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Bae S, Lee K, Kim BC, Jun JK, Choi KS, Suh M. Cost-Utility Analysis for Colorectal Cancer Screening According to the Initiating Age of National Cancer Screening Program in Korea. J Korean Med Sci 2024; 39:e98. [PMID: 38501184 PMCID: PMC10948257 DOI: 10.3346/jkms.2024.39.e98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/17/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND This study aimed to identify the most cost-effective strategy for colorectal cancer screening using the fecal immunochemical test (FIT), focusing on screening initiation age in Korea. METHODS We designed Markov simulation models targeting individuals aged 40 years or older. Twelve strategies combining screening initiation ages (40, 45, or 50 years old), termination ages (80 or no limit), and intervals (1 or 2 years) were modeled, and the most cost-effective strategy was selected. The robustness of the results was confirmed using one-way and probabilistic sensitivity analyses. Furthermore, the cost-effectiveness of the qualitative and quantitative FIT methods was verified using scenario analysis. RESULTS The 2-year interval strategy with a screening age range of 45-80 years was the most cost-effective (incremental cost-utility ratio = KRW 7,281,646/quality adjusted life years). The most sensitive variables in the results were transition rate from advanced adenoma to local cancer and discount rate. The uncertainty in the model was substantially low. Moreover, strategies starting at the age of 40 years were also cost-effective but considered suboptimal. The scenario analysis showed that there was no significant difference in cost-effectiveness between strategies with various relative screening ratio of quantitative and qualitative method. CONCLUSION The screening method for advancing the initiation age, as presented in the 2015 revised national screening recommendations, was superior regarding cost-effectiveness. This study provides a new paradigm for the development of a national cancer screening system in Korea, which can be utilized as a scientific basis for economic evaluations.
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Affiliation(s)
- Seowoo Bae
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
| | - Kyeongmin Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Kui Son Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
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Kim GH, Lee YC, Kim TJ, Hong SN, Chang DK, Kim YH, Yang DH, Moon CM, Kim K, Kim HG, Kim ER. Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea. World J Gastrointest Oncol 2024; 16:51-60. [PMID: 38292837 PMCID: PMC10824123 DOI: 10.4251/wjgo.v16.i1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The incidence of colorectal cancer (CRC) and preinvasive CRC (e.g., early colon cancer and advanced adenoma) is gradually increasing in several countries. AIM To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea. METHODS This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC, and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies. Colonoscopy-related complications by age group were also determined. RESULTS The incidence of CRC showed a rapid increase, then decreased after 2012 in the 50-75 year-age group. During the study period, the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age. Since 2009, the increase has been rapid, showing a pattern similar to the increase in colonoscopies. The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007. The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age. CONCLUSION The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed. As the risk of colonoscopy-related hospitalization and death is high in the elderly, if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75, colonoscopy-related complications can be reduced for those aged 76 years or over.
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Affiliation(s)
- Ga Hee Kim
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Tae Jun Kim
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Sung Noh Hong
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Dong Kyung Chang
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Young-Ho Kim
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Dong-Hoon Yang
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Chang Mo Moon
- Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University, Seoul 07985, South Korea
| | - Kyunga Kim
- Biomedical Statistics Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Hyun Gun Kim
- Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, South Korea
| | - Eun-Ran Kim
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
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Rim CH, Lee WJ, Akhmedov O, Sabirov U, Ten Y, Ziyayev Y, Tillyashaykhov M, Rim JS. Challenges and Suggestions in the Management of Stomach and Colorectal Cancer in Uzbekistan: The Third Report of the Uzbekistan-Korea Oncology Consortium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085477. [PMID: 37107759 PMCID: PMC10138433 DOI: 10.3390/ijerph20085477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/13/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
In general, as the national standard of living and life expectancy of people increase, the health burden of cancer also increases. Prevention strategies, including the screening and investigation of the causes of cancer as well as the expansion of treatment infrastructure, are necessary. In this review, we discussed the management strategies for gastric and colorectal cancers in Uzbekistan. Gastrointestinal cancers can be significantly prevented by certain screening strategies such as endoscopic examination. Furthermore, as both cancer types are closely related to the eating habits and lifestyles of people in Uzbekistan, such causes should be investigated and prevented. Practical advice to increase the efficiency of treatment is included, considering the current situation in Uzbekistan. Data from South Korea, which has performed nationwide screening for two decades and has made progress in improving the prognosis of patients with gastrointestinal cancers, will be discussed as a literature control.
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Affiliation(s)
- Chai Hong Rim
- Department of Radiation Oncology, Korea University Ansan Hospital, Korea University, Seoul 15355, Republic of Korea
| | - Won Jae Lee
- Department of Healthcare Management, Gachon University, Seongnam-si 13120, Republic of Korea
| | - Odiljon Akhmedov
- Department of science, Republican Specialized Scientific Practical-Medical Center of Oncology and Radiology, Farobiy Street 383, Tashkent 100179, Uzbekistan
| | - Ulugbek Sabirov
- Ministry of Health of the Republic of Uzbekistan, Tashkent 100011, Uzbekistan
| | - Yakov Ten
- Department of science, Republican Specialized Scientific Practical-Medical Center of Oncology and Radiology, Farobiy Street 383, Tashkent 100179, Uzbekistan
| | - Yakhyo Ziyayev
- Department of science, Republican Specialized Scientific Practical-Medical Center of Oncology and Radiology, Farobiy Street 383, Tashkent 100179, Uzbekistan
| | - Mirzagaleb Tillyashaykhov
- Department of science, Republican Specialized Scientific Practical-Medical Center of Oncology and Radiology, Farobiy Street 383, Tashkent 100179, Uzbekistan
- Correspondence: (M.T.); (J.S.R.); Tel.: +998-712462582 (M.T.); +82-2-2626-1523 (J.S.R.); Fax: +82-2-837-6245 (J.S.R.)
| | - Jae Suk Rim
- Department of Oral and Maxillofacial Surgery, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro 2-dong, Guro-gu, Seoul 08308, Republic of Korea
- Correspondence: (M.T.); (J.S.R.); Tel.: +998-712462582 (M.T.); +82-2-2626-1523 (J.S.R.); Fax: +82-2-837-6245 (J.S.R.)
