• The Korean Journal of Pain
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• v.30 no.1
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• pp.34-43
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• 2017

Background: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ${\geq}85%$ own homes; public rental flats are reserved for those with low-income. Methods: Chronic pain was defined as pain ${\geq}3$ months. From 2009-2014, residents aged 40-60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. Results: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36-3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25-3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18-4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34-5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94-6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of "major illness"; screening as a search for answers to pain; and labelling pain as an end in itself. Conclusions: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.

• Parasites, Hosts and Diseases
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• v.52 no.1
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• pp.85-87
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• 2014

We encountered a patient with heavy Hymenolepis nana infection. The patient was a 44-year-old Korean man who had suffered from chronic hepatitis (type B) for 15 years. A large number of H. nana adult worms were found during colonoscopy that was performed as a part of routine health screening. The parasites were scattered throughout the colon, as well as in the terminal ileum, although the patient was immunocompetent. Based on this study, colonoscopy may be helpful for diagnosis of asymptomatic H. nana infections.

• Journal of Preventive Medicine and Public Health
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• v.41 no.2
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• pp.100-106
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• 2008

Objectives : We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. Methods : A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1 - May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. Results : Among 985 survey respondents(380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. Conclusions : In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.671-676
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• 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.

• Health Policy and Management
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• v.9 no.1
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• pp.139-155
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• 1999

This study was performed to assess the practice behavior and the need for cancer screening in order to design the community projects in Suwon city. A random sample of urban married women was surveyed on knowledge, attitude, and practice of breast and cervical cancer screening by telephone from April 28th to May 19th. Four hundred two married women completed the questionnaire, and the results were as follows: 1. Urban women were not generally knowledgeable about symptoms, signs and etiology of breast and cervical cancer. Only 11.4% of respondents were fully aware of those subjects. 2. Two hundred eighty six repondents(71.1%) reported having had a mammogram or Pap smear, while 116 respondents(28.9%) reported never having had a mammogram nor Pap smear. 3. The rate of mammogram increased by age and income status significantly(p〈0.05). 4. The majority(73.1%) of women who had a mammogram reported that it was part of a routine physical examination and another 24.3% of the women reported that they had a mammogram for specific breast problems. Meanwhile, the reasons reported for never having a mammogram were as follows; never had any problems (72.1%), no chance(11.2%), no time(4.3%). 5. The main factors associated with adherence to mammography screening guidelines was monthly income status. 6. The majority(80.6%) of women who had a Pap smear reported that it was part of a routine physical examination and another 16.0% of the women reported that it was part of a routine physical examination and another 16.0% of the women reported that they had a Pap smear for specific uterus problems. Meanwhile, the reasons reported for never having a Pap smear were: never had any problems(69.0%) and no chance(11.5%) 7. Women with higher income status were most likely to have a Pap smear regularly (p〈0.01), and the rate of Pap smear increased by education level significantly(p〈0.05). The main factors associated with adherence to Pap smear screening guidelines were education level and monthly income status, similar to those of mammograph. These findings indicate that married women in Suwon city show a lower rate of breast and cervical cancer screening practice than that of developed countries. The rate of mammograph was especially low. It is, therefore, suggested that cost, environmental factors, process, and information for screening tests be considered more programmatically before designing a community project for breast and cervical cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3753-3756
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• 2014

