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33 "Kui Son Choi"
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Special Article
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2023
Eun Hye Park, Kyu-Won Jung, Seo Hyun Choi, Nam Ju Park, Mee Joo Kang, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Kui Son Choi, Han-Kwang Yang, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2026;58(2):349-367.   Published online March 23, 2026
DOI: https://doi.org/10.4143/crt.2026.298
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2023, with international comparisons.
Materials and Methods
Cancer incidence, survival, and prevalence rates were calculated using the Korea National Cancer Incidence Database (1999-2023), with survival follow-up until December 31, 2024. Mortality data were obtained from the Ministry of Data and Statistics, while international comparisons were based on GLOBOCAN data.
Results
In 2023, 288,613 newly diagnosed cancer cases (age-standardized rate [ASR], 288.6 per 100,000) and 85,271 deaths from cancer (ASR, 64.3 per 100,000) were reported. Among the incident cases, 145,452 (50.4%) were aged 65 years or older. Prostate cancer became the most common cancer among men for the first time. The proportion of localized-stage cancers increased from 45.6% in 2005 to 51.8% in 2023. Korea had the lowest cancer mortality among countries with similar incidence rates and the lowest mortality-to-incidence ratios for stomach, colorectal, and breast cancer. The 5-year relative survival rate (2019-2023) was 73.7% overall and 92.7% for localized-stage cancers. Over 2.73 million prevalent cases were identified in 2023, representing 5.3% of the Korean population.
Conclusion
These findings indicate that Korea’s cancer control efforts have contributed to early detection and improved survival outcomes. As Korea enters a super-aged society in 2025, cancer burden will continue to increase, requiring sustained and adaptive cancer control strategies.
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Original Article
Changes in Uptake, Participant Disparities, and Screening Outcomes of the Korean National Lung Cancer Screening Program: A Five-Year Experience
Chang Kyun Choi, Na-Young Lee, Mina Suh, Kui Son Choi, Yeol Kim
Received January 15, 2025  Accepted November 6, 2025  Published online November 10, 2025  
DOI: https://doi.org/10.4143/crt.2025.067    [Accepted]
AbstractAbstract PDF
Purpose
Low-dose computed tomography (LDCT) is effective in reducing lung cancer mortality among high-risk smokers. The Korean National Lung Cancer Screening Program (KNLCS), the world’s first nationwide lung cancer screening initiative using LDCT, was launched in 2019. This study aimed to evaluate the KNLCS uptake rates in relation to participants’ economic status and changes in positive screening rates across screening rounds.
Materials and Methods
Data from the National Health Insurance Service (NHIS) and National Cancer Screening Information System for 2019–2023 were analyzed. Eligible participants in the KNLCS were current smokers aged 54–74 years with a smoking history of at least 30 pack-years. The KNLCS provides counseling by physicians on screening results and smoking cessation. Screening uptake rates, counseling rates, and Lung CT Screening Reporting and Data System (Lung-RADS) distributions were assessed.
Results
Screening uptake rates increased from 24.7% in 2019 to 51.2% in 2023 (p < 0.001). Economic disparities were observed, with higher-income groups showing consistently higher uptake rates than lower-income group. Screening positive rates has been decreased from 9.1% in 2019 to 7.0% in 2023 according to increasing the proportion of subsequent screening participants. The inter-institutional variance in Lung-RADS category 4 decreased significantly over the years (p < 0.001).
Conclusion
The KNLCS rapidly increased screening uptake rates by systematically inviting eligible participants. Positive screening rates decreased primarily due to a reduction in Lung-RADS category 3 findings in subsequent rounds.
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Special Articles
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2022
Eun Hye Park, Kyu-Won Jung, Nam Ju Park, Mee Joo Kang, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Kui Son Choi, Han-Kwang Yang, The Community of Population-Based Regional Cancer Registries
Cancer Res Treat. 2025;57(2):312-330.   Published online March 11, 2025
DOI: https://doi.org/10.4143/crt.2025.264
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2022, with international comparisons.
Materials and Methods
Cancer incidence, survival, and prevalence rates were calculated using the Korea National Cancer Incidence Database (1999-2022), with survival follow-up until December 31, 2023. Mortality data obtained from Statistics Korea, while international comparisons were based on GLOBOCAN data.
Results
In 2022, 282,047 newly diagnosed cancer cases (age-standardized rate [ASR], 287.0 per 100,000) and 83,378 deaths from cancer (ASR, 65.7 per 100,000) were reported. The proportion of localized-stage cancers increased from 45.6% in 2005 to 50.9% in 2022. Stomach, colorectal, and breast cancer showed increased localized-stage diagnoses by 18.1, 18.5, and 9.9 percentage points, respectively. Compared to 2001-2005, the 5-year relative survival (2018-2022) increased by 20.4 percentage points for stomach cancer, 7.6 for colorectal cancer, and 5.6 for breast cancer. Korea had the lowest cancer mortality among countries with similar incidence rates and the lowest mortality-to-incidence (M/I) ratios for these cancers. The 5-year relative survival (2018-2022) was 72.9%, contributing to over 2.59 million prevalent cases in 2022.
Conclusion
Since the launch of the National Cancer Screening Program in 2002, early detection has improved, increasing the diagnosis of localized-stage cancers and survival rates. Korea recorded the lowest M/I ratio among major comparison countries, demonstrating the effectiveness of its National Cancer Control Program.

Citations

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Prediction of Cancer Incidence and Mortality in Korea, 2025
Kyu-Won Jung, Mee Joo Kang, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Jeong-Eun Kim, Hyun-Joo Kong, Kui Son Choi, Han-Kwang Yang
Cancer Res Treat. 2025;57(2):331-338.   Published online March 11, 2025
DOI: https://doi.org/10.4143/crt.2025.263
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to project cancer incidence and mortality for 2025 to estimate Korea’s current cancer burden.
Materials and Methods
Cancer incidence data from 1999 to 2022 were obtained from the Korea National Cancer Incidence Database, while cancer mortality data from 1993 to 2023 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2025. A joinpoint regression model was applied to identify significant changes in trends, using only the most recent trend data for predictions.
Results
A total of 304,754 new cancer cases and 84,019 cancer deaths are expected in Korea in 2025. The most commonly diagnosed cancer is projected to be thyroid cancer, followed by the colorectal, lung, breast, prostate and stomach cancers. These six cancers are expected to account for 63.8% of the total cancer burden. Lung cancer is expected to be the leading cause of cancer-related deaths, followed by liver, colorectal, pancreatic, stomach, and gallbladder cancers, together comprising 66.6% of total cancer deaths.
Conclusion
The increasing incidence of female breast cancer and the rise in prostate and pancreatic cancers are expected to continue. As aging accelerates, cancer commonly found in older adults are projected to rise significantly.

