Purpose Screening for second primary cancer (SPC) is one of the key components to survivorship care. We aim to evaluate the oncologists’ experience with SPCs and assess the current practice, perceived barriers, and recommendations related to SPC screening. Materials and Methods A nationwide survey was conducted with a representative sample of 496 Korean oncologists. A questionnaire based on the findings from our previous qualitative study was administered. Results More than three-fourths of oncologists (76.3%), who participated in the study, had experience with SPC patients. Over half of them (51.9%) stated that it was an embarrassing experience. While the current management practice for SPC varies, most oncologists (80.2%) agreed on the necessity in proactively providing information on SPC screening. A short consultation time (52.3%), lack of guidelines and evidence on SPC screening (47.7%), and patients’ lack of knowledge about SPCs (45.1%) or SPC screening (41.4%) were most frequently reported as barriers to providing appropriate care for managing SPC. Oncologists recommended the development of specific screening programs or guidelines in accordance to the type of primary cancer (65.9%), the development of an internal system for SPC screening within the hospital (59.7%) or systematic connection with the national cancer screening program (44.3%), and education of oncologists (41.4%) as well as patients (48.9%) regarding SPC screening. Conclusion Many oncologists reported the occurrence of SPC as an embarrassing experience. Given the variations in current practice and the lack of consensus, further studies are warranted to develop the optimal clinical strategy to provide SPC screening for cancer survivors.
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PURPOSE A specialized breast surgeon is important to give comprehensive treatments to breast cancer patients. The purpose of this study was to evaluate the characteristics and treatment results of breast cancer patients in my breast clinic, and to share the experience of clinical management and data base recording and its clinical use. MATERIALS AND METHODS I had performed 1,018 breast cancer surgeries from Mar. 1992 to Mar. 1998 at the Breast Clinic in Asan Medical Center. RESULTS The results were as follows; 1,008 cases were female (99.0%), and 10 cases were male (1.0%). The peak incidence was in 40~49 years of age (36.5%), followed by 30~39 years (24.0%) and 50~59 years (23.3%). 647 cases (63.6%) were under the age of 50. The most common operative method was a modified radical mastectomy in 747 cases (73.4%), and breast conserving surgery was performed in 173 cases (17.0%). Immediate breast reconstruction was performed in 63 cases (tissue expander with implant in 50 cases, direct implant in 4 cases, TRAM flap in 8 cases, and LD flap in one case), and SSM (skin-sparing mastectomy) through circumareolar incision was done in 9 cases. According to TNM classificasion, the most common was stage II in 49.2% (501 cases), and the proportion of early-breast cancer (stage 0 and I) was 33.7%. The axillary lymph node metastasis was present in 43.5%. The 5-year overall survival and disease free survival rate was 81.4% and 70.7%. There was no local recurrence in breast conserving surgery by median follow-up of 32 months. CONCLUSION As a breast surgeon, I have tried to apply the appropriate operation methods according to the patients condition. The survival data was fairly good, and there was no local recurrence after breast conserving surgery yet. Data computerization was very useful for evaluating the characteristics of the patients.
PURPOSE Uterine cervical cancer is one of the most common cancers in Korean women. Although Pap smear has been a most effective cancer-screening technique, resulting in a significant reduction in mortality from cervical cancer in the screened populations, the number of women undergoing Pap smear is relatively small. Thus, the authors investigated the etiologic factors underlying low performance rate of this screening test. MATERIALS AND METHODS This study was done in the selected 13 villages in Koryung and Kimchun County of Kyungbuk Province. The subjects were 431 resident women over 20 years old. The questionnaires of interview included sociodemographic, sociopsyco-logical, obstetric and gynecological data, and perceived benefit and barrier to undergo Pap smear. Framework of this study was based on health belief model. The data was interpreted by frequency analysis, chi-square test, and multiple regression analysis. RESULTS Univariate analysis identified several significant variables. Positive predictors of test compliance were age, marital status, education attainment, social security, economic status, knowledge and perceived benefit of Pap smear, and existence of cue to action. Negative predictors were smoking, drinking, personality, number of children, number of gravidity and parity, and existence of barrier.
Barriers to undergo Pap smear were need, spare time, ignorance about Pap smear, shame, cost and difficulty for medical access. Cue to action to undergo Pap smear were motivated by health professional of clinic, hospital, and health-related institution, voluntarily for health promotion, peer pressure, health examination program etc.
Major predictors to undergo Pap smear on multivariate logistic regression analysis were score of barrier, score of cue to action, and marital status. CONCLUSION It nay be considered that, in developing screening programs, barriers, and cue to action to undergo Pap smear, and the women who do not have a spouse should be targeted.