National Cancer Screening Programs and Evidence-Based Healthcare Policy in South Korea

Jung, Minsoo

doi:10.1016/j.healthpol.2014.08.012

Cited by 26 publications

(22 citation statements)

References 15 publications

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“…Despite the recent quantitative expansion of the NCSP, no evidence for the effect of the nationwide program has been established. Some challenging issues for the NCSP, such as the low participation rate among the eligible population, low positive predictive rate, and low sensitivity of screening checkups, are still present 11, 18, 19. Moreover, income inequalities in screening attendance still exist because of various barriers that prevent the low-income population from attending cancer screening 18, 20.…”

Section: Discussionmentioning

confidence: 99%

Difference of stage at cancer diagnosis by socioeconomic status for four target cancers of the National Cancer Screening Program in Korea: Results from the Gwangju and Jeonnam cancer registries

Kweon

Kim

Kang

et al. 2017

Journal of Epidemiology

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BackgroundThe aim of this study was to evaluate whether stage at cancer diagnosis differed according to patient economic status.MethodsA total of 10,528 patients with cancer of the stomach, colorectum, breast, or cervix, which are target organs of the Korean National Cancer Screening Program (NCSP; fully implemented in 2005) were extracted from population-based cancer registries. The patients were classified into four groups based on socioeconomic status (SES), as determined using their National Health Insurance (NHI) monthly premium at the time of cancer diagnosis. Cancer stage at diagnosis was defined as early (in situ/local) or late stage (regional/distant) based on the Surveillance, Epidemiology, and End Results (SEER) summary stage. Multivariable logistic regression analysis was performed to estimate the risk of non-local stage using age, residential area, and community deprivation index as covariates.ResultsThe lowest SES subjects showed significantly higher risks of being diagnosed at a later stage for stomach, colorectal, and female breast cancer, but not for cervical cancer, compared with the highest SES subjects. The estimated ORs were 1.28 (95% CI, 1.10–1.49), 1.29 (95% CI, 1.03–1.61), and 1.35 (95% CI, 1.02–1.81) in the lowest SES subjects with stomach, colorectal, and breast cancer, respectively.ConclusionsIn conclusion, later stage diagnoses of stomach, colon, and female breast cancer are still associated with SES in Korea in the era of the NCSP for the lower SES population.

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Section: Discussionmentioning

confidence: 99%

Difference of stage at cancer diagnosis by socioeconomic status for four target cancers of the National Cancer Screening Program in Korea: Results from the Gwangju and Jeonnam cancer registries

Kweon

Kim

Kang

et al. 2017

Journal of Epidemiology

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“…For evaluating the efficacy of population-based cancer screening modalities, the reduction of mortality rate within the screened population is the gold-standard indicator [20,72] , but it should not be a mandatory requirement, since these outcomes will not be observable for many years [143] ; survival rate change is indeed a necessary indicator. Any benefits and risks should be compared and reviewed before adopting a certain method of screening [57,117,144] . If the risks outweigh the benefits, it cannot be regarded as effective and is therefore not recommended.…”

Section: Effectiveness Of Screening Is In Anticipationmentioning

confidence: 99%

“…The surveillance adherence rates should be increased and improved [40,145] , and should be supported by patients, providers, and health care systems/governments [37] . From the perspective of public health, cost-effective evaluation should be considered, and the benefits and risks of screening should be compared, as well [31,86,144,146] . Obviously, benefits of liver cancer screening, at least in terms of greater benefits than harms from the surveillance, have been evident so far.…”

Section: Effectiveness Of Screening Is In Anticipationmentioning

confidence: 99%

Liver cancer screening in China: practices and its extended questions

Chen¹,

Zhang²,

Lu³

et al. 2019

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Screening for liver cancer (hepatocellular carcinoma) in China started in early 1970s with the application of alphafetoprotein (AFP) in high-incidence regions. It has been extended to nationwide areas, emerging from the concepts of conducting screening in populations at-risk with positive hepatitis B surface antigen to the practice programs in rural and urban areas, and finally to the development of recommendations to guide medical practice for health care providers. The implementation of screening for liver cancer has resulted in earlier detection and hence the early curable treatment for patients who have gained short-or long-term survival, and even reduction in mortality rates, although these outcomes are more anecdotal than rigorously evidence-based. AFP or ultrasound examination has been considered as sensitive and specific methods for early detection but are with limitations. The combined use of these two modalities for screening populations at-risk every six months seems to have been reached consensus. The feasibility of screening for liver cancer is still debated because of differing opinions and even opposition to the choice of targeted sub-populations, the intrinsic necessity, and the contributions of the main risk factors among Western countries and China/Asian areas. Yet, the over 51% of global burden of liver cancer is in China, the solution to the early detection and treatment of liver cancer should fully consider the actual situation in China. The effectiveness of screening for liver cancer is worthy of anticipation.

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“…For example, immunization programs against viral hepatitis B and human papillomavirus has been established in 1995 and in 2016, respectively, through the national immunization program, which shows very high vaccination rate [ 11 ]. The national screening program provides screening for stomach, liver, colorectal, breast, and cervical cancer for adults in every 2 years, free of charge [ 12 ]. Despite those preventable interventions, stomach and liver cancers were predicted to become among the most burdensome for Korean men in 2015, with cervical cancer expected to account for an overwhelming proportion of the cancer burden in Korean women [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The Economic Burden of Cancers Attributable to Infection in the Republic of Korea: A Prevalence-Based Study

Nguyen

Han

et al. 2020

IJERPH

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Infection is a major cause of cancers. We estimated the economic burden of cancers attributable to infection in 2014 in Korea, where cancer causing infection is prevalent, but the economic burden of it has never been examined. Cancer patients were defined as those having made medical claims as recorded by the National Health Insurance Service, which is a mandatory insurance for all citizen. We multiplied the costs by the population-attributable fraction for each type of cancer. The study included direct and indirect costs, where direct costs comprised direct medical and non-medical costs of inpatients and outpatients, while indirect costs were estimated by identifying future income loss due to premature death, productivity loss during hospitalization/outpatient visits, and job loss. In 2014, there were 100,054 infection-related cancer patients, accounting for 10.7% of all Korean cancer cases for that year. Direct costs of cancers associated with infection stood at nearly USD 676.9 million, while indirect costs were much higher at USD 2.57 billion. The average expenditure of a typical patient was USD 32,435. Economic burden of cancers attributable to infection is substantial in Korea, accounting for 0.23% of the national gross domestic product and 1.36% of national healthcare expenditure in 2014.

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National Cancer Screening Programs and Evidence-Based Healthcare Policy in South Korea

Cited by 26 publications

References 15 publications

Difference of stage at cancer diagnosis by socioeconomic status for four target cancers of the National Cancer Screening Program in Korea: Results from the Gwangju and Jeonnam cancer registries

Difference of stage at cancer diagnosis by socioeconomic status for four target cancers of the National Cancer Screening Program in Korea: Results from the Gwangju and Jeonnam cancer registries

Liver cancer screening in China: practices and its extended questions

The Economic Burden of Cancers Attributable to Infection in the Republic of Korea: A Prevalence-Based Study

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