Background: Although gastric cancer screening is common among countries with a high prevalence of gastric cancer, there is little data to support the effectiveness of this screening. This study was designed to determine the differences in stage at diagnosis of gastric cancer according to the screening history and screening method (upper gastrointestinal series (UGIS) vs endoscopy). Methods: The study population was derived from the National Cancer Screening Programme (NCSP), a nationwide organised screening programme in Korea. The study cohort consisted of 19 168 gastric cancer patients who had been diagnosed in 2007 and who were invited to undergo gastric cancer screening via the NCSP between 2002 and 2007. Results: Compared with never-screened patients, the odds ratios for being diagnosed with localised gastric cancer in endoscopy-screened patients and UGIS-screened patients were 2.10 (95% CI=1.90–2.33) and 1.24 (95% CI=1.13–1.36), respectively. Conclusions: Screening by endoscopy was more strongly associated with a diagnosis of localised stage gastric cancer compared with screening by UGIS.

Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country. The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable. The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening. The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.

Lee KS, et al. Cancer Res Treat. 2011 Jun;43(2):83-88. http://dx.doi.org/10.4143/crt.2011.43.2.83

Background: Cancer screening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancer screening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1%) and the third highest was cervical cancer (76.1%). Despite overall increases in the screening rate, disparities in breast and cervical cancer screening, based on sociodemographic characteristics, still exist. Methods: Data from 4,139 women aged 40 to74 years from the 2005 to 2009 Korea National Cancer Screening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women. Results: Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancer screening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors. Conclusions: Disparities in breast and cervical cancer screening associated with low sociodemographic status persist in Korea.