.30 LYS, and the incremental cost-effectiveness ratio (ICER) estimate for screening was 7,581,679 KW/LYS (6,727 USD/LYS). ICER estimates were lower for older patients (${\geq}$ 50 years) than younger patients (4,047,033 KW/LYS vs 5,680,793 KW/LYS). The proportion of early-stage cancers detected was 16.3% higher in the screened group. Conclusions: In light of Korea's per capita gross domestic product (32,272 USD in 2012), the current NCSP's incremental cost per LYS appears acceptable.