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Maes‐Carballo M, García‐García M, Gómez‐Fandiño Y, Estrada‐López CR, Iglesias‐Álvarez A, Bueno‐Cavanillas A, Khan KS. Systematic review of shared decision-making in guidelines about colorectal cancer screening. Eur J Cancer Care (Engl) 2022; 31:e13738. [PMID: 36254840 PMCID: PMC9786598 DOI: 10.1111/ecc.13738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION We aimed to systematically evaluate quality of shared decision-making (SDM) in colorectal cancer (CRC) screening clinical practice guidelines (CPGs) and consensus statements (CSs). METHODS Search for CRC screening guidances was from 2010 to November 2021 in EMBASE, Web of Science, MEDLINE, Scopus and CDSR, and the World Wide Web. Three independent reviewers and an arbitrator rated the quality of each guidance using a SDM quality assessment tool (maximum score: 31). Reviewer agreement was 0.88. RESULTS SDM appeared in 41/83 (49.4%) CPGs and 9/19 (47.4%) CSs. None met all the quality criteria, and 51.0% (52/102) failed to meet any quality items. Overall compliance was low (mean 1.63, IQR 0-2). Quality was better in guidances published after 2015 (mean 1, IQR 0-3 vs. mean 0.5, IQR 0-1.5; p = 0.048) and when the term SDM was specifically reported (mean 4.5, IQR 2.5-4.5 vs. mean 0.5, IQR 0-1.5; p < 0.001). CPGs underpinned by systematic reviews showed better SDM quality than consensus (mean 1, IQR 0-3 vs. mean 0, IQR 0-2, p = 0.040). CONCLUSION SDM quality was suboptimal and mentioned in less than half of the guidances, and recommendations were scarce. Guideline developers should incorporate evidence-based SDM recommendations in guidances to underpin the translation of evidence into practice.
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Affiliation(s)
- Marta Maes‐Carballo
- Department of General Surgery, Breast Cancer UnitComplexo Hospitalario de OurenseOurenseSpain,Department of General SurgeryHospital Público de VerínOurenseSpain,Department of Preventive Medicine and Public HealthUniversity of GranadaGranadaSpain
| | - Manuel García‐García
- Department of General Surgery, Breast Cancer UnitComplexo Hospitalario de OurenseOurenseSpain
| | - Yolanda Gómez‐Fandiño
- Department of General Surgery, Breast Cancer UnitComplexo Hospitalario de OurenseOurenseSpain
| | | | - Andrés Iglesias‐Álvarez
- Department of General SurgeryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Aurora Bueno‐Cavanillas
- Department of Preventive Medicine and Public HealthUniversity of GranadaGranadaSpain,Instituto de Investigación Biosanitaria IBSGranadaSpain,CIBER of Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public HealthUniversity of GranadaGranadaSpain,Instituto de Investigación Biosanitaria IBSGranadaSpain
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Jung KU, Kim HO, Kim H. Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version. J Anus Rectum Colon 2022; 6:231-238. [DOI: 10.23922/jarc.2022-050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kyung Uk Jung
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Hyung Ook Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Hungdai Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
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Park IJ. Direction of diagnosis and treatment improvement in colorectal cancer. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2022. [DOI: 10.5124/jkma.2022.65.9.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Cancer is a major public health problem and the leading cause of death in Korea since 2000. Colorectal cancer is the third leading cause of cancer-related death. Therefore, early detection through screening, surgical techniques improvement, anticancer drugs, adjuvant treatment, and medical resources advancement is important to reduce colorectal cancer-related mortality.Current Concepts: In Korea, the 5-year relative survival rate of patients with colorectal cancer is approximately mid-70%, which is superior to other developed countries, such as the United States, United Kingdom, and Japan, with 60% to 68% because of the well performed screening program and technical improvement. Efforts are underway to conduct active endoscopic treatment for early colorectal cancer and identify cases requiring surgery. Minimally invasive surgery has evolved beyond conventional applications into disease-specific methods, and the robotic system has an important role for evolvement. Performing metastatic colorectal cancer efforts is necessary to improve the survival rate through active surgical treatment and gene therapy.Discussion and Conclusion: Eventually, the role of the patient’s genetic information in diagnosing and treating colorectal cancer is expected to increase. In some cases, diagnosing colorectal cancer using a non-invasive method is already realized. Active surgical treatment based on personal characteristics contributes in improving the treatment outcomes for difficult-to-treat metastatic colorectal cancer. After the period of overall colorectal cancer treatment results improvement, we will undertake the precision treatment era.
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Jung KU, Kim HO, Kim H. Epidemiology, risk factors, and prevention of colorectal cancer. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2022. [DOI: 10.5124/jkma.2022.65.9.549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Colorectal cancer remains the fourth most common malignancy in Korea, and has been ranked as the third leading cause of cancer deaths in 2020. This study aims to describe the epidemiologic status of colorectal cancer in Korea, and provide basic data for effective primary and secondary prevention methods by summarizing risk factors and screening tools.Current Concepts: Although colorectal cancer incidence and mortality have decreased in recent years in Korea, it still poses a significant public health burden. From the early 1990s until the mid-2000s, the 5-year relative survival of patients with colorectal cancer in Korea continuously increased. This can be attributed to the successful introduction of the government-led screening program; development of improved surgical techniques, anticancer drugs, and adjuvant treatment; and advances medical resources and infrastructure along with economic growth. However, since the late 2000s, the improvement in survival has stagnated. The coronavirus disease 2019 outbreak has reduced hospital visits and screenings, which is assumed to cause delays in diagnosis, leading to a worse prognosis in the patients. To overcome these obstacles, it is essential to explore modifiable environmental risk factors and appropriate screening test methods in Korea.Discussion and Conclusion: Primary prevention through risk factor modification and secondary prevention using suitable screening programs can reduce the incidence and mortality rates of colorectal cancer.
