Cancer Research and Treatment

Special Article

Korean Practical Guidelines for Geriatric Assessment and Management of Older Adults with Cancer: A Korean Cancer Association Guideline for Geriatric Oncology: Minsu Kang, Jeonghyun Kang, Changhoon Song, Heung-Kwon Oh, Hong Chung, Ilhak Lee, Jae Hung Jung, Jae Hyun Jeon, Eunjin Jeong, Jeong Rim Koh, Jung Hye Kwon, Jung-Yeon Choi, Kidong Kim, Kwangmin Kim, Kyung Hyun Moon, Minkyu Jung, Se Jin Hong, Su-Jin Koh, Sukki Cho, Suzy Kim, Yun-Gyoo Lee, Miyoung Choi, Dong Ah Park, Mi Ah Han, In Gyu Hwang, Jin Won Kim, Jee Hyun Kim; Received November 22, 2025 Accepted February 14, 2026 Published online February 19, 2026; DOI: https://doi.org/10.4143/crt.2025.1283 [Accepted]

Abstract PDF: The Korean Cancer Association’s clinical practice guidelines for geriatric oncology provide an evidence-based, multidisciplinary framework to optimize cancer care for the growing population of older adults. Geriatric Assessment (GA) identifies multidimensional vulnerabilities often missed by standard performance measures, providing critical information to guide individualized treatment planning. This guideline recommends using validated geriatric screening tools, life expectancy prediction models, and toxicity risk calculators to support risk stratification and decision-making. By integrating GA-based multidisciplinary interventions and shared decision-making into clinical practice, clinicians can avoid both overtreatment and undertreatment, reduce treatment-related toxicity, and potentially enhance quality of life. Although the certainty of evidence for most recommendations ranged from very low to low, the panel reached a consensus to provide conditional recommendations. This decision reflects the judgment that the clinical benefits—specifically in reducing treatment-related toxicity and identifying vulnerabilities—outweigh the limitations of current evidence, addressing the urgent need for standardized geriatric care in Korea. Ultimately, these guidelines aim to support individualized, patient-centered care and serve as a practical foundation for clinical and educational applications within the Korean healthcare system.

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Original Articles

General

Presentation of Benefits and Harms in Cancer Screening Guidelines for Koreans: A Systematic Review: Mi Ah Han, Hunju Lee, Kwangmin Kim, Seong Jung Kim, Eu Chang Hwang, Jae Hung Jung; Cancer Res Treat. 2025;57(4):923-931. Published online March 27, 2025; DOI: https://doi.org/10.4143/crt.2024.1151

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study systematically reviewed cancer screening guidelines for the Korean population to evaluate the benefits and harms of the recommended cancer screening practices.
Materials and Methods
We searched international electronic databases from inception to July 2023. Two reviewers independently conducted reference screening and data extraction. Data were extracted based on recommendations from each guideline and presentation of benefits and harms. General characteristics of the cancer screening guidelines, including cancer type, recommended screening methods, certainty of evidence, were collected. Moreover, we obtained key information on the benefits and harms of screening interventions, including the quantification of their relative and absolute effects.
Results
Fifteen recommendations were identified for the use of interventions for the early detection of stomach, liver, colorectal, breast, cervical, and lung cancers in nine guidelines published between 2011 and 2015. Seven guidelines collected evidence through de novo systematic reviews. Eight guidelines presented the certainty of evidence and strength of recommendations. Benefits are presented as relative risks, and harms are presented as absolute risks. Six recommendations presented the absolute effects of both benefits and harms (comparable); eight presented them unevenly, including quantifying benefits relatively but presenting harms as absolute measures (asymmetric); and one presented neither benefits nor harms (incomplete).
Conclusion
More than half of guidelines fail to present the benefits and harms of screening in a balanced manner. To enable users and beneficiaries make informed decisions based on evidence, the benefits and harms supporting recommendations should be given in a transparent and balanced manner.

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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

Abstract PDF PubReader ePub

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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Trends of Mammography Use in a National Breast Cancer Screening Program, 2004-2008: Sun Mi Lim, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Eun-Cheol Park, Yeonju Kim, Mi Ah Han, Dong Kwan Oh, Jung Im Shim; Cancer Res Treat. 2010;42(4):199-202. Published online December 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.4.199

Abstract PDF PubReader ePub

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.

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Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008: Jung Im Shim, Yeonju Kim, Mi Ah Han, Hoo-Yeon Lee, Kui Sun Choi, Jae Kwan Jun, Eun-Cheol Park; Cancer Res Treat. 2010;42(4):191-198. Published online December 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.4.191

Abstract PDF PubReader ePub

Purpose

This study aims to investigate the current situation of national colorectal cancer screening by analyzing participation rates, positive rates of screening methods and screening rate of secondary screening tests in colorectal screening of the national cancer screening program in 2008.

Materials and Methods

With database about target population and screened individuals of the national cancer screening program, the results of target population and participants of colorectal cancer screening in 2008 were analyzed. Among adults aged over 50 years of medical aid and beneficiaries of national health insurance paying lower 50% premiums in the total subscribers, 4,640,365 were target population of colorectal cancer screening and the data of 984,915 undergoing fecal occult blood test (FOBT) as a primary screening were analyzed.

Results

The colorectal cancer screening rate was 21.2% and the rates of national health insurance subscribers, females and the elderly aged 60-64 years were higher than those of others. The recipients with a positive result in FOBT recorded approximately 7.5%. Medical aid beneficiaries (7.9%), males (8.8%) and seniors aged over 75 years (9.1%) showed higher positive rates than the average one. Out of the FOBT positive recipients, 43.0% took a secondary screening and the rate undergoing colonoscopy (31.4%) was higher than that of doing double-contrast barium enema test (11.6%).

Conclusion

Colorectal cancer screening rate of medical aid beneficiaries and people paying lower 50% premiums among national health insurance subscribers, was different according to demographic characters (gender, age and types of health insurance). This finding meant that screening for the vulnerable needed to be encouraged by considering socio-demographic characters. Additionally, more efforts were necessary to increase the secondary screening rate of people with a positive result in primary one.

Citations

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