Citations

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  • Prostate cancer in Korea: Nationwide trends in prevalence and medication use during 2011–2021
    Jaehee Jung, Hyunha Kang, Eunjung Choo, Hye-Young Kang, Chang Wook Jeong, Ha-Lim Jeon, Hankil Lee
    Cancer Epidemiology.2026; 101: 102987.     CrossRef
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    Jingmin Che, Woo Sun Kwon, Jaeyoung Kim, Erkhembayar Jadamba, Hyo Jun Han, Yuhnam Kim, Choong-kun Lee, Chan Hee Park, Ye Jin Moon, Han Byeol Mun, Hyun Cheol Chung, Sun Young Rha
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    Journal of Internal Medicine.2026;[Epub]     CrossRef
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    Ye Jin Moon, Woo Sun Kwon, Chan Hee Park, Jinsoo Jang, Juin Park, Byeong Gyu Yoon, Han Byeol Mun, Namju Kim, Choong-kun Lee, Hei Cheul Jeung, Su-Jin Shin, Tae Soo Kim, Sun Young Rha
    Journal of Gastric Cancer.2026; 26(2): 260.     CrossRef
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    Gynecologic Oncology.2026; 208: 113.     CrossRef
  • The volume of Gleason grade group 1 prostate cancer at biopsy predicts unfavorable pathology but not upgrading after radical prostatectomy
    Tae Ho Hwang, Young Dong Yu, Kyung Hwa Choi, Seung Ryeol Lee, Young Kwon Hong, Dong Soo Park, Tae Heon Kim
    International Urology and Nephrology.2025; 58(1): 91.     CrossRef
  • Factors That Impact the Quality of Life of Breast Cancer Patients: A Cross-Sectional Study
    Kyung-Sook Cha, Dohyun Lee, Su-Mi Im
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    Heejin Lee, Jung Eun Lee, Minji Kang
    Scientific Reports.2025;[Epub]     CrossRef
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Original Articles
Gastrointestinal cancer
A Machine Learning Risk Prediction Model for Gastric Cancer with SHapley Additive exPlanations
Bomi Park, Chung Ho Kim, Jae Kwan Jun, Mina Suh, Kui Son Choi, Il Ju Choi, Hyun Jin Oh
Cancer Res Treat. 2025;57(3):821-829.   Published online December 16, 2024
DOI: https://doi.org/10.4143/crt.2024.843
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Gastric cancer (GC) prediction models hold potential for enhancing early detection by enabling the identification of high-risk individuals, facilitating personalized risk-based screening, and optimizing the allocation of healthcare resources.
Materials and Methods
In this study, we developed a machine learning-based GC prediction model utilizing data from the Korean National Health Insurance Service, encompassing 10,515,949 adults who had not been diagnosed with GC and underwent GC screening during 2013-2014, with a follow-up period of 5 years. The cohort was divided into training and test datasets at an 8:2 ratio, and class imbalance was mitigated through random oversampling.
Results
Among various models, logistic regression demonstrated the highest predictive performance, with an area under the receiver operating characteristic curve (AUC) of 0.708, which was consistent with the AUC obtained in external validation (0.669). Importantly, the outcomes were robust to missing data imputation and variable selection. The SHapley Additive exPlanations (SHAP) algorithm enhanced the explainability of the model, identifying advancing age, being male, Helicobacter pylori infection, current smoking, and a family history of GC as key predictors of elevated risk.
Conclusion
This predictive model could significantly contribute to the early identification of individuals at elevated risk for GC, thereby enabling the implementation of targeted preventive strategies. Furthermore, the integration of noninvasive and cost-effective predictors enhances the clinical utility of the model, supporting its potential application in routine healthcare settings.

Citations

Citations to this article as recorded by  
  • Liver cancer risk stratification using deep learning on nationwide longitudinal health screening data: a retrospective cohort study
    Yewon Choi, Sungmin Cho, Changdai Gu, Chungho Kim, Bomi Park, Hwiyoung Kim
    BMC Medical Informatics and Decision Making.2026;[Epub]     CrossRef
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    Minji Seo, Ka Man Cheung, Serene J. L. Lam, Peter Y. M. Woo, Winnie W. Y. Sung, James C. H. Chow, Ada S. M. Yip, Stephen K. K. Ng, Martin S. C. Lee, Henry H. W. Liu, Daisy M. Y. Kan, Sau Shan Kao, Harry H. Y. Yiu, David C. C. Lam
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    Xueyan Li
    American Journal of Cancer Research.2025; 15(2): 470.     CrossRef
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    Wulian Lin, Guanpo Zhang, Hong Chen, Weidong Huang, Guilin Xu, Yunmeng Zheng, Chao Gao, Jin Zheng, Dazhou Li, Wen Wang
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    Shuai Bao, Yiang Wang, Shinai Ma, Huanjun Liu, Xiyu Xue, Yuxin Ma, Mingcong Zhang, Dianyao Wang
    Agriculture.2025; 15(17): 1834.     CrossRef
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    Hyon Hee Kim, Ji Yeon Han, Yae Bin Lim, Young Seo Lim, Seung-In Seo, Kyung Joo Lee, Woon Geon Shin
    Applied Sciences.2025; 15(23): 12428.     CrossRef
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    Daeyoung Hong, Jiung Kim, Jiyong Jung
    Diagnostics.2025; 15(24): 3175.     CrossRef
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Genitourinary cancer
Determinants of Prostate Cancer Screening in Korean Men: A Nationwide Study Using the Korean National Cancer Screening Survey 2023
Giap Viet Nguyen, Kyeongmin Lee, Hyeon Ji Lee, EunKyo Kang, Mina Suh, Jae Kwan Jun, Kui Son Choi
Cancer Res Treat. 2025;57(2):539-546.   Published online October 29, 2024
DOI: https://doi.org/10.4143/crt.2024.879
AbstractAbstract PDFPubReaderePub
Purpose
Research on the prevalence of prostate cancer (PCa) screening and reasons for undergoing screening is limited. We aimed to identify the factors influencing PCa screening behavior and explore the underlying motivations among Korean men.
Materials and Methods
This cross-sectional study used data from the 2023 Korean National Cancer Screening Survey, which employs a nationally representative random sampling method. This study included 1,784 men aged 40-74 years. The respondents reported their experiences with PCa screening. Multivariable logistic regression analysis was conducted to identify the factors associated with participation in PCa screening.
Results
The lifetime PCa screening rate was 18.6%. Among screening modalities, transrectal ultrasonography was the most frequently used (31.9%), followed by prostate-specific antigen tests (25.6%) and digital rectal examinations (21.5%). The multivariable analysis identified several factors that significantly increased the likelihood of screening participation, including older age, living with a spouse, poor self-reported health, and abstinence from alcohol consumption in the previous 12 months. Men who had undergone colorectal cancer screening were more likely to participate in PCa screening (adjusted odds ratio, 4.01; 95% confidence interval, 2.03 to 7.93) than those who had not. The primary motivations for screening were recommendations from family or social networks (31.9%) and inclusion in health examination packages (24.3%), whereas healthcare provider recommendations (18%) and symptomatic concerns (5.7%) were the least influential.
Conclusion
Our findings highlight the importance of providing evidence-based information for PCa screening recommendations and the need for improved communication and implementation of a shared decision-making approach for PCa screening in Korea.

