• 환경영향평가
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• 제10권3호
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• pp.195-209
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• 2001

The objective of this study is intended to propose plans for reforming environmental impact assessment(EIA) systems by reviewing the current legal systems of EIA related laws and their implementation status in Korea, and by comparing the Korean situation to EIA systems in several foreign countries. This study tried to integrate all EIA related systems scattered over several laws into one comprehensive EIA law, and also to develop legal procedures necessary to accomplish the legislative purpose of the integrated EIA law. Therefore, I propose four reforms (1) All EIA systems should be integrated into one comprehensive EIA act. (2) Administrative plans and policies, though environmentally harmful, which are not currently subject to any prior consultation system, should be covered by the prior consultation system. (3) A screening or scoping should be adopted. (4) Widen civil participation should be encouraged and the administrative control enforcement and introduction of group litigation or citizen suits would be considered.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3763-3767
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• 2016

Background: Cervical cancer is the second most common cancer among females across the world. It is a preventable cancer and early detection is very feasible. This study aimed to identify which women characteristics are potentially associated with and may have an important in uence on the uptake of cervical cancer screening in Kurdish women living in the west of Iran.. Materials and Methods: A cross sectional study was conducted in late 2014. A random sample of women aged 40 years and above without history of cervical cancer and identi ed as Kurdish background were selected and interviewed by two trained interviewers. Information about sociodemographic and reproductive factors, history of diseases, and cervical screening was collected using a questionnaire and women who had undergone a hysterectomy were excluded. Univariate analyses were used to describe the general characteristics of the study population. Multivariable logistic regression models with self-reported screening history were used to estimate odds ratios (ORs) with 95% con dence intervals (CI). Signi cance was considered at the 5% level. Results: A total of 561 women were included in this study (mean age $43.6{\pm}5.17$ years) participation in cervical screening at least once was about 32%. Cervical screening uptake percentage was signi cantly lower among people over 60 years of age (adjusted OR= 0.26, 95% CI: 0.11-0.64), and those who were illiterate (OR= 0.41 95% CI: 0.23-0.73) and post-menopausal (OR= 0.56, 95% CI: 0.35-0.91). Women with ${\leq}1$ child were less likely to report a Pap test (adjusted OR=0.43 95%CI: 0.13-1.37) Cervical screening uptake was higher among women with health insurance (OR= 2.31, 95% CI: 1.50-3.56). Conclusions: Cervical screening participation in this study was low compared to other studies in developed countries. The screening uptake was different based on age, education, parity, insurance coverage and menopausal status. It is recommended to target these groups of women in cervical screening program.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10757-10762
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• 2015

The purpose of this study was to demonstrate the feasibility of VIA screening with cryotherapy and to record normative values for indicators anticipated in similar low resource settings. Women aged 30-49 years were targeted, resulting in 1961 women screened and treated at two primary health care (PHC) centres near Suva, Fiji. Recruitment was through provision of information, education and communication (IEC). Referrals to a gynaecology outpatient department (OPD) at a referral hospital occurred throughout the screening pathway. Participation was 32% (95%CI 31-33%), higher in iTaukei (Melanesians) women (34%, 95%CI 33-36) compared to Fijians of Indian descent (26%, 95%CI 24-28). Regression analysis, adjusted for confounders, indicated significantly lower participation in those of Indian descent, and age groups 35-39 and 45-49 years. Of those examined by VIA, 190 were positive with aceto-white lesions (9.9%), within the expected range of 8-15%, with minor geographic and ethnic variation. Positive VIA results were more common in the peri-urban area, and in those aged 35-39 years. Of women aged 30-49 years, 59 received cryotherapy (none of whom had significant complications), 91 were referred to OPD, two cervical carcinomas were identified and eight cervical intra-epithelial neoplasms (CIN) II-III were diagnosed. These results provide normative findings from a community-based VIA screening program for other similar low resource settings.

• 보건교육건강증진학회지
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• 제33권3호
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• pp.37-48
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• 2016

Objectives: The purpose of the study was to find determinants for participation in the National health screening program participation according to sex in Korean. Methods: Data for 5,355 from the Korea National Health and Nutrition Examination Survey VI was included. Impact factors were analyzed by sex using logistic regression. Results: The participation in men rates(65.6%) higher than women(60.6%). In the case of men, those who have higher age (OR=0.33, 95% CI 0.21-0.52), higher income(OR=0.72, 95% CI 0.54-0.97), higher education (OR=0.54, 95% CI 0.36-0.81), occupation(OR=1.80, 95% CI 1.38-2.36), spouse(OR=1.95, 95% CI 1.45-2.62) were shown to have health examination more frequently. In the case of women, those who live in more developed city(OR=1.42, 95% CI 1.1-1.76), have higher age(OR=0.17, 95% CI 0.11-0.26), higher income(OR=0.17, 95% CI 0.11-0.26), higher education(OR=0.68, CI 0.46-0.99), occupation(OR=1.54, CI 1.32-1.80) and health insurance(OR=2.68, 95% CI 1.17-6-15) were shown to have health examination more frequently insurance were shown to have health examination more frequently. Conclusions: As a result, for both, age, income, education and occupation influenced health examination rate. Additionally, for men, marital status and for women, residence and the type of their health insurance was influenced. Individualized intervention is needed to increase participation rate.

