Cancer Research and Treatment

Special Article

Utilization, Reimbursement, and Barriers to Accessing Sequencing Tests for Cancer Care in the Asia-Pacific Region: KSMO Initiatives to Address Cancer Care Inequity: Omali Pitiyarachchi, Aaron C. Tan, Tawasapon Thambamroong, Rogelio Velasco Jr, Yuji Uehara, Daphne Lee, Hsiang-Fong Kao, Vivek Agarwala, Yueh Ni Lim, Dimas Priantono, Ardhi Rahman Ahani, Kyaw Zin Win, Young Saing Kim, Changhoon Yoo; Received August 20, 2025 Accepted December 18, 2025 Published online December 19, 2025; DOI: https://doi.org/10.4143/crt.2025.896 [Accepted]

Abstract PDF: Purpose
The Asia Pacific region is marked by healthcare diversity and economic disparity.
Materials and Methods
To understand the utilization and reimbursement practices of next-generation sequencing (NGS) and other sequencing methods relevant to oncology clinical practice in the region, a semi-structured survey was undertaken of respondents from 11 countries represented by the Korean Society of Medical Oncology (KSMO) 2024 Young Oncologist Forum alumni.
Results
While 79% of respondents reported access to NGS at their institution, full government reimbursement was uncommon and varied by test type and clinical setting. Japan and South Korea offered the most comprehensive public coverage, including for circulating tumor deoxyribonucleic acid (ctDNA)-based liquid biopsy. Lower- and upper-middle-income countries, such as the Philippines, Indonesia, and India, reported no government reimbursement, thus relying on user-pay methods or private insurance payments. One marked barrier to NGS reimbursement was the prohibitive cost of tests (100%), followed by a limited budget to fund testing (79%), and then by policy or regulatory restrictions (50%). On a similar note, insurance coverage (93%) and patient income (86%) were key concerns regarding access and equity to tests. Test reimbursement (or lack thereof) and cost were cited almost universally as the most elevated concerns by the respondents.
Conclusion
The findings demonstrated a wide disparity in access, funding and reimbursement of sequencing tests across the region. Addressing cost, improving reimbursement mechanisms, and building infrastructure capacity will be critical for the equitable integration of NGS into routine cancer care in the Asia-Pacific.

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Original Article

General

Functional Impairments in the Mental Health, Depression and Anxiety Related to the Viral Epidemic, and Disruption in Healthcare Service Utilization among Cancer Patients in the COVID-19 Pandemic Era: Kyumin Kim, Harin Kim, Joohee Lee, Inn-Kyu Cho, Myung Hee Ahn, Ki Young Son, Jeong Eun Kim, Hee Jeong Kim, Sang Min Yoon, So Hee Kim, Moon Jung Kwon, Hwa Jung Kim, Su-Jin Koh, Seyoung Seo, Seockhoon Chung; Cancer Res Treat. 2022;54(3):671-679. Published online September 17, 2021; DOI: https://doi.org/10.4143/crt.2021.585

Abstract PDF PubReader ePub

Purpose
Literature is scarce regarding cancer care utilization during the massive outbreak of coronavirus disease 2019 (COVID-19) in the Republic of Korea. We investigated functional impairments in mental health and their relationships with depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization among cancer patients in the COVID-19 pandemic era.
Materials and Methods
We used an online survey with questions related to the disturbances faced by patients with cancer in utilizing healthcare services in the pandemic era. Current mental health status was assessed using the Work and Social Adjustment Scale (WSAS), Stress and Anxiety to Viral Epidemics-6 (SAVE-6) scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Brief Resilience Scale (BRS), Cancer-Related Dysfunctional Beliefs about Sleep Scale (C-DBS), and Fear of COVID-19 over Cancer (FCC).
Results
Among the 221 responders, 95 (43.0%) reported disruptions in healthcare service utilization during the COVID-19 pandemic. Logistic regression analysis revealed that functional impairment in the mental health of these patients was expected due to disruptions in healthcare service utilization, high levels of depression, anxiety regarding the viral epidemic, fear of COVID over cancer, and low resilience. Mediation analysis showed that patient resilience and cancer-related dysfunctional beliefs about sleep partially mediated the effects of viral anxiety on functional impairment.
Conclusion
In this pandemic era, patients with cancer experience depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization, which may influence their functional impairments in mental health.

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Special Article

Guidelines for Cancer Care during the COVID-19 Pandemic in South Korea: Jii Bum Lee, Minkyu Jung, June Hyuk Kim, Bo Hyun Kim, Yeol Kim, Young Seok Kim, Byung Chang Kim, Jin Kim, Sung Ho Moon, Keon-Uk Park, Meerim Park, Hyeon Jin Park, Sung Hoon Sim, Hong Man Yoon, Soo Jung Lee, Eunyoung Lee, June Young Chun, Youn Kyung Chung, So-Youn Jung, Jinsoo Chung, Eun Sook Lee, Hyun Cheol Chung, Tak Yun, Sun Young Rha; Cancer Res Treat. 2021;53(2):323-329. Published online March 15, 2021; DOI: https://doi.org/10.4143/crt.2020.1256

Abstract PDF PubReader ePub

At the end of 2019, the cause of pneumonia outbreaks in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In February 2020, the World Health Organization named the disease cause by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). In response to the pandemic, the Korean Cancer Association formed the COVID-19 task force to develop practice guidelines. This special article introduces the clinical practice guidelines for cancer patients which will help oncologists best manage cancer patients during the COVID-19 pandemic.

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Original Article

What We Talk about When We Talk about Caregiving: The Distribution of Roles in Cancer Patient Caregiving in a Family-Oriented Culture: Ansuk Jeong, Dongwook Shin, Jong Hyock Park, Keeho Park; Cancer Res Treat. 2019;51(1):141-149. Published online March 21, 2018; DOI: https://doi.org/10.4143/crt.2017.557

Abstract PDF Supplementary Material PubReader ePub

Purpose
When it comes to cancer care, the psychological well-being of family caregivers has gotten its deserved attention. However, the specific roles that the family caregivers take have not been examined as much. The current study aimed to investigate the distribution of family caregivers’ roles, particularly in a family-oriented culture, Korea.
Materials and Methods
A sample of 439 participants was recruited from 11 national and regional cancer centers in Korea. The participants who were 60 years old or above went through treatments for their gastric, colorectal, or lung cancer. The individual survey included questions regarding the family type, living arrangement, and the sources of support when it comes to their physical, emotional, financial, and decision-making needs.
Results
The responses from the participants showed that cancer caregiving is shared by multiple family caregivers; the major source of support for elderly cancer patients on diverse domains was their spouse; patients’ reliance on their daughter(s) increased for emotional support; and patients’ reliance on their son(s) stood out for financial support and decision-making support. Also, the older the patients were, the heavier their reliance was on the adult children, including sons, daughters, and daughters-in-law.
Conclusion
Future support programs for elderly cancer patients are suggested to involve multiple family caregivers to encourage effective and efficient intervention. Also, the limitations of the current study and the suggestions for future research are discussed.

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Hanne Konradsen, Anne Brødsgaard, Birte Østergaard, Erla Svavarsdóttir, Karin B. Dieperink, Lorenz Imhof, Marie Louise Luttik, Romy Mahrer‐Imhof, Cristina García‐Vivar
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