Citations

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  • Global viewpoints: evolving epidemiology and treatment patterns of prostate cancer in Asia
    Kagenori Ito, Keiichiro Mori, Rajeev Kumar, Ravindra B. Sabnis, Bannakij Lojanapiwat, Takahiro Kimura, Shin Egawa
    BJU International.2025; 136(6): 970.     CrossRef
  • 3,461 View
  • 101 Download
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Special Articles
Trends in Cancer-Screening Rates in Korea: Findings from the National Cancer Screening Survey, 2004-2023
EunKyo Kang, Kui Son Choi, Jae Kwan Jun, Yeol Kim, Hyeon Ji Lee, Chang Kyun Choi, Tae Hee Kim, Sun Hwa Lee, Mina Suh
Cancer Res Treat. 2025;57(1):28-38.   Published online August 2, 2024
DOI: https://doi.org/10.4143/crt.2024.325
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to report the overall national trends in the rates of cancer screening based on recommendations and provide insights into the changing trends of these rates across different demographics.
Materials and Methods
This study used data from the Korean National Cancer Screening Survey (KNCSS), which surveys nationwide cancer-screening rates and includes 4,500 individuals meeting the Korean National Cancer Screening Program (NCSP) protocol age criteria. Cancer-screening rates were assessed using structured questionnaires; yearly trends were analyzed for both lifetime cancer-screening rates and rates of screening based on recommendations, and subgroup analyses were performed based on age and sex.
Results
The rates of cancer screening based on recommendations showed significant increments: the stomach cancer-screening rate increased from 39.2% in 2004 to 77.5% in 2023 (3.50% per year), the liver cancer-screening rate increased from 20.0% to 48.8% (4.30% per year), and the colorectal cancer, increased from 19.9% to 70.7% (5.15% per year). The breast cancer-screening rate increased from 33.2% to 72.7% (2.88% per year), and the cervical cancer, increased from 58.3% to 70.2% (1.08% per year). Despite some differences, particularly in relation to sociodemographic factors, screening rates increased significantly for all cancer types.
Conclusion
Cancer-screening rates in Korea increased consistently from 2004 to 2023, demonstrating the effectiveness of the national cancer-screening program. However, the increments in breast, cervical and lung cancer-screening rates were relatively lower, indicating the need for additional efforts and strategies.

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    Wen‐Feng Hsu, Masau Sekiguchi, Jeongkuk Seo, Hyun‐Soo Kim, Takahisa Matsuda, Han‐Mo Chiu
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The Cancer Clinical Library Database (CCLD) from the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) Project
Sangwon Lee, Yeon Ho Choi, Hak Min Kim, Min Ah Hong, Phillip Park, In Hae Kwak, Ye Ji Kang, Kui Son Choi, Hyun-Joo Kong, Hyosung Cha, Hyun-Jin Kim, Kwang Sun Ryu, Young Sang Jeon, Hwanhee Kim, Jip Min Jung, Jeong-Soo Im, Heejung Chae
Cancer Res Treat. 2025;57(1):19-27.   Published online July 15, 2024
DOI: https://doi.org/10.4143/crt.2024.218
AbstractAbstract PDFPubReaderePub
The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

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Data Resource Profile: The Cancer Public Library Database in South Korea
Dong-Woo Choi, Min Yeong Guk, Hye Ri Kim, Kwang Sun Ryu, Hyun-Joo Kong, Hyo Soung Cha, Hyun-Jin Kim, Heejung Chae, Young Sang Jeon, Hwanhee Kim, Jipmin Jung, Jeong-Soo Im, Kui Son Choi
Cancer Res Treat. 2024;56(4):1014-1026.   Published online April 30, 2024
DOI: https://doi.org/10.4143/crt.2024.207
AbstractAbstract PDFSupplementary MaterialPubReaderePub
This paper provides a comprehensive overview of the Cancer Public Library Database (CPLD), established under the Korean Clinical Data Utilization for Research Excellence project (K-CURE). The CPLD links data from four major population-based public sources: the Korea National Cancer Incidence Database in the Korea Central Cancer Registry, cause-of-death data in Statistics Korea, the National Health Information Database in the National Health Insurance Service, and the National Health Insurance Research Database in the Health Insurance Review & Assessment Service. These databases are linked using an encrypted resident registration number. The CPLD, established in 2022 and updated annually, comprises 1,983,499 men and women newly diagnosed with cancer between 2012 and 2019. It contains data on cancer registration and death, demographics, medical claims, general health checkups, and national cancer screening. The most common cancers among men in the CPLD were stomach (16.1%), lung (14.0%), colorectal (13.3%), prostate (9.6%), and liver (9.3%) cancers. The most common cancers among women were thyroid (20.4%), breast (16.6%), colorectal (9.0%), stomach (7.8%), and lung (6.2%) cancers. Among them, 571,285 died between 2012 and 2020 owing to cancer (89.2%) or other causes (10.8%). Upon approval, the CPLD is accessible to researchers through the K-CURE portal. The CPLD is a unique resource for diverse cancer research to investigate medical use before a cancer diagnosis, during initial diagnosis and treatment, and long-term follow-up. This offers expanded insight into healthcare delivery across the cancer continuum, from screening to end-of-life care.

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Original Articles
Lung and Thoracic cancer
Strategies to Improve Smoking Cessation for Participants in Lung Cancer Screening Program: Analysis of Factors Associated with Smoking Cessation in Korean Lung Cancer Screening Project (K-LUCAS)
Yeol Kim, Jaeho Lee, Eunju Lee, Juntae Lim, Yonghyun Kim, Choon-Taek Lee, Seung Hun Jang, Yu-Jin Paek, Won-Chul Lee, Chan Wha Lee, Hyae Young Kim, Jin Mo Goo, Kui Son Choi, Boyoung Park, Duk Hyoung Lee, Hong Gwan Seo
Cancer Res Treat. 2024;56(1):92-103.   Published online August 7, 2023
DOI: https://doi.org/10.4143/crt.2022.1598
AbstractAbstract PDFPubReaderePub
Purpose
Smoking cessation intervention is one of the key components of successful lung cancer screening program. We investigated the effectiveness and related factors of smoking cessation services provided to the participants in a population-based lung cancer screening trial.
Materials and Methods
The Korean Lung Cancer Screening Project (K-LUCAS) is a nationwide, multi-center lung cancer screening trial that evaluates the feasibility of implementing population-based lung cancer screening. All 5,144 current smokers who participated in the K-LUCAS received a mandatory smoking cessation counseling. Changes in smoking status were followed up using a telephone survey in 6 months after lung cancer screening participation. The lung cancer screening’s impact on smoking cessation is analyzed by variations in the smoking cessation interventions provided in screening units.
Results
Among 4,136 survey responders, participant’s motivation to quit smoking increased by 9.4% on average after lung cancer screening. After 6 months from the initial screening, 24.3% of participants stopped smoking, and 10.6% of participants had not smoked continuously for at least 6 months after screening. Over 80% of quitters stated that participation in lung cancer screening motivated them to quit smoking. Low-cost public smoking cessation program combined with lung cancer screening increased the abstinence rates. The smokers were three times more likely to quit smoking when the smoking cessation counseling was provided simultaneously with low-dose computed tomography screening results than when provided separately.
Conclusion
A mandatory smoking cessation intervention integrated with screening result counselling by a physician after participation in lung cancer screening could be effective for increasing smoking cessation attempts.