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

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4519-4528
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• 2013

Breast cancer incidence and mortality rates are increasing in the Arab world and the involved women are often diagnosed at advanced stages of breast cancer. This literature review explores factors influencing Arab women's breast cancer screening behavior. Searched databases were: Medline, PubMed, Cochrane Database of Systematic Reviews, CINAHL Plus, Google Scholar, Index Medicus for WHO Eastern Mediterranean, and Asian Pacific Journal of Cancer Prevention. Breast cancer screening participation rates are low. Screening programs are opportunistic and relatively new to the region. Knowledge amongst women and health care providers, professional recommendation, socio-demographic factors, cultural traditions, beliefs, religious, social support, accessibility and perceived effectiveness of screening influence screening behavior.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.609-614
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• 2016

Background: Although breast cancer is the most common cancer in women, economic evaluation of breast cancer screening is not fully addressed in developing countries. The main objective of the present study was to analyze the cost-effectiveness of breast cancer screening using mammography in 35-69 year old women in an Iranian setting. Materials and Methods: This was an economic evaluation study assessing the cost-effectiveness of a population-based screening program in 35-69 year old women residing in rural areas of South east Iran. The study was conducted from the perspective of policy-makers of insurance. The study population consisted of 35- to 69-year old women in rural areas of Kerman with a population of about 19,651 in 2013. The decision tree modeling and economic evaluation software were used for cost-effectiveness and sensitivity analyses of the interventions. Results: The total cost of the screening program was 7,067.69 US$ and the total effectiveness for screening and no-screening interventions was 0.06171 and 0.00864 disability adjusted life years averted, respectively. The average cost-effectiveness ratio DALY averted US$ for screening intervention was 7,7082.5 US$ per DALY averted and 589,027 US $ for no-screening intervention. The incremental cost-effectiveness ratio DALY averted was 6,264 US$ per DALY averted for screening intervention compared with no-screening intervention. Conclusions: Although the screening intervention is more cost-effective than the alternative (noscreening) strategy, it seems that including breast cancer screening program in health insurance package may not be recommended as long as the target group has a low participation rate.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2829-2832
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• 2012

Background: This study aimed to research the awareness of screening colonoscopy (SC) among patients with colorectal cancer (CRC) and their relatives. Methodology: A questionnaire form including information and behavior about colonoscopic screening for CRCs of patients and their first-degree relatives (FDRs) was prepared. Results: A total of 406 CRC patients were enrolled into the study, with 1534 FDRs (siblings n: 1381 and parents n: 153). Positive family history for CRC was found in 12% of the study population. Previous SC was performed in 11% of patients with CRC. Mean age of the patients whose FDRs underwent SC was lower than the patients whose FDRs did not (52 vs 57 years; p<0,001). The frequency of SC in FDRs was 64% in patients diagnosed CRC under 35 years of age. Persons having a positive family history of CRC had SC more often (51 vs 22%, p<0,001). FDRs of patients having a higher educational level and income had SC more frequently. Conclusions: When screening for CRC is planned, elderly subjects, those with family history for CRC, and those with low educational and lower income should be given esspecial attention in order that they be convinced to undergo screening for CRC.

• 한국콘텐츠학회논문지
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• 제19권3호
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• pp.349-356
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• 2019

본 연구의 목적은 2016년 1월부터 검진연령이 만 20세까지 확대된 자궁경부암 검진에 대한 한국 20대 여성의 인식의 인지 정도를 조사하여 파악하고, 수검의도 간의 관련성을 규명하는 것이다. 자료는 2017년 11월1일부터 10일까지 C지역 여성을 대상으로 총 353명의 설문 응답을 수집하였다. 353부를 활용하여 빈도분석, 교차분석, 로지스틱 회귀분석을 실시하였다. 분석결과, 현행 자궁경부암 검진 사업에 대해 129명(36.5%)만이 인지하고 있었다. 또한 자궁경부암 검진 사업에 대해 인지한 경우 그렇지 않은 경우보다 수검의도가 1.63배 높았다. 따라서 학교보건 사업과 연계하여 20세 이전의 여성을 대상으로 자궁경부암 검진에 대한 교육과 홍보를 강화하여 20대 여성의 수검률을 높일 필요가 있다.