Background: Cervical cancer is relatively common in Thai women, but the proportion of females receiving Pap smear screening is still low. Objective: The purpose of this cross-sectional study was to study factors related to cervical cancer screening uptake by Hmong hilltribe women in Lomkao District, Phetchabun Province. Materials and Methods: Interview data were collected from 547 of these women aged 30-60 years living in the study area and analyzed using multiple logistic regression. Results: The results showed that 64.9% of the study sample had received screening, and that 47.2% had attended due to a cervical screening campaign. The most common reason given for not receiving screening was lack of time (21.4%). The factors found to be positively associated with uptake (p value <0.05) were as follows: number of years of school attendance (OR=1.56, 95%CI:1.02-2.38), animistic religious beliefs (OR=0.55, 95%CI:0.33-0.91), a previous pregnancy (OR=6.20, 95%CI:1.36-28.35), receipt of information about cervical cancer screening (OR=2.25, 95%CI:1.35-3.76), and perceived risk of developing cervical cancer (OR=1.83, 95%CI:1.25-2.67). Conclusions: To promote the uptake of cervical screening, Hmong hilltribe women need to know more about cervical cancer and cervical cancer screening, and access to screening services should be provided in conjunction with existing everyday services, such as family planning and routine blood pressure monitoring or diabetes services.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6909-6912
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• 2015

Cancer is a major public health problem due to the jeavy disease burden, fatality and tendency for increased incidence. Of all cancer types, cervical cancer is reported to be the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases worldwide in 2012. It features a long preclinical phase with slowly progressing precancerous lesions such as CIN 2 and 3 and adenocarcinoma in situ. Therefore, screening programs such as with Pap smear tests may play an important role in cervical cancer prevention. The purpose of this study was to present results of a Pap smear screening survey for cervical cancer targeting women living in an urban area in the province of Mersin, located in the Mediterranean region of Turkey. This community-based descriptive study included women living at Akdeniz county of Mersin province. A total of 1,032 screened women between 30 and 65 ages within the routine screening programme constituted the study population. The mean age of the participants was $43.8{\pm}8.6$ (min. 30, max. 65) years. The percentage of the participants who had previously undergone smears was 40.6%. Epithelial cell changes were found in 26 (2.5%) participants, with ASC-US in 18 (1.7%), ASC-H in 2 (0.2%), LSIL in 5 (0.5%) and HSIL in 1 (0.1%). The most common clinical presentation together with epithelial changes was abnormal vaginal discharge. Taking into account the presence of women who had never undergone Pap test; it should be offered at primary level of health care in the form of a community-based service to achieve reduced morbidity and mortality rates.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5237-5242
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• 2015

Background: Socioeconomic factors are associated with screening in terms of reducing the risk of cervical cancer. This study aimed to clearly establish the effect of screening on variation in socio-economic factor-specific survival estimates. Materials and Methods: Survival estimates were calculated using the life table method for 165 women from the routine care control arm and 67 from the visual inspection with acetic acid screening arm diagnosed with cervical cancer during 2000-2006 in rural south India. Kaplan-Meier survival curves were plotted to compare the variation in survival by socioeconomic factors. Results: Whereas there was a significant variation in survival estimates of the different categories of age at diagnosis among the screen-detected cancers with women aged<50 years having an improved survival, no significant variation was noted among women diagnosed with cervical cancer from the control arm. Compared to the variation among the cancer cases detected in the unscreened control group, screening widened the variation in survival estimates by age and type of house, and reduced the variation by education. The direction of the magnitude of the survival estimates was reversed within the different categories of occupation, marital status and household income in the screen-detected cancer cases compared to control group cancer cases. Also, women diagnosed with stage 1 disease had a very good survival. Conclusions: Screening changed the pattern of survival by socio-economic factors. We found improved survival rates in screened women aged <50 years, with no formal education, manual workers and married women.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3437-3442
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• 2013

The high incidence of gastric cancer and consequent mortality pose severe threats to human health. Early screening, diagnosis and treatment are the key to improve the prognosis of the patients with gastric cancer. Gastroscopy with biopsy is an efficient method for the diagnosis of early gastric cancer, but the associated discomfort and high cost make it difficult to be a routine method for screening gastric cancer. Serum tumor marker assay is a simple and practical method for detection of gastric cancer, but it is limited by poor sensitivity and specificity. Therefore, people have been looking for novel serum markers of gastric cancer in recent years. Here we review the novel serum tumor markers of gastric cancer and their diagnostic significance, focusing on the discoveries from serum proteomics analyses and epigenetics researches.