Citations

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  • Strategies for sustainable lung cancer screening: a multi-faceted perspective to long-term surveillance in SOLACE
    Emily Nischwitz, Roberta Eufrasia Ledda, Tom Stargardt, Carsten Wältner, Katarzyna Sejbuk-Rozbicka, Joanna Bidzinska, Joanna Moes-Sosnowska, Joanna Chorostowska-Wynimko, Mathis Konrad, Elizabeth Tong, Małgorzata Gałazka-Sobotka, Edyta Szurowska, Dominik R
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    Na-Young Yoon, Minji Seo, Nayoung Lee, Yeol Kim
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    Dixan A. Benitez, Guadalupe Cumplido-Laso, Marcos Olivera-Gómez, Nuria Del Valle-Del Pino, Alba Díaz-Pizarro, Sonia Mulero-Navarro, Angel Román-García, Jose Maria Carvajal-Gonzalez
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    Cheol Min Lee, Sil Vi Han Park, Jinri Kim, Bumjo Oh, Kiheon Lee, Yeol Kim, Yu-Jin Paek
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    Choon-Young Kim, Yeol Kim, Cheol Min Lee
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  • 257 Download
  • 6 Web of Science
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Gastrointestinal cancer
Overview of the National Cancer Screening Program for Colorectal Cancer in Korea over 14 Years (2004-2017)
Bomi Park, Eun Young Her, Kyeongmin Lee, Fatima Nari, Jae Kwan Jun, Kui Son Choi, Mina Suh
Cancer Res Treat. 2023;55(3):910-917.   Published online March 8, 2023
DOI: https://doi.org/10.4143/crt.2022.1432
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the participation and follow-up test compliance rates and key performance indicators of the National Cancer Screening Program (NCSP) for colorectal cancer (CRC) from 2004 to 2017.
Materials and Methods
The overall outcomes of the NCSP for CRC were analyzed using the NCSP data collected from 2004 to 2017 and the Korean Central Cancer Registry for CRC from 2005 to 2017. We cross-sectionally analyzed the participation and follow-up test compliance rates and performance indicators for each year. The trend of participation rates as an annual percentage change was assessed, and other statistical analyses were performed.
Results
The screening participation rates increased from 7.3% in 2004 to 30.5% in 2017. Additionally, the screening rates were higher among individuals aged 60-69 years and National Health Insurance Service beneficiaries of low-income status. However, the adherence to the follow-up test decreased from 63% in 2004 to 32% in 2017. The follow-up tests using the double-contrast barium enema method decreased from 42.2% in 2004 to 0.3% in 2017. However, follow-up tests by colonoscopy increased from 21.0% in 2004 to 31.8% in 2017. Furthermore, the positivity, false-positive, and interval CRC rates decreased, whereas the specificity increased from 2004 to 2016, indicating improved performance of CRC.
Conclusion
The participation rates and performance of the NCSP for CRC have steadily improved, whereas adherence to follow-up tests has decreased. Additionally, there is a rapid growth in colonoscopy volume as a follow-up test. Continued efforts are required to improve the follow-up rates.

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    Hyoung Il Choi, Jae Myung Cha, Young Sang Kim, Dae Hyeon Cho, Han Ju Pack, Soo-Young Na, Ji Hye Kim, Hyun Gun Kim, Young-Jin Park, Hye Jung Kwon, Kyeong Ok Kim, Geon Ho Lee, Yoo Jin Lee
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Breast cancer
Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women
Eunji Choi, Mina Suh, So-Youn Jung, Kyu-Won Jung, Sohee Park, Jae Kwan Jun, Kui Son Choi
Cancer Res Treat. 2023;55(1):136-144.   Published online April 4, 2022
DOI: https://doi.org/10.4143/crt.2021.962
AbstractAbstract PDFPubReaderePub
Purpose
High breast cancer incidence and dense breast prevalence among women in forties are specific to Asian. This study examined the natural history of breast cancer among Korean women.
Materials and Methods
We applied a three-state Markov model (i.e., healthy, preclinical, and clinical state) to fit the natural history of breast cancer to data in the Korean National Cancer Screening Program. Breast cancer was ascertained by linkage to the Korean Central Cancer Registry. Disease-progression rates (i.e., transition rates between three states), mean sojourn time (MST) and mammographic sensitivity were estimated across 10-year age groups and levels of breast density determined by the Breast Imaging, Reporting and Data System.
Results
Overall prevalence of dense breast was 53.9%. Transition rate from healthy to preclinical state, indicating the preclinical incidence of breast cancer, was higher among women in forties (0.0019; 95% confidence interval [CI], 0.0017 to 0.0021) and fifties (0.0020; 95% CI, 0.0017 to 0.0022), than women in sixties (0.0014; 95% CI, 0.0012 to 0.0017). The MSTs, in which the tumor is asymptomatic but detectable by screening, were also fastest among younger age groups, estimated as 1.98 years (95% CI, 1.67 to 2.33), 2.49 years (95% CI, 1.92 to 3.22), and 3.07 years (95% CI, 2.11 to 4.46) for women in forties, fifties, and sixties, respectively. Having dense breasts increased the likelihood of the preclinical cancer risk (1.96 to 2.35 times) and decreased the duration of MST (1.53 to 2.02 times).
Conclusion
This study estimated Korean-specific natural history parameters of breast cancer that would be utilized for establishing optimal screening strategies in countries with higher dense breast prevalence.

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Gastrointestinal cancer
Trends in the Performance of the Korean National Cancer Screening Program for Gastric Cancer from 2007 to 2016
Ji Eun Ryu, Eunji Choi, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu Won Jung, Kui Son Choi
Cancer Res Treat. 2022;54(3):842-849.   Published online September 30, 2021
DOI: https://doi.org/10.4143/crt.2021.482
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The Korean National Cancer Screening Program (KNCSP) has implemented two screening methods for gastric cancer—upper gastrointestinal series (UGIS) and endoscopy—for Koreans aged ≥40 years. We aimed to assess performance trends for both screening methods.
Materials and Methods
The KNCSP database was used to evaluate individuals who underwent screening from 2007 to 2016. The final gastric cancer diagnosis was ascertained by linking with the Korean Central Cancer Registry. We conducted a prospective, cross-sectional analysis to estimate performance indicators of gastric cancer screening by UGIS and endoscopy, stratified by sociodemographic factors.
Results
We found that screening rates for gastric cancer increased from 28% to 51.7% between 2007 and 2016, and that the rate of endoscopy use for gastric cancer screening increased sharply. Cancer detection rates (CDR) of UGIS and endoscopy were 0.41 and 2.25 per 1,000 screens in 2007–2008 and 0.26 and 1.99 in 2015–2016, respectively. Interval cancer rates (ICR) per 1,000 negative screenings were 1.33 (2007–2008) and 1.21 (2015–2016) for UGIS and 1.14 (2007–2008) and 0.88 (2015–2016) for endoscopy. The sensitivity of UGIS decreased from 23.6% (2007–2008) to 17.6% (2015–2016), whereas that of endoscopy increased from 66.4% (2007–2008) to 69.3% (2015–2016). Specificity was maintained at >99% for both methods over the study period.
Conclusion
The use of endoscopy for gastric cancer screening within the KNCSP has increased. Endoscopy has higher CDR, sensitivity, and specificity, and lower ICR estimates than does UGIS.

