The current status of gastric cancer screening in Korea: report on the National Cancer Screening Programme, 2009.

OBJECTIVE: The objective of this study was to evaluate the results of the National Cancer Screening Programme (NCSP) for gastric cancer in 2009 and provide the rates of participation in organized gastric cancer screening in Korea. METHODS: The data were obtained from the National Cancer Screening Information System, and the participation rates in gastric cancer screening were calculated. Recall rates, defined as the proportion of abnormal cases among participants, were estimated with 95% confidence intervals (CIs). RESULTS: The target population of the 2009 NCSP included 6,842,209 Korean men and women aged 40 and older. Of those adults, 2,328,715 were screened with upper endoscopy or upper gastrointestinal (UGI) series (34.0%). For the first time, the number of adults (56.3%) screened with upper endoscopy exceeded the number screened with UGI series. Participation rates varied by gender and health insurance type. Overall, the recall rates of upper endoscopy and UGI series were 0.3% (95% CI, 0.34 to 0.36) and 1.6% (95% CI, 1.62 to 1.67), respectively. CONCLUSIONS: According to our research, efforts to facilitate participation and to reduce disparities in gastric cancer screening among Korean men and women are needed.

Gastric cancer screening in Korea: report on the national cancer screening program in 2008.

PURPOSE: The National Cancer Screening Program (NCSP) began in 1999. The objective of this report is to evaluate the results of the NCSP in 2008 and provide essential evidence associated with the gastric cancer screening program in Korea. MATERIALS AND METHODS: Data was obtained from the National Cancer Screening Information System; participation rates in gastric cancer screening were calculated. According to screening modalities, recall rates were estimated with 95% confidence intervals (CIs). RESULTS: The target population of the gastric cancer screening program in 2008 was 7,132,820 Korean men and women aged 40 and over, 2,076,544 of whom underwent upper endoscopy or upper gastrointestinal (UGI) series as screening tools (participation rate, 29.1%). Disparities in participation rates were observed relating to gender and health insurance type. Overall, recall rates of upper endoscopy and UGI series were 3.1% (95% CI, 3.0 to 3.1) and 33.3% (95% CI, 33.3 to 33.4), respectively. CONCLUSION: According to our research, efforts to facilitate participation and to reduce disparities in gastric cancer screening among Korean men and women are needed. These results will provide essential data for evidence-based strategies in gastric cancer control in Korea.

Reproductive and Hormonal Factors Associated with Fatty or Dense Breast Patterns among Korean Women.

PURPOSE: Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women. MATERIALS AND METHODS: Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis. RESULTS: In univariate logistic regression, older age, higher body mass index, older age at menarche, and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend <0.01, respectively), whereas nulliparous and premenopausal status were positively associated. Compared to women who had ≥2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend <0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32). CONCLUSION: Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.

Trends of mammography use in a national breast cancer screening program, 2004-2008.

PURPOSE: Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program. MATERIALS AND METHODS: The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence. RESULTS: Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group. CONCLUSION: The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups.