Cancer Research and Treatment

Original Articles

Novel Breast Cancer Risk Assessment Tools for Pre- and Post-Menopausal Asian Women: Development and Validation in a Nationwide Mammographic Screening Cohort: Wonyoung Jung, Yong-Moon Mark Park, Sang Hyun Park, Kyungdo Han, Junhee Park, Yohwan Yeo, Jung Kwon Lee, Dale P. Sandler, Dong Wook Shin; Received September 4, 2024 Accepted January 30, 2025 Published online January 31, 2025; DOI: https://doi.org/10.4143/crt.2024.861 [Accepted]

Abstract PDF: Purpose
Widely used breast cancer risk-prediction tools are based on data from Western countries, but risk factors may differ for Asian women. Hence, we aimed to develop a risk assessment tool for breast cancer in Asian women using a nationwide, population-based mammographic screening cohort.
Materials and Methods
Women aged ≥40 years who underwent breast cancer screening and general health examination in 2009 were included. Age, body mass index (BMI), breast density, lifestyle and reproductive factors, and comorbidities were used to develop 5-year breast cancer risk-prediction models for premenopausal (n=771,856) and postmenopausal (n=1,108,047) women at baseline. The best-fit risk prediction model was constructed using backward stepwise selection in a Cox proportional hazards model and was transformed into a risk score nomogram. The performance was assessed by discrimination and calibration.
Results
In premenopausal women, high BMI, low parity, short breastfeeding period, early age at menarche, high breast density, a history of benign breast masses, and family history of breast cancer contributed to the risk prediction of breast cancer. In postmenopausal women, age, diabetes mellitus, dyslipidemia, late-onset menopause, and hormone replacement therapy use were additional risk predictors of breast cancer. Our risk-prediction model showed a concordant statistic of 0.58 (0.57–0.59) for premenopausal women and 0.64 (0.63–0.65) for postmenopausal women. The calibration plot demonstrated good correlations for both models.
Conclusion
Our breast cancer risk-prediction model demonstrated performance comparable to that of Western countries, especially among postmenopausal women. This provides a foundation for implementing risk-based screening recommendations in Asian women.

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Weight Change after Cancer Diagnosis and Risk of Diabetes Mellitus: A Population-Based Nationwide Study: Hye Yeon Koo, Kyungdo Han, Mi Hee Cho, Wonyoung Jung, Jinhyung Jung, In Young Cho, Dong Wook Shin; Received June 25, 2024 Accepted August 28, 2024 Published online August 29, 2024; DOI: https://doi.org/10.4143/crt.2024.586 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub

Purpose
Cancer survivors are at increased risk of diabetes mellitus (DM). Additionally, the prevalence of obesity, which is also a risk factor for DM, is increasing in cancer survivors. We investigated the associations between weight change after cancer diagnosis and DM risk.
Materials and Methods
This retrospective cohort study used data from the Korean National Health Insurance Service. Participants who were newly diagnosed with cancer from 2010 to 2016 and received national health screening before and after diagnosis were included and followed until 2019. Weight change status after cancer diagnosis was categorized into four groups: sustained normal weight, obese to normal weight, normal weight to obese, or sustained obese. Cox proportional hazard analyses were performed to examine associations between weight change and DM.
Results
The study population comprised 264,250 cancer survivors. DM risk was highest in sustained obese (adjusted hazard ratios [aHR], 2.17; 95% confidence interval [CI], 2.08 to 2.26), followed by normal weight to obese (aHR, 1.66; 95% CI, 1.54 to 1.79), obese to normal weight (aHR, 1.29; 95% CI, 1.21 to 1.39), and then sustained normal weight group (reference). In subgroup analyses according to cancer type, most cancers showed the highest risks in sustained obese group.
Conclusion
Obesity at any time point was related to increased DM risk, presenting the highest risk in cancer survivors with sustained obesity. Survivors who changed from obese to normal weight had lower risk than survivors with sustained obesity. Survivors who changed from normal weight to obese showed increased risk compared to those who sustained normal weight. Our finding supports the significance of weight management among cancer survivors.

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Effects of smoking behavior change on diabetes incidence after cancer development: A nationwide cohort study
MI Hee Cho, Jinhyung Jung, Hye Yeon Koo, Wonyoung Jung, Kyungdo Han, In Young Cho, Dong Wook Shin
Diabetes & Metabolism.2025; 51(1): 101604. CrossRef

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Lung and Thoracic cancer

Psychometric Validation of the Korean Version of the Cancer Survivors’ Unmet Needs (CaSUN) Scale among Korean Non–Small Cell Lung Cancer Survivors: Danbee Kang, Genehee Lee, Sooyeon Kim, Heesu Nam, Sunga Kong, Sungkeun Shim, Jae Kyung Lee, Wonyoung Jung, Sumin Shin, Hong Kwan Kim, Jae Ill Zo, Young Mog Shim, Dong Wook Shin, Juhee Cho; Cancer Res Treat. 2023;55(1):61-72. Published online February 23, 2022; DOI: https://doi.org/10.4143/crt.2021.1583

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Purpose
The purpose of the study was to validate the Korean version of Cancer Survivors’ Unmet Needs (CaSUN) scale among non–small cell lung cancer survivors.
Materials and Methods
Participants were recruited from outpatient clinics at the Samsung Medical Center in Seoul, South Korea, from January to October 2020. Participants completed a survey questionnaire that included the CaSUN. Exploratory and confirmatory factor analysis and Pearson’s correlations were used to evaluate the reliability and validity of the Korean version of the CaSUN (CaSUN-K). We also tested known-group validity using an independent t test or ANOVA.
Results
In total, 949 provided informed consent and all of which completed the questionnaire. Among the 949 patients, 529 (55.7%) were male; the mean age and median time since the end of active treatment (standard deviation) was 63.4±8.8 years and the median was 18 months. Although the factor loadings were different from those for the original scale, the Cronbach’s alpha coefficients of the six domains in the CaSUN-K ranged from 0.68 to 0.95, indicating satisfactory internal consistency. In the CFA, the goodness-of-fit indices for the CaSUN-K were high. Moderate correlations demonstrated the convergent validity of CaSUN-K with the relevant questionnaire. More than 60% of the participants reported information-related unmet needs, and the CaSUN-K discriminated between the needs reported by the different subgroups that we analyzed.
Conclusion
The CaSUN-K is a reliable and valid measure for assessing the unmet needs in a cancer population, thus this tool help population to receive timely, targeted, and relevant care.

Citations

Citations to this article as recorded by

Unmet needs among long-term breast cancer survivors
Rina A. Yarosh, Hazel B. Nichols, Rachel Hirschey, Erin E. Kent, Deborah K. Mayer, Melissa A. Troester, Eboneé N. Butler
Cancer Causes & Control.2025;[Epub] CrossRef
Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial
Wonyoung Jung, Alice Ahn, Genehee Lee, Sunga Kong, Danbee Kang, Dongok Lee, Tae Eun Kim, Young Mog Shim, Hong Kwan Kim, Jongho Cho, Juhee Cho, Dong Wook Shin
JMIR Research Protocols.2024; 13: e54707. CrossRef
Validity and Reliability of a Simplified Chinese Version of Cancer Survivors' Unmet Needs Scale (CaSUN)
Xiaojingyuan Xu, Xiaoyun Liang, Shiquan Yin
Psycho-Oncology.2024;[Epub] CrossRef
Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea
Junhee Park, Wonyoung Jung, Genehee Lee, Danbee Kang, Young Mog Shim, Hong Kwan Kim, Ansuk Jeong, Juhee Cho, Dong Wook Shin
Healthcare.2023; 11(14): 2012. CrossRef
Kanserden Kurtulanların Karşılanmayan İhtiyaçları Ölçeğinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması
Gülyeter Erdoğan Yüce, Gamze Muz, Ayser Döner
Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi.2023; 10(3): 264. CrossRef
Psychometric properties of the Slovenian version of the Cancer Survivors’ Unmet Needs (CaSUN-SL) measure in post-treatment cancer survivors
Špela Miroševič, Polona Selič-Zupančič, Judith Prins, Vesna Homar, Zalika Klemenc-Ketiš
BMC Psychology.2022;[Epub] CrossRef

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