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Close layer
General
Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004–2018
Seri Hong, Yun Yeong Lee, Jaeho Lee, Yeol Kim, Kui Son Choi, Jae Kwan Jun, Mina Suh
Cancer Res Treat. 2021;53(2):330-338.   Published online October 20, 2020
DOI: https://doi.org/10.4143/crt.2020.263
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The Korean National Cancer Screening Survey (KNCSS) is a nationwide annual cross-sectional survey conducted for the past 15 years. This study aimed to report trends in the overall screening rates of both organized and opportunistic cancer screening programs from 2004–2018.
Materials and Methods
KNCSS data were collected using a structured questionnaire. For five major cancers (i.e., stomach, liver, colorectal, breast, and cervical cancer), we evaluated both the lifetime screening rate and the screening rate with recommendations. The study population included men aged 40–74 years and women aged 20–74 years with no cancer histories.
Results
Screening rate with recommendations increased from 2004 annually by 4.4% and 1.5% until 2013 for stomach and liver cancers, respectively, by 4.0% until 2012 for breast cancer, and by 3.6% and 1.2% until 2014 for colorectal and cervical cancers, respectively, followed by nonsignificant trends thereafter. In 2018, screening rates with recommendations for these cancers were 72.8%, 26.2%, 63.1%, 58.4%, and 55.6%, respectively.
Conclusion
Screening rates for the five types of cancer demonstrated a marked increase between 2004 and 2018. However, many recent screening rates have been flattened with nonsignificant trends, and there are lower rates for cervical cancer screening among young age groups. Steady efforts are needed to achieve higher screening participation rates overall, especially for the cervical cancer screening of young women in their 20s.

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Breast cancer
Impact of Awareness of Breast Density on Perceived Risk, Worry, and Intentions for Future Breast Cancer Screening among Korean Women
Anh Thi Ngoc Tran, Ji Hae Hwang, Eunji Choi, Yun Yeong Lee, Mina Suh, Chan Wha Lee, Yeol Kim, Kui Son Choi
Cancer Res Treat. 2021;53(1):55-64.   Published online August 18, 2020
DOI: https://doi.org/10.4143/crt.2020.495
AbstractAbstract PDFPubReaderePub
Purpose
This study sought to examine perceived risk and concerns for breast cancer according to awareness of breast density and states thereof among Korea women and to identify the impact of such awareness on screening intentions.
Materials and Methods
This study was based on the 2017 Korean National Cancer Screening Survey of a nationally representative and randomly selected sample of Koreans. Ordinal logistic regression was conducted to examine associations for awareness of and knowledge on breast density in relation to psychological factors. Multivariate logistic regression analyses were conducted to investigate significant factors associated with intentions to undergo breast cancer screening.
Results
Among a total of 1,609 women aged 40-69 years, 62.0% were unaware of their breast density, and only 29.7% had good breast density knowledge. Awareness of one’s breast density and knowledge about breast density were positively associated with perceptions of absolute and comparative risk and cancer worry. Women aware of their breast density (adjusted odds ratio [aOR], 1.35 for women aware of having a non-dense breast; aOR, 4.17 for women aware of having a dense breast) and women with a good level of breast density knowledge (aOR, 1.65) were more likely to undergo future breast cancer screening.
Conclusion
Breast density awareness and knowledge showed positive associations with psychological factors and breast cancer screening intentions. However, the majority of Korean women were not aware of their breast density status and demonstrated poor knowledge about breast density. These results demonstrate a need for better health communication concerning breast density.

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Disparities in the Participation Rate of Colorectal Cancer Screening by Fecal Occult Blood Test among People with Disabilities: A National Database Study in South Korea
Dong Wook Shin, Dongkyung Chang, Jin Hyung Jung, Kyungdo Han, So Young Kim, Kui Son Choi, Won Chul Lee, Jong Heon Park, Jong Hyock Park
Cancer Res Treat. 2020;52(1):60-73.   Published online May 7, 2019
DOI: https://doi.org/10.4143/crt.2018.660
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Implementation of screening program may lead to increased health disparity within the population if participation differs by socioeconomic status. In Korea, colorectal cancer screening is provided at no or minimal cost to all people over 50 by National Cancer Screening Program. We investigated colorectal cancer screening participation rate and its trend over the last 10 years in relation to disabilities.
Materials and Methods
We linked national disability registration data with National Cancer Screening Program data. Age, sex-standardized participation rates were analyzed by type and severity of disability for each year, and factors associated with colorectal cancer screening participation were examined by multivariate logistic regression.
Results
Age, sex-standardized participation rate in people without disability increased from 16.2 to 33.9% (change, +17.7), but it increased from 12.7% to 27.2% (change, +14.5) among people with severe disability. People with severe disabilities showed a markedly lower colorectal cancer screening participation rate than people without disability (adjusted odds ratio [aOR], 0.714; 95% confidence interval, 0.713 to 0.720). People with autism (aOR, 0.468), renal failure (aOR, 0.498), brain injury (aOR, 0.581), ostomy (aOR, 0.602), and intellectual disability (aOR, 0.610) showed the lowest participation rates.
Conclusion
Despite the availability of a National Cancer Screening Program and overall increase of its usage in the Korean population, a significant disparity was found in colorectal cancer screening participation, especially in people with severe disabilities and or several specific types of disabilities. Greater effort is needed to identify the barriers faced by these particularly vulnerable groups and develop targeted interventions to reduce inequality.

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Development of Protocol for Korean Lung Cancer Screening Project (K-LUCAS) to Evaluate Effectiveness and Feasibility to Implement National Cancer Screening Program
Jaeho Lee, Juntae Lim, Yeol Kim, Hyae Young Kim, Jin Mo Goo, Choon-Taek Lee, Seung Hun Jang, Won-Chul Lee, Chan Wha Lee, Jin Young An, Ki Dong Ko, Min Ki Lee, Kui Son Choi, Boyoung Park, Duk Hyoung Lee
Cancer Res Treat. 2019;51(4):1285-1294.   Published online February 19, 2019
DOI: https://doi.org/10.4143/crt.2018.464
AbstractAbstract PDFPubReaderePub
Purpose
To reduce lung cancer mortality, lung cancer screening was recommended using low-dose computed tomography (LDCT) to high-risk population. A protocol for multicenter lung cancer screening pilot project was developed to evaluate the effectiveness and feasibility of lung cancer screening to implement National Cancer Screening Program in Korea.
Materials and Methods
Multidisciplinary expert committee was comprised to develop a standardized protocol for Korean Lung Cancer Screening Project (K-LUCAS). K-LUCAS is a population-based single arm trial that targets high-risk population aged 55-74 years with at least 30 pack-year smoking history. LDCT results are reported by Lung-RADS suggested by American Radiology Society. Network-based system using computer-aided detection program is prepared to assist reducing diagnostic errors. Smoking cessation counselling is provided to all currently smoking participants. A small pilot test was conducted to check the feasibility and compliance of the protocols for K-LUCAS.
Results
In pilot test, 256 were participated. The average age of participants was 63.2 years and only three participants (1.2%) were female. The participants had a smoking history of 40.5 pack-year on average and 53.9% were current smokers. Among them, 86.3% had willing to participate in lung cancer screening again. The average willingness to quit smoking among current smokers was 12.7% higher than before screening. In Lung-RADS reports, 10 (3.9%) were grade 3 and nine (3.5%) were grade 4. One participant was diagnosed as lung cancer.
Conclusion
The protocol developed by this study is assessed to be feasible to perform K-LUCAS in multicenter nationwide scale.

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Beliefs and Intentions to Undergo Lung Cancer Screening among Korean Males
Nhung Cam Bui, Yoon Young Lee, Mina Suh, Boyoung Park, Hyunsoon Cho, Yeol Kim, Kui Son Choi
Cancer Res Treat. 2018;50(4):1096-1105.   Published online November 16, 2017
DOI: https://doi.org/10.4143/crt.2017.393
AbstractAbstract PDFPubReaderePub
Purpose
Low-dose computed tomography (LDCT) has been reported as an effective screening method for lung cancer in high-risk populations. We aimed to examine willingness to be screened among Korean males using LDCT and to determine factors associated with lung cancer screening intentions (LCS) based on the Health Belief Model (HBM).
Materials and Methods
Data were obtained from the 2015 Korean National Cancer Screening Survey, a cross-sectional survey that utilized nationally representative random sampling. The survey included 1,730 male participants 40-74-year-old. Respondents were questioned regarding their willingness to undergo LCS and components of HBM. Factors associated with intentions to undergo screening were explored using logistic regression.
Results
Among participants, 65.2% were current smokers. Among high-risk subjects, 60.6% of men reported intentions to undergo LCS, compared to 49.9% of average-risk males. Men with higher perceived susceptibility in the average- and high-risk groups were, respectively, 1.63 (95% confidence interval [CI], 1.39 to 1.91) and 2.30 (95% CI, 1.14 to 4.63) times more likely to intend to undergo LCS compared to those with lower perceived barriers. Also, men in the average- and high-risk groups with higher perceived barriers to screening were, respectively, 0.79 (95% CI, 0.68 to 0.91) and 0.52 (95% CI, 0.29 to 0.92) times less likely to intend to undergo LCS compared to those with lower perceived barriers.
Conclusion
Tailored interventions designed to promote accurate perceptions of susceptibility and risk, as well as to reduce perceived barriers to screening, may effectively increase adherence to recommendations for LCS among high-risk Korean men.

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Risky Lifestyle Behaviors among Gastric Cancer Survivors Compared with Matched Non-cancer Controls: Results from Baseline Result of Community Based Cohort Study
Minkyung Kim, Kui Son Choi, Mina Suh, Jae Kwan Jun, Kumban Walter Chuck, Boyoung Park
Cancer Res Treat. 2018;50(3):738-747.   Published online July 24, 2017
DOI: https://doi.org/10.4143/crt.2017.129
AbstractAbstract PDFPubReaderePub
Purpose
This study investigated the prevalence of smoking, drinking, and physical inactivity and the associated factors of these behaviors in gastric cancer survivors.
Materials and Methods
The baseline data from the nationwide cohort study was used. Four hundred thirty-seven gastric cancer survivors who survived ≥ 2 years from diagnosis and reported completion of treatment were matched with 4,370 controls according to age, sex, education, and household income.
Results
The prevalence rates of current smoking and drinking among gastric cancer survivors were 8.7% and 38.3%, which were significantly lower than those among matched controls (p ≤ 0.001), but the prevalence rates of physical inactivity were not significantly different (55.8% vs. 59.9%, p=0.248). In gastric cancer survivors, ≥ 5 years since cancer diagnosis and current drinking contributed to more current smoking; otherwise, age increment and femalewere associatedwith lower current smoking. Thosewith household income ≥ $2,000 and current smokers were more likely to drink and female showed less drinking. Female, currently employed state, and self-rated health status were associated with more physical inactivity.
Conclusion
Although gastric cancer survivors showed better health behaviors than controls, suggesting that the diagnosis of cancer may motivate individuals towards healthy behaviors, their current prevalence rates of smoking and drinking were still high, and more than 50% of them were physically inactive. Tailored interventions to improve their health behaviors considering associated factors for the gastric cancer survivors are necessary.

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    Shan Liu, Jia Liu, Jun He
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    Sunghye Choo, Sanghee Kim, Yong Chan Lee, Eunsung Kim
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Stages of Adoption for Fecal Occult Blood Test and Colonoscopy Tests for Colorectal Cancer Screening in Korea
Nhung Cam Bui, Ha Na Cho, Yoon Young Lee, Mina Suh, Boyoung Park, Jae Kwan Jun, Yeol Kim, Kui Son Choi
Cancer Res Treat. 2018;50(2):416-427.   Published online May 10, 2017
DOI: https://doi.org/10.4143/crt.2017.075
AbstractAbstract PDFPubReaderePub
Purpose
While colorectal cancer (CRC) is common in Asian countries, screening for CRC is not. Moreover, CRC screening behaviors in Asian populations remain largely unknown. The present study aimed to investigate the stages of adopting CRC screening in Korea according to screening modality.
Materials and Methods
Data were obtained from the 2014 Korean National Cancer Screening Survey, a cross-sectional survey that utilized nationally representative random sampling to investigate cancer screening rates. A total of 2,066 participants aged 50-74 years were included in this study. Chi-square test and multinomial logistic regressionwere applied to determine stages of adoption for fecal occult blood test (FOBT) and colonoscopy and factors associated with each stage.
Results
Of 1,593 participants included in an analysis of stage of adoption for FOBT, 36% were in action/maintenance stages, while 18%, 40%, and 6% were in precontemplation, contemplation, and relapse/relapse risk stages, respectively. Of 1,371 subjects included in an analysis of stage of adoption for colonoscopy, 48% were in action/maintenance stages, with 21% in precontemplation, 21% in contemplation, and 11% in relapse/relapse risk stages. Multinomial logistic regression highlighted sex, household income, place of residency, family history of cancer, having private cancer insurance, smoking status, alcohol use, and regular exercise as being associated with stages of adoption for FOBT and colonoscopy.
Conclusion
This study outlines the distributions of stages of adoption for CRC screening by screening modality. Interventions to improve screening rates should be tailored to individuals in particular stages of adoption for CRC screening by modality.