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Analyzing Factors Associated with the Behavior-Change Stage of Colorectal Cancer Screening. Healthcare (Basel) 2022; 10:healthcare10081492. [PMID: 36011149 PMCID: PMC9407742 DOI: 10.3390/healthcare10081492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
This study attempted to identify the stages of colorectal cancer screening (CRCS) behavior change by applying the precaution adoption process model (PAPM) and to examine the factors affecting each stage. A quantitative, descriptive, cross-sectional design was used. A total of 305 workers at one of the largest industrial complexes in South Korea were allocated using convenience sampling. Data were analyzed using independent t-test, one way ANOVA and multi-nominal logistic regression using SPSS 25.0 (SPSS Inc., Chicago, IL, USA). Most of the subjects were in the undecided-to-act stage. The factors affecting each stage were gender, marital status, family history, private insurance subscription, perceived barrier, and self-efficacy. It is critical to select a target group considering the behavioral change stage to establish a strategy for improving the CRCS rate. Developing and implementing a CRCS education program in consideration of the behavioral change stage will be a strategy to increase the examination of effectiveness of CRCS.
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Karam S, Darzi AJ, Bognanni A, Morsi RZ, Tannous EE, Charide R, Choe SI, Stalteri R, Lee Y, Piggott T, Jewell L, Schünemann F, Langendam M, Parmelli E, Saz-Parkinson Z, Roi A, Vilahur N, Vali Y, Waffenschmidt S, Owens DK, Leontiadis GI, Moayyedi P, Brozek JL, Schünemann HJ. Analytical Frameworks in Colorectal Cancer Guidelines: Development of Methods for Systematic Reviews, their Application and Practical Guidance for their use. J Clin Epidemiol 2022; 149:206-216. [PMID: 35724863 DOI: 10.1016/j.jclinepi.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 04/07/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Analytical frameworks are graphical representation of the key questions answered by a systematic review and can support the development of guideline recommendations. Our objectives were to a) conduct a systematic review to identify, describe and compare all analytical frameworks published as part of a systematic and guideline development process related to colorectal cancer (CRC); and b) to use this case study to develop guidance on how to conduct systematic reviews of analytical frameworks. METHODS We developed a search strategy to identify eligible studies in Medline and Embase from 1996 until December 2020. We also manually searched guideline databases and websites to identify all guidelines and systematic reviews in CRC that utilized an analytical framework. We assessed the quality of the guidelines using the Appraisal of Guidelines for Research and Evaluation II tool. The systematic review was registered in PROSPERO, registration CRD42020172117. RESULTS We screened 34,505 records and identified 1,166 guidelines and 3,127 systematic reviews on CRC of which 5 met our inclusion criteria. These 5 publications included 4 analytical frameworks in colorectal cancer (one update). We also describe our methodological approach to systematic reviews for analytical frameworks and underlying concepts for developing analytical framework using a bottom up or top-down approach. CONCLUSION Few guidelines and systematic reviews are utilizing analytical frameworks in the development of recommendations. Development of analytical frameworks should begin with a systematic search for existing analytical frameworks and follow a structured conceptual approach for their development to support guideline recommendations. Our methods may be helpful in achieving these objectives.
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Affiliation(s)
- Samer Karam
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Michael G. DeGroote Cochrane Canada and MacGRADE Centres, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Andrea J Darzi
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Michael G. DeGroote Cochrane Canada and MacGRADE Centres, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Antonio Bognanni
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Michael G. DeGroote Cochrane Canada and MacGRADE Centres, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Rami Z Morsi
- Department of Neurology, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA
| | - Elie E Tannous
- Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Rana Charide
- AUB GRADE Center, Clinical Research Institute, American University of Beirut, Beirut, Lebanon, Riad El Solh, Beirut, Lebanon 1107-2020
| | - Se-In Choe
- Department of Surgery, McMaster University, Hamilton, Canada
| | - Rosa Stalteri
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Michael G. DeGroote Cochrane Canada and MacGRADE Centres, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Yung Lee
- Department of Surgery, McMaster University, Hamilton, Canada
| | - Thomas Piggott
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Michael G. DeGroote Cochrane Canada and MacGRADE Centres, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
| | - Laura Jewell
- Memorial University of Newfoundland, Discipline of Family Medicine, Happy Valley-Goose Bay, Canada
| | - Finn Schünemann
- Institut für Evidenz in der Medizin, Universitätsklinikum Freiburg, Breisacher Str. 86, 79110 Freiburg
| | - Miranda Langendam
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam Public Health institute, University of Amsterdam, Amsterdam, Netherlands
| | - Elena Parmelli
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | - Annett Roi
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Nadia Vilahur
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Yasman Vali
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam Public Health institute, University of Amsterdam, Amsterdam, Netherlands
| | - Siw Waffenschmidt
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Institute for Quality and Efficiency in Health Care, Cologne, Germany
| | - Douglas K Owens
- Stanford Health Policy, Department of Medicine and Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | | | - Paul Moayyedi
- Department of Medicine, McMaster University, Hamilton (ON), Canada
| | - Jan L Brozek
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Department of Medicine, McMaster University, Hamilton (ON), Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St West; Hamilton, ON L8N 3Z5, Canada; Michael G. DeGroote Cochrane Canada and MacGRADE Centres, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada; Department of Medicine, McMaster University, Hamilton (ON), Canada.
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Kim KW, Lee HJ, Han K, Moon JM, Hong SW, Kang EA, Lee J, Soh H, Koh SJ, Im JP, Kim JS. Risk of Diabetes in Subjects with Positive Fecal Immunochemical Test: A Nationwide Population-Based Study. Endocrinol Metab (Seoul) 2021; 36:1069-1077. [PMID: 34731934 PMCID: PMC8566131 DOI: 10.3803/enm.2021.1119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/19/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Positive fecal immunochemical test (FIT) results have been recently suggested as a risk factor for systemic inflammation. Diabetes induces inflammation in the gastrointestinal tract via several ways. We investigated the association between FIT results and the incidence of diabetes. METHODS A total of 7,946,393 individuals aged ≥50 years from the National Cancer Screening Program database who underwent FIT for colorectal cancer (CRC) screening from 2009 to 2012 were enrolled. The primary outcome was newly diagnosed diabetes based on the International Classification of Disease 10th revision codes and administration of anti-diabetic medication during the follow-up period. RESULTS During a mean follow-up of 6.5 years, the incidence rates of diabetes were 11.97, 13.60, 14.53, and 16.82 per 1,000 personyears in the FIT negative, one-positive, two-positive, and three-positive groups, respectively. The hazard ratios (HRs) for the incidence of diabetes were 1.14 (95% confidence interval [CI], 1.12 to 1.16; HR, 1.21; 95% CI, 1.16 to 1.27; and HR, 1.40; 95% CI, 1.28 to 1.55) in the one-positive, two-positive, and three-positive FIT groups compared with the FIT negative group, respectively. The effect was consistent in individuals with normal fasting blood glucose (adjusted HR 1.55 vs. 1.14, P for interaction <0.001). CONCLUSION Positive FIT results were associated with a significantly higher risk of diabetes, suggesting that the FIT can play a role not only as a CRC screening tool, but also as a surrogate marker of systemic inflammation; thus, increasing the diabetes risk.
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Affiliation(s)
- Kwang Woo Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
- Kyungdo Han Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdoro, Dongjak-gu, Seoul 06978, Korea Tel: +82-2-820-7025, Fax: +82-2-823-1746, E-mail:
| | - Jung Min Moon
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seung Wook Hong
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ae Kang
- Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Jooyoung Lee
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Hosim Soh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seong-Joon Koh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Pil Im
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Corresponding authors: Joo Sung Kim Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8112, Fax: +82-2-743-6701, E-mail:
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Kim HI, Yoon JY, Kwak MS, Cha JM. Real-World Use of Colonoscopy in an Older Population: A Nationwide Standard Cohort Study Using a Common Data Model. Dig Dis Sci 2021; 66:2227-2234. [PMID: 32691386 DOI: 10.1007/s10620-020-06494-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/11/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUNDS AND AIMS Rapid population aging is considered to be a major factor in increased colonoscopy use in Korea. However, real-world use of colonoscopy in older populations is rarely evaluated using Korean databases. METHODS We conducted a retrospective, observational cohort study of individuals aged over 20 years between 2012 and 2017. We used the Health Insurance Review and Assessment-National Patient Samples database, previously converted to the standardized Observational Medical Outcomes Partnership-Common Data Model. The use of diagnostic colonoscopy and colonoscopic polypectomy was evaluated, stratified by age group and sex. RESULTS During the study period, we captured data from the database on 240,406 patients who underwent diagnostic colonoscopy and 88,984 who underwent colonoscopic polypectomy. During the study period, use of diagnostic colonoscopy and colonoscopic polypectomy steadily increased, but both procedures were most significantly increased in the 65- to 85-year group compared to other age groups (p < 0.05). Average ages for both procedures significantly increased in the most recent 3 years (p < 0.05). Polypectomy rates for men plateaued in the 50- to 64-year age group, but rates for women steadily increased up to the 65- to 85-year group. Polypectomy rates were higher for men than for women in all index years. CONCLUSIONS The use of diagnostic colonoscopy and colonoscopic polypectomy significantly increased in the 65- to 85-year age group. Our findings suggest that more available colonoscopy resources should be allocated to older populations, considering the aging society in Asian countries.
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Affiliation(s)
- Ha Il Kim
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Jin Young Yoon
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Min Seob Kwak
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Myung Cha
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
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Lee K, Seo H, Choe S, Jeong SY, Park JW, Suh M, Shin A, Choi KS. Intentions to undergo primary screening with colonoscopy under the National Cancer Screening Program in Korea. PLoS One 2021; 16:e0247252. [PMID: 33626070 PMCID: PMC7904222 DOI: 10.1371/journal.pone.0247252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/04/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We sought to investigate intentions to undergo primary screening with colonoscopy in an attempt to predict future colorectal cancer screening behaviors and the feasibility of implementing colonoscopy as the primary screening modality for colorectal cancer in the National Cancer Screening Program (NCSP) of Korea. METHODS Data were obtained from a nationwide online survey conducted in 2018. The survey included a total of 800 eligible adults aged over 45 years. Study measures included the history of screening colonoscopy within the past 10 years and intentions to undergo primary screening with colonoscopy under the NCSP based on the five constructs of the Health Belief Model. Logistic regression analysis was conducted to examine factors associated with intentions to undergo primary screening with colonoscopy. RESULTS Approximately 77% of the participants expressed strong willingness to undergo primary screening with colonoscopy under the NCSP. Higher perceived severity and perceived benefits were significantly associated with stronger intentions to undergo screening with colonoscopy (adjusted odds ratio [aOR], 1.53; 95% confidence interval [CI], 1.10-2.14 and aOR, 2.74; 95% CI, 1.76-4.28, respectively). Greater perceived barriers (aOR, 0.65; 95% CI, 0.45-0.93) were significantly associated with weaker intentions. Cues to action elicited the strongest screening intentions (aOR, 8.28; 95% CI, 5.23-13.12). CONCLUSION The current study findings highlight the need for increasing awareness of the severity of CRC and the benefits of colonoscopy screening. Family-orientated recommendation strategies and reducing complications may boost an individual's intentions to undergo colonoscopy.
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Affiliation(s)
- Kyeongmin Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
| | - Haejoo Seo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sunho Choe
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ji Won Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
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13
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Luu XQ, Lee K, Lee YY, Suh M, Kim Y, Choi KS. Acceptance on colorectal cancer screening upper age limit in South Korea. World J Gastroenterol 2020; 26:3963-3974. [PMID: 32774070 PMCID: PMC7385558 DOI: 10.3748/wjg.v26.i27.3963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/06/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Korea National Cancer Screening Program currently provides screening for colorectal cancer (CRC) for adults older than 50 years with no upper age limit. In general, people are likely to only pay attention to the benefits of cancer screening and to neglect its risks. Most consider the benefits of cancer screening as being far greater than the risks and are unaware that any potential benefits and harms can vary with age.
AIM To report acceptance of an upper age limit for CRC screening and factors associated therewith among cancer-free individuals in Korea.
METHODS The present study analyzed data from the Korea National Cancer Screening Survey 2017, a nationally representative random sample of 4500 Korean individuals targeted for screening for the five most common types of cancer. A total of 1922 participants were included in the final analysis. The baseline characteristics of the study population are presented as unweighted numbers and weighted proportions. Both univariate and multivariate logistic regression models were developed to examine factors related with acceptance of an upper age limit for CRC screening; subgroup analysis was also applied.
RESULTS About 80% (1554/1922) of the respondents agreed that CRC screening should not be offered for individuals older than 80 years. Specifically, those who had never been screened for CRC had the highest acceptance rate (91%). Overall, screening history for CRC [screened by both fecal occult blood test and colonoscopy, adjusted odds ratio (aOR) = 0.33, 95%CI: 0.22-0.50] and other cancers (aOR = 0.55, 95%CI: 0.34-0.87), as well as a family history of cancer (aOR = 0.66, 95%CI: 0.50-0.87), were negatively associated with acceptance of an upper age limit for CRC screening. In contrast, metropolitan residents (aOR = 1.86, 95%CI: 1.29-2.68) and people who exercised regularly (aOR = 1.42, 95%CI: 1.07-1.89) were more likely to accept an upper age limit. After subgrouping, we found gender, marital status, and lifetime smoking history among never-screened individuals and residential region, family history of cancer, and physical activity among never-screened individuals to be associated with acceptance of an upper age limit.
CONCLUSION This study describes acceptance of an upper age limit for CRC screening and factors associated with it, and provides perspectives that should be considered, in addition to scientific evidence, when developing population-based cancer screening policies and programs.
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Affiliation(s)
- Xuan Quy Luu
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, South Korea
| | - Kyeongmin Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, South Korea
| | - Yun Yeong Lee
- National Cancer Control Institute, National Cancer Center, Goyang-si 10408, South Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang-si 10408, South Korea
| | - Yeol Kim
- National Cancer Control Institute, National Cancer Center, Goyang-si 10408, South Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, South Korea
- National Cancer Control Institute, National Cancer Center, Goyang-si 10408, South Korea
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14
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Kim BC, Kang M, Park E, Shim JI, Kang S, Lee J, Tchoe HJ, Kong KA, Kim DH, Kim YJ, Choi KS, Moon CM. Clinical Factors Associated with Adherence to the Follow-Up Examination after Positive Fecal Occult Blood Test in National Colorectal Cancer Screening. J Clin Med 2020; 9:jcm9010260. [PMID: 31963658 PMCID: PMC7019756 DOI: 10.3390/jcm9010260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background: The compliance with the follow-up examination after a positive fecal occult blood test (FOBT) is lower than expected. We aimed to evaluate the adherence rate to the follow-up examination in patients with a positive FOBT and to identify the clinical factors associated with this adherence. Methods: The study population comprised adults aged ≥50 years who participated in the National Cancer Screening Program for colorectal cancer (CRC) in 2013. Compliance was defined as undergoing follow-up examination within 1 year of a positive FOBT. Results: From 214,131 individuals with a positive FOBT, 120,911 (56.5%) were in the compliance group and 93,220 (43.5%) were in the non-compliance group. On multivariate analysis, good compliance was associated with men (odds ratio (OR) = 1.12, 95% confidence interval (CI) (1.09–1.15)), younger ages (70–79 years, OR = 2.19 (2.09–2.31); 60–69 years, OR = 3.29 (3.13–3.46); 50–59 years, OR = 3.57 (3.39–3.75) vs. >80 years), previous experience of CRC screening (a negative FOBT, OR = 1.18 (1.15–1.21); a positive FOBT, OR = 2.42 (2.31–2.54)), absent previous experience of colonoscopy or barium enema (OR = 2.06 (1.99–2.13)), higher economic income (quartile, 75%, OR = 1.14 (1.11–1.17); 100%, OR = 1.22 (1.19–1.25)), current smokers (OR = 1.12 (1.09–1.15)), alcohol intake (OR = 1.03 (1.01–1.05)), active physical activity (≥3 times/week, OR = 1.13 (1.11–1.15)), depression (OR = 1.11 (1.08–1.14)), and present comorbidities (Charlson Comorbidity Index, ≥1). Conclusion: This study identified clinical factors, namely, male, younger ages, prior experience of fecal test, absent history of colonoscopy or double-contrast barium enema (DCBE) within 5 years, and high socioeconomic status to be associated with good adherence to the follow-up examination after a positive FOBT.
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Affiliation(s)
- Byung Chang Kim
- Center for Colorectal Cancer, Center for Cancer Prevention and Detection, Cancer Epidemiology Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea;
| | - Minjoo Kang
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Eunjung Park
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Jeong-Im Shim
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Shinhee Kang
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Jessie Lee
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Ha Jin Tchoe
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Kyeong Ae Kong
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 03760, Korea;
| | - Duk Hwan Kim
- Digestive Disease Center, Department of Internal Medicine, CHA University School of Medicine, Gyeonggi-do 11160, Korea;
| | - Yu Jin Kim
- Department of Internal Medicine, Hallym University College of Medicine, Gangwon-do 24252, Korea;
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
- Correspondence: (K.S.C.); (C.M.M.); Tel.: +82-31-920-2912 (K.S.C.); +82-2-2650-2945 (C.M.M.); Fax: +82-31-920-2189 (K.S.C.); +82-2-2655-2076 (C.M.M.)
| | - Chang Mo Moon
- Department of Internal Medicine, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea
- Tissue Injury Defense Research Center, Ewha Womans University, Seoul 03760, Korea
- Correspondence: (K.S.C.); (C.M.M.); Tel.: +82-31-920-2912 (K.S.C.); +82-2-2650-2945 (C.M.M.); Fax: +82-31-920-2189 (K.S.C.); +82-2-2655-2076 (C.M.M.)
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15
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Sohn DK, Shin IW, Yeon J, Yoo J, Kim BC, Kim B, Hong CW, Han KS. Validation of an automated adenoma detection rate calculating system for quality improvement of colonoscopy. Ann Surg Treat Res 2019; 97:319-325. [PMID: 31824887 PMCID: PMC6893215 DOI: 10.4174/astr.2019.97.6.319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 01/10/2023] Open
Abstract
Purpose This study aimed to validate an automated calculating system developed for determining the adenoma detection rate (ADR). Methods To calculate the automated ADR, the data linking processes were as follows: (1) matching the selected colonoscopy results with the pathological results, (2) matching the polyp number from colonoscopy with that from pathology and confirming the histopathological results of each colonic polyp, and (3) confirming the histopathological results, especially the adenoma status of each colonic polyp. To verify the accuracy of the automated ADR calculating system, we manually calculated the ADR for 3 months through medical record review. Accuracy was calculated by measuring the error rate for each value. The cause of error was analyzed by additional order and chart review. Results After excluding 318 cases, 2,543 patients (1,351 men and 1,192 women; median age, 57.9 years) who underwent colonoscopy were included in this study. When the automated calculating system was used, polyps were found in 1,336 cases (52.6%) and adenomas were found in 1,003 cases (39.4%). When the manual calculating system was used, polyps were found in 1,327 cases (52.2%) and adenomas were found in 1,003 cases (39.4%). The accuracies of the polyp detection rate and ADR according to the automated calculating system were 99.3% and 100%, respectively. Conclusion We developed a system to automatically calculate the ADR by extracting hospital electronic medical record results and verified that it provided satisfactory results. It may help to improve colonoscopy quality.
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Affiliation(s)
- Dae Kyung Sohn
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Il Won Shin
- Information Technology Team, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Jeonghwa Yeon
- Endoscopy Room, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Jin Yoo
- Endoscopy Room, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Bun Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Chang Won Hong
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Kyung Su Han
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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16
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Jo SY, Park H, Lee BK, Baik SJ, Lee HJ, Park YM. Prevalence of and Risk Factors for Diseases in Korean Americans and Native Koreans Undergoing Health Checkup. Korean J Fam Med 2019; 40:388-394. [PMID: 31639887 PMCID: PMC6887762 DOI: 10.4082/kjfm.18.0093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 08/14/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Korean Americans constitute the fifth largest subgroup in the Asian American population. Despite their increasing population, research and guidelines regarding their health status assessment and disease screening are lacking. This study aimed to compare the prevalence of diseases in Korean Americans and native Koreans to determine the risk factors and guidelines for disease screening. METHODS Patients who visited the Gangnam Severance Hospital from February 2010 to May 2015 for a health checkup were enrolled in this study. Baseline characteristics, laboratory data, and the organs (stomach, colon, thyroid, brain, prostate, lung, liver, kidney, pancreas, adrenal gland, and heart) of patients were examined. Data regarding patients' dietary patterns were also obtained. Overall, 1,514 Korean Americans (group 1) and 1,514 native Koreans (group 2) were enrolled. RESULTS The following diseases were more prevalent in group 1 than in group 2: reflux esophagitis (12.9% vs. 10%), gastric ulcer (3.0% vs. 5.5%), colorectal polyp (37.7% vs. 28.7%), hemorrhoids (32.2% vs. 29.9%), and benign prostatic hyperplasia (30.2% vs. 14.3%). Although not statistically significant, coronary artery disease has a high prevalence rate of >20% in both groups. Dietary patterns were not significant between the two groups. CONCLUSION This study showed that the prevalence of several diseases in Korean Americans differed from that observed in native Koreans. Therefore, a foundation for setting up new guidelines for disease screening among Korean Americans is established.
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Affiliation(s)
- So Young Jo
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojin Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Kwon Lee
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Su Jung Baik
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Ju Lee
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yoo Mi Park
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kim JW, Kim SY, Choi JH, Kim HS, Lee JK, Kim YT, Park G, Kang DR. Complications Following Colonoscopy in a Nationwide Standard Cohort: A Retrospective Case-control Study. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 73:152-158. [PMID: 31013558 DOI: 10.4166/kjg.2019.73.3.152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/15/2019] [Accepted: 02/02/2019] [Indexed: 01/10/2023]
Abstract
Background/Aims Despite the many reports of colonoscopy complications worldwide, few studies have been performed at the population level in Korea. In this study, a population-based study was performed to evaluate the incidence of post-colonoscopy perforations compared to a control group. Methods Between January 2011 and December 2011, data for all cases (age over 45) who underwent a colonoscopy were collected from National Health Insurance Service using a random sampling method. The clinical characteristics and perforation incidence (within 30 days after the colonoscopy) of cases were identified, and cases were then compared with controls who had not undergone a colonoscopy. Results Among 1,380,000 subjects, 31,177 cases and 62,354 controls were identified. Perforation occurred in 14 patients (0.04%) in the case group and one patient (<0.01%) in the control group (RR, 28.0; 95% CI 3.7-212.9, p<0.001). Subgroup analysis was followed according to the endoscopic procedure, gender and age. In subgroup analysis, colonoscopy-associated perforations occurred more in the therapeutic procedure (RR, 26; 95% CI 1.46-461.46), male (RR, 50; 95% CI 2.96-844.41), and age of 45-60 years (RR, 30; 95% CI 1.71-525.23). Conclusions A colonoscopy procedure is related to an increased risk of perforation at the population level. In addition, the therapeutic procedure, male, and age of 45-60 years appeared to be associated with an increased risk of perforation.
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Affiliation(s)
- Ji Woo Kim
- Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Su Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Hye Choi
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Kuk Lee
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yun Tae Kim
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Geunu Park
- Department of Biostatistics, Yonsei University, Seoul, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
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18
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Choi YJ, Lee DH, Han KD, Kim HS, Yoon H, Shin CM, Park YS, Kim N. Optimal Starting Age for Colorectal Cancer Screening in an Era of Increased Metabolic Unhealthiness: A Nationwide Korean Cross-Sectional Study. Gut Liver 2019; 12:655-663. [PMID: 29938455 PMCID: PMC6254626 DOI: 10.5009/gnl17514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/16/2018] [Accepted: 03/29/2018] [Indexed: 12/11/2022] Open
Abstract
Background/Aims The association between metabolic syndrome and colorectal cancer (CRC) has been suggested as one of causes for the increasing incidence of CRC, particularly in younger age groups. The present study examined whether the current age threshold (50 years) for CRC screening in Korea requires modification when considering increased metabolic syndrome. Methods We analyzed data from the National Health Insurance Corporation database, which covers ~97% of the population in Korea. CRC risk was evaluated with stratification based on age and the presence/absence of relevant metabolic syndrome components (diabetes, dyslipidemia, and hypertension). Results A total of 51,612,316 subjects enrolled during 2014 to 2015 were analyzed. Among them, 19.3% had diabetes, hypertension, dyslipidemia, or some combination thereof. This population had a higher incidence of CRC than did those without these conditions, and this was more prominent in subjects <40 years of age. The optimal cutoff age for detecting CRC, based on the highest Youden index, was 45 years among individuals without diabetes, dyslipidemia, and hypertension. Individuals with at least one of these components of metabolic syndrome had the highest Youden index at 62 years old, but the value was only 0.2. Resetting the cutoff age from 50 years to 45 years achieved a 6% increase in sensitivity for CRC detection among the total population. Conclusions Starting CRC screening earlier, namely, at 45 rather than at 50 years of age, may improve secondary prevention of CRC in Korea.
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Affiliation(s)
- Yoon Jin Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Soo Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Park CH, Kim NH, Park JH, Park DI, Sohn CI, Jung YS. Impact of family history of colorectal cancer on age-specific prevalence of colorectal neoplasia. J Gastroenterol Hepatol 2019; 34:537-543. [PMID: 30462856 DOI: 10.1111/jgh.14553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/02/2018] [Accepted: 11/14/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIM There are no established guidelines on screening strategies for persons with a family history of colorectal cancer (CRC) in Korea. We aimed to evaluate the age-specific risk of colorectal neoplasia according to family history of CRC. METHODS Participants who underwent screening colonoscopy were included. Age-specific prevalence of non-advanced adenoma (NAA) and advanced colorectal neoplasia (ACRN) was calculated according to family history of CRC. RESULTS Among 35 997 participants, 1339 (3.7%) had a family history of CRC in first-degree relatives. A family history of CRC was an independent risk factor for NAA (adjusted odds ratio [AOR] 1.33, 95% confidence interval [CI] 1.16-1.52). In the subgroup analysis by age, family history of CRC was a risk factor for NAA in the 50-59 and ≥ 60 years groups (AOR [95% CI]: 1.42 [1.04-1.91] and 2.33 [1.34-4.09], respectively), but not in the 30-39 and 40-49 years groups. In the curve of age-specific prevalence of NAA, the gap of the prevalence between the family history and non-family history groups began to widen after the mid-50s. In cases of ACRN, a family history of CRC was not a risk factor in the entire age group (AOR 1.16, 95% CI 0.75-1.70). In the curve of age-specific prevalence of ACRN, however, the gap of the prevalence between the family history and non-family history groups began to widen after the early 60s. CONCLUSION Although a family history of CRC is a risk factor for NAA, it may affect NAA development from the mid-50s and ACRN development from the early 60s.
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Affiliation(s)
- Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Nam Hee Kim
- Preventive Health Care, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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20
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Shin HY, Suh M, Park B, Jun JK, Choi KS. Perceptions of colorectal cancer screening and recommendation behaviors among physicians in Korea. BMC Cancer 2017; 17:860. [PMID: 29246126 PMCID: PMC5732373 DOI: 10.1186/s12885-017-3881-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 12/07/2017] [Indexed: 12/18/2022] Open
Abstract
Background Physician recommendations for colorectal cancer (CRC) screening have consistently been shown to be a strong predictor of screening. The aim of this study was to investigate perceptions of CRC screening modalities and recommendation behaviors among physicians in Korea. Methods A cross-sectional, nationally representative survey conducted between November 2013 and February 2014. In total, 379 physicians (241 primary care physicians and 138 physicians affiliated with the Korean Association for the Study of Intestinal Diseases responded to this survey (overall response rate of 31.4%). Results About 29% of all respondents “always” recommended and about 67% “sometimes” recommended CRC screening. Colonoscopy was perceived as an effective primary screening tool for CRC, and 80% of the physicians recommended colonoscopy for CRC screening. Only 7% recommended FOBT. In multivariate analysis, recommending FOBT was associated with stronger belief in the screening efficacy of FOBT (aOR 3.70, 95% CI 2.09, 6.57), weaker belief in the screening efficacy of colonoscopy (aOR 0.29, 95% CI 0.12, 0.69), and negative decisional balance for colonoscopy screening (aOR 0.82, 95% CI 0.71, 0.95). Conclusions Although FOBT is provided free-of-charge through a nationwide CRC screening program, colonoscopy was more commonly recommended and preferred by physicians. Electronic supplementary material The online version of this article (10.1186/s12885-017-3881-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye Young Shin
- National Cancer Control Institute, National Cancer Centre, 323 Ilsan-ro, Ilsandong-gu, Goyang, 410-769, Republic of Korea.,College of Nursing, Korea University, 145, Anam-ro, Seongbuk-Gu, Seoul, 137-713, Republic of Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Centre, 323 Ilsan-ro, Ilsandong-gu, Goyang, 410-769, Republic of Korea
| | - Boyoung Park
- Graduate School of Cancer Science and Policy, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Centre, 323 Ilsan-ro, Ilsandong-gu, Goyang, 410-769, Republic of Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
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21
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Kang Y, Son H. Gender Differences in Factors Associated With Colorectal Cancer Screening: A National Cross-Sectional Study in Korea. Asia Pac J Public Health 2017; 29:495-505. [PMID: 28679285 DOI: 10.1177/1010539517718336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The rate of and factors influencing colorectal cancer screening differs by gender. We aimed to determine the behaviors for and predict the factors influencing self-reported colorectal cancer screening in Korean adults. Secondary analysis was performed with data from the cross-sectional 2012 Community Health Survey. We examined the relationship between gender and self-reported screening using data for 115 045 adults aged ≥50 years; 62.4% of men and 65.5% of women underwent colorectal cancer screening. In the multivariate logistic regression analysis, men with private insurance and who attended regular health checkups were more likely to undergo screening; men who were employed, ate salty food, were older, or smoked were less likely. Women with private insurance, who lived with a spouse, were more educated, were housewives, or attended regular health checkups were more likely, and older women were less likely to undergo screening. Therefore, gender-specific interventions are needed to encourage colorectal cancer screening.
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Affiliation(s)
- Youngmi Kang
- 1 Kyung Hee University, Seoul, Republic of Korea
| | - Heesook Son
- 2 Chung-Ang University, Seoul, Republic of Korea
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22
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Ko LK, Taylor VM, Yoon J, Copeland WK, Hwang JH, Lee EJ, Inadomi J. The impact of medical tourism on colorectal screening among Korean Americans: A community-based cross-sectional study. BMC Cancer 2016; 16:931. [PMID: 27905896 PMCID: PMC5134124 DOI: 10.1186/s12885-016-2965-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 11/23/2016] [Indexed: 12/29/2022] Open
Abstract
Background Colorectal cancer (CRC) remains the most commonly diagnosed cancer among Korean Americans (KAs) in part due to low screening rates. Recent studies suggest that some KA patients engage in medical tourism and receive medical care in their home country. The impact of medical tourism on CRC screening is unknown. The purpose of this paper was to 1) investigate the frequency of medical tourism, 2) examine the association between medical tourism and CRC screening, and 3) characterize KA patients who engage in medical tourism. Methods This is a community-based, cross-sectional study involving self-administered questionnaires conducted from August 2013 to October 2013. Data was collected on 193 KA patients, ages 50–75, residing in the Seattle metropolitan area. The outcome variable is up-to-date with CRC screening, defined as having had a stool test (Fecal Occult Blood Test or Fecal Immunochemical Test) within the past year or a colonoscopy within 10 years. Predictor variables are socio-demographics, health factors, acculturation, knowledge, financial concerns for medical care costs, and medical tourism. Results In multi-variate modeling, medical tourism was significantly related to being up-to-date with CRC screening. Participants who engaged in medical tourism had 8.91 (95% CI: 3.89–23.89) greater odds of being up-to-date with CRC screening compared to those who did not travel for healthcare. Factors associated with engaging in medical tourism were lack of insurance coverage (P = 0.008), higher levels of education (P = 0.003), not having a usual place of care (P = 0.002), older age at immigration (P = 0.009), shorter years-of-stay in the US (P = 0.003), and being less likely to speak English well (P = 0.03). Conclusions This study identifies the impact of medical tourism on CRC screening and characteristics of KA patients who report engaging in medical tourism. Healthcare providers in the US should be aware of the customary nature of medical tourism among KAs and consider assessing medical tests done abroad when providing cancer care. Trial registration Not applicable.
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Affiliation(s)
- Linda K Ko
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Department of Health Services, University of Washington School of Public Health, 1100 Fairview Ave. N, M3-B232, Seattle, WA, 98109-1024, USA.
| | - Victoria M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Department of Health Services, University of Washington School of Public Health, 1100 Fairview Ave. N, M3-B232, Seattle, WA, 98109-1024, USA
| | - Jihye Yoon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wade K Copeland
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Joo Ha Hwang
- Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA, USA
| | - Eun Jeong Lee
- National Asian Pacific Center on Aging, Seattle, WA, USA
| | - John Inadomi
- Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA, USA
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Kang HT, Bahk HJ, Shim JY, Kim NK. Management of long-term colorectal cancer survivors in Korea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2016. [DOI: 10.5124/jkma.2016.59.4.276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyun Jung Bahk
- Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Yong Shim
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Kyu Kim
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Jeong WK, Lee EH, Jung SE. Quality management of medical imaging for public health screening. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.12.1125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Hye Lee
- Department of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Seung Eun Jung
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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