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  • Bir İlçede Aile Sağlığı Merkezine Başvuran 30-70 Yaş Kadın ve 50-70 Yaş Erkeklerin Kanser Taramalarına Yönelik Bilgi, Tutum ve Davranışları
    Duygu Onbaşı, Şahadet Kurnaz, Burak Aykın, Gülçin Yapıcı
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  • 181 Download
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Risk and Characteristics of Postcolonoscopy Interval Colorectal Cancer after a Positive Fecal Test: A Nationwide Population-Based Study in Korea
Chang Kyun Lee, Kui Son Choi, Chang Soo Eun, Dong-Il Park, Dong Soo Han, Minjoo Yoon, Mina Suh, Jae Kwan Jun
Cancer Res Treat. 2018;50(1):50-59.   Published online February 24, 2017
DOI: https://doi.org/10.4143/crt.2017.027
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Fecal tests remain a mainstay of population-based colorectal cancer (CRC) screening programs worldwide. However, data on interval CRC (iCRC) arising after follow-up colonoscopy of a positive fecal test are scarce. We conducted a nationwide population-based study to reveal the risk and characteristics of iCRC in this setting.
Materials and Methods
We searched the National Cancer Screening Program for CRC database in Korea (2005-2010). Incidence of iCRC within the program was estimated, then Cox proportional-hazards regression analysis was performed to determine the independent predictors of iCRC. The clinical characteristics of iCRC were compared with screen-detected CRC (sCRC).
Results
We identified 280 iCRC among 150,660 negative colonoscopies as a follow-up exam to a positive fecal immunochemical test (FIT), and 2,427 sCRC. The overall incidence of iCRC was 0.49/1,000 person-years (95% confidence interval [CI], 0.48 to 0.51). iCRC was more likely to occur in men (adjusted hazard ratio [aHR], 1.79; 95% CI, 1.39 to 2.30) and elderly patients (aHR, 1.77; 95% CI, 1.38 to 2.28 in 65-74 years; aHR, 3.13, 95% CI, 2.13-4.60 in ≥ 75 years). The National Quality Improvement Program for colonoscopy reduced a short-term risk of iCRC (aHR, 0.48; 95% CI, 0.27 to 0.87). Compared with sCRC, iCRC was more likely to occur in the proximal colon, be diagnosed at the localized stage, and have a lower CRC mortality (32.7 vs. 17.4%, 56.8 vs. 34.1%, 12.5 vs. 17.7%, respectively; all p < 0.05).
Conclusion
In a population-based CRC screening program with FIT, the burden of iCRC after follow-up colonoscopy was substantial. Men and elderly patients possess a significantly higher risk of iCRC.

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Trends in Participation Rates for the National Cancer Screening Program in Korea, 2002-2012
Mina Suh, Seolhee Song, Ha Na Cho, Boyoung Park, Jae Kwan Jun, Eunji Choi, Yeol Kim, Kui Son Choi
Cancer Res Treat. 2017;49(3):798-806.   Published online November 11, 2016
DOI: https://doi.org/10.4143/crt.2016.186
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The National Cancer Screening Program (NCSP) in Korea supports cancer screening for stomach, liver, colorectal, breast, and cervical cancer. This study was conducted to assess trends in participation rates among Korean men and women invited to undergo screening via the NCSP as part of an effort to guide future implementation of the program in Korea.
Materials and Methods
Data from the NCSP for 2002 to 2012 were used to calculate annual participation rates with 95% confidence intervals (CI) by sex, insurance status, and age group for stomach, liver, colorectal, breast, and cervical cancer screening.
Results
In 2012, participation rates for stomach, liver, colorectal, breast, and cervical cancer screening were 47.3%, 25.0%, 39.5%, 51.9%, and 40.9%, respectively. The participation rates increased annually by 4.3% (95% CI, 4.0 to 4.6) for stomach cancer, 3.3% (95% CI, 2.5 to 4.1) for liver cancer, 4.1% (95% CI, 3.2 to 5.0) for colorectal cancer, 4.6% (95% CI, 4.1 to 5.0) for breast cancer, and 0.9% (95% CI, –0.7 to 2.5) for cervical cancer from 2002 to 2012.
Conclusion
Participant rates for the NCSP for the five above-mentioned cancers increased annually from 2002 to 2012.

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    Tran Thi Xuan Mai, Yoon Young Lee, Mina Suh, Eunji Choi, Eun Young Lee, Moran Ki, Hyunsoon Cho, Boyoung Park, Jae Kwan Jun, Yeol Kim, Jin-Kyoung Oh, Kui Son Choi
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Responses to Overdiagnosis in Thyroid Cancer Screening among Korean Women
Sangeun Lee, Yoon Young Lee, Hyo Joong Yoon, Eunji Choi, Mina Suh, Boyoung Park, Jae Kwan Jun, Yeol Kim, Kui Son Choi
Cancer Res Treat. 2016;48(3):883-891.   Published online December 28, 2015
DOI: https://doi.org/10.4143/crt.2015.218
AbstractAbstract PDFPubReaderePub
Purpose
Communicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon.
Materials and Methods
Data were acquired from subjects included in the 2013 Korean National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey. Of the 4,100 respondents in the 2013 KNCSS, women were randomly subsampled and an additional face-to-face interview was conducted. Finally, a total of 586 female subjects were included in this study. Intention to undergo thyroid cancer screening was assessed before and after receiving information on overdiagnosis.
Results
Prior awareness of overdiagnosis in thyroid cancer screening was 27.8%. The majority of subjects intended to undergo thyroid cancer screening before and after receiving information on overdiagnosis (87% and 74%, respectively). Only a small number of subjects changed their intention to undergo thyroid cancer screening from positive to negative after receiving information on overdiagnosis. Women of higher education level and Medical Aid Program recipients reported being significantly more likely to change their intention to undergo thyroid cancer screening afterreceiving information on overdiagnosis,whilewomen with stronger beliefs on the efficacy of cancer screening were less likely to change their intention.
Conclusion
Women in Korea appeared to be less concerned about overdiagnosis when deciding whether or not to undergo thyroid cancer screening.

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Relationship between Salt Preference and Gastric Cancer Screening: An Analysis of a Nationwide Survey in Korea
Ji-Yeon Shin, Jeongseon Kim, Kui Son Choi, Mina Suh, Boyoung Park, Jae Kwan Jun
Cancer Res Treat. 2016;48(3):1037-1044.   Published online December 11, 2015
DOI: https://doi.org/10.4143/crt.2015.333
AbstractAbstract PDFPubReaderePub
Purpose
Epidemiological studies have demonstrated an association between excessive salt intake and gastric cancer risk, and this potential risk increases the need for adequate gastric cancer screening in individuals with high salt intake. However, the association between salt intake and gastric cancer screening in the general population has rarely been investigated. We explored the association between salt preference and participation in gastric cancer screening among a nationally representative Korean population.
Materials and Methods
The study population was derived from the Korean National Cancer Screening Survey (KNCSS) 2006-2007, an annual nationwide interview survey investigating cancer screening rates. Of 4,055 individuals who participated in the KNCSS 2006-2007, 3,336 individuals aged over 40 years were included in our analysis. The odds ratio (OR) and 95% confidence interval (CI) were estimated using polytomous logistic regression.
Results
Individuals with higher salt preference were less likely to participate in regular gastric cancer screening. After adjusting for age, sex, monthly household income, education, family history of cancer, and self-rated health status, ORs for undergoing regular gastric cancer screening were 1.00, 0.82 (95% CI, 0.61 to 1.12), 0.74 (95% CI, 0.54 to 1.00), 0.77 (95% CI, 0.56 to 1.05), and 0.38 (95% CI, 0.16 to 0.92) according to the level of salt preference (p for trend=0.048).
Conclusion
Individuals with higher salt preference showed suboptimal gastric cancer screening adherence compared to those with a lower salt preference. These findings highlight the need for better delivery of educational messages to change risk perceptions regarding gastric cancer screening practice.

Citations

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Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004-2013
Mina Suh, Kui Son Choi, Boyoung Park, Yoon Young Lee, Jae Kwan Jun, Duk-Hyoung Lee, Yeol Kim
Cancer Res Treat. 2016;48(1):1-10.   Published online April 15, 2015
DOI: https://doi.org/10.4143/crt.2014.204
AbstractAbstract PDFPubReaderePub
Purpose
The Korean National Cancer Screening Survey (KNCSS), a nationwide cross-sectional survey, has been conducted annually since 2004. The current study was conducted to report on the trends in screening rates among Korean men and women, and to evaluate policies regarding cancer screening programs implemented to reduce the burden of cancer.
Materials and Methods
The current study used KNCSS data. The eligible study population included men aged 40-74 years and women aged 30-74 years with no cancer history. The lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated for five major cancers (i.e., stomach, liver, colorectal, breast, and cervix uteri).
Results
The screening rates with recommendation increased by 4.2% (95% confidence interval [CI], 3.7% to 4.8%) annually for stomach cancer, 1.2% (95% CI, 0.1% to 2.4%) for liver cancer, 3.0% (95% CI, 1.8% to 4.1%) for colorectal cancer, 3.7% (95% CI, 2.7% to 4.8%) for breast cancer, and 1.3% (95% CI, 0.8% to 1.8%) for cervical cancer. In 2013, the screening rates with recommendation for stomach, liver, colorectal, breast, and cervical cancers were 73.6%, 33.6%, 55.6%, 59.7%, and 67.0%, respectively.
Conclusion
Both the lifetime screening rates and screening rates with recommendation for the five above-mentioned cancers increased annually from 2004 to 2013.

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Cost-Effectiveness of Liver Cancer Screening in Adults at High Risk for Liver Cancer in the Republic of Korea
Young Hwa Lee, Kui Son Choi, Jae Kwan Jun, Mina Suh, Hoo-Yeon Lee, Youn Nam Kim, Chung Mo Nam, Eun-Cheol Park, Woo-Hyun Cho
Cancer Res Treat. 2014;46(3):223-233.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.223
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, forliver cancer screening in the high-risk population of Korea. Materials and Methods A stochastic modelwas used to simulate the cost-effectiveness ofliver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and costwas based on the direct cost ofthe screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio. Results Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years. Conclusion In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as qualityadjusted life-years or disability-adjusted life-years.

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    Thi Phuong Thao Tran, Minji Han, Ngoc Minh Luu, Jin‐Kyoung Oh
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Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey, 2004-2012
Mina Suh, Kui Son Choi, Yoon Young Lee, Jae Kwan Jun
Cancer Res Treat. 2013;45(2):86-94.   Published online June 30, 2013
DOI: https://doi.org/10.4143/crt.2013.45.2.86
AbstractAbstract PDFPubReaderePub
PURPOSE
The Korean National Cancer Screening Survey (KNCSS), a nationwide, annual cross-sectional survey, has been conducted since 2004. The current study was conducted in order to report on trends in cancer screening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri).
MATERIALS AND METHODS
KNCSS data were collected between 2004 and 2012. The eligible study population included cancer-free men who were 40 years of age and older and women who were 30 years of age and older. The lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated.
RESULTS
Lifetime screening rates and screening rates with recommendation for the five types of cancer rose steadily until 2010, showed a slight drop or were stable in 2011, and increased again in 2012. On average, screening rates with recommendation have shown annual increases of 4.3% (95% confidence interval [CI], 3.6 to 5.0%) for stomach cancer, 0.8% (95% CI, -0.5 to 2.1%) for liver cancer, 2.4% (95% CI, 1.3 to 3.5%) for colorectal cancer, 4.5% (95% CI, 3.9 to 5.1%) for breast cancer, and 1.3% (95% CI, 0.6 to 2.0%) for cervical cancer. Disparities in age groups and household incomes have been decreasing since 2004.
CONCLUSION
Cancer screening rates in Korea showed a significant increase from 2004 to 2012, and screening rates for gastric and breast cancer are now approaching 70%. The 10-Year Plan for Cancer Control target for screening rates was met or nearly met for all cancer types examined, with the exception of liver and colorectal cancer.

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Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2011
Boyoung Park, Kui Son Choi, Yoon Young Lee, Jae Kwan Jun, Hong Gwan Seo
Cancer Res Treat. 2012;44(2):113-120.   Published online June 30, 2012
DOI: https://doi.org/10.4143/crt.2012.44.2.113
AbstractAbstract PDFPubReaderePub
PURPOSE
The Korean National Cancer Screening Survey (KNCSS) is a nationwide survey conducted annually, since 2004. This study was conducted in order to report on trends in rates of cancer screening for five major cancers-stomach, liver, colorectal, breast, and cervix uteri in Korea.
MATERIALS AND METHODS
Data collected by the KNCSS between 2004 and 2011 were used in this study. The eligible study population included cancer-free men who were 40 years old and over, and women who were 30 years old and over. Lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated.
RESULTS
Both lifetime screening rates and screening rates with recommendation have increased since 2004. On average, screening rates with recommendation have shown an annual increase of 4.2% (95% CI, 3.3 to 5.2%) for stomach cancer, 1.1% (95% CI, -0.5 to 2.7%) for liver cancer, 2.2% (95% CI, 0.8 to 3.6%) for colorectal cancer, 4.0% (95% CI, 3.0 to 4.9%) for breast cancer, and 0.2% (95% CI, -0.9 to 1.3%) for cervical cancer. Increases in rates of cancer screening, with the exception of liver and cervical cancers, were significant, and screening rates for stomach and breast cancer in particular showed a marked increase.
CONCLUSION
Cancer screening rates among Koreans showed a consistent increase from 2004 to 2011 and rates of screening for gastric, breast, and cervical cancer are approaching 70%.

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Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2010
Eun-Ha Lee, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Eun-Cheol Park, Jin Soo Lee
Cancer Res Treat. 2011;43(3):141-147.   Published online September 30, 2011
DOI: https://doi.org/10.4143/crt.2011.43.3.141
AbstractAbstract PDFPubReaderePub
PURPOSE
The Korean National Cancer Screening Survey (KNCSS) is a continuous nationwide survey implemented by the National Cancer Center in Korea since 2004. The purpose of the present study was to report trends in cancer screening rates for the five major cancers (stomach, liver, colorectal, breast, and cervix uteri) in Korean men and women.
MATERIALS AND METHODS
The study used KNCSS data collected between 2004 and 2010. The survey was conducted on Korean men aged 40-74 years and Korean women aged 30-74 years with no history of cancer diagnosis. The annual percentage change and corresponding 95% confidence intervals were used to examine changes in annual screening rates.
RESULTS
Screening rates with recommendation increased by 4.4% annually for stomach cancer, 1.5% for liver cancer, 2.8% per year for colorectal cancer, 4.5% for breast cancer, and 1.2% for cervix uteri cancer. The increasing trend in cancer screening rates, with the exception of liver cancer, was significant.
CONCLUSION
Cancer screening rates have increased consistently from 2004 to 2010 among Korean men and women. Stomach and breast cancer screening rates in particular have increased markedly.

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Gastric Cancer Screening in Korea: Report on the National Cancer Screening Program in 2008
Kyung Sook Lee, Dong Kwan Oh, Mi Ah Han, Hoo-Yeon Lee, Jae Kwan Jun, Kui Son Choi, Eun-Cheol Park
Cancer Res Treat. 2011;43(2):83-88.   Published online June 30, 2011
DOI: https://doi.org/10.4143/crt.2011.43.2.83
AbstractAbstract PDFPubReaderePub
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.

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