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Systematic Review
Quantifying the duration of the preclinical detectable phase in cancer screening: a systematic review
Sandra M. E. Geurts, Anne M. W. M. Aarts, André L. M. Verbeek, Tony H. H. Chen, Mireille J. M. Broeders, Stephen W. Duffy
Epidemiol Health. 2022;44:e2022008.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022008
  • 5,896 View
  • 401 Download
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to provide an overview of published mathematical estimation approaches to quantify the duration of the preclinical detectable phase (PCDP) using data from cancer screening programs.
METHODS
A systematic search of PubMed and Embase was conducted for original studies presenting mathematical approaches using screening data. The studies were categorized by mathematical approach, data source, and assumptions made. Furthermore, estimates of the duration of the PCDP of breast and colorectal cancer were reported per study population.
RESULTS
From 689 publications, 34 estimation methods were included. Five distinct types of mathematical estimation approaches were identified: prevalence-to-incidence ratio (n=8), maximum likelihood estimation (n=16), expectation-maximization algorithm (n=1), regression of observed on expected (n=6) and Bayesian Markov-chain Monte Carlo estimation (n=5). Fourteen studies used data from both screened and unscreened populations, whereas 19 studies included only information from a screened population. Estimates of the duration of the PCDP varied between 2 years and 7 years for breast cancer in the Health Insurance Plan study (annual mammography and clinical breast examinations in women aged 40-64 years) and 2 years and 5 years for colorectal cancer in the Calvados study (a guaiac fecal occult blood test in men and women aged 45-74 years).
CONCLUSIONS
Different types of mathematical approaches lead to different estimates of the PCDP duration. We advise researchers to use the method that matches the data available, and to use multiple methods for estimation when possible, since no method is perfect.
Summary
Korean summary
Key Message
Quantifying the duration of the preclinical detectable phase is important for the design and evaluation of cancer screening programs. Different types of mathematical estimation approaches lead to different estimates of the preclinical detectable phase duration. We advise researchers to use the method that matches the data available, and to use multiple methods for estimation when possible, since no method is perfect.

Citations

Citations to this article as recorded by  
  • Estimating the Length of the Preclinical Detectable Phase for Open-Angle Glaucoma
    Johan Aspberg, Anders Heijl, Boel Bengtsson
    JAMA Ophthalmology.2023; 141(1): 48.     CrossRef
Original Articles
Factors related to cancer screening behaviors
Boyoung Choi, Tae Rim Um, Kwang-Soo Lee
Epidemiol Health. 2018;40:e2018011.   Published online March 29, 2018
DOI: https://doi.org/10.4178/epih.e2018011
  • 10,314 View
  • 226 Download
  • 4 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate the factors related to cancer screening behaviors (CSB).
METHODS
The 2014 Korean Community Health Survey used for analysis. The dependent variable was CSB, and the independent variables were demographic, health behavioral, and regional factor. Propensity score matching (PSM) used to control health behavior and regional factors, which were influencing CSB. For statistical analysis, chi-square test and logistic regression analysis used.
RESULTS
Logistic regression analysis after PSM showed that gender, age, marital status, educational level, monthly household income, employment type, alcohol drinking, smoking, body mass index group, chronic disease, and subjective health status influenced the CSB, there were statistical differences.
CONCLUSIONS
To improve cancer screening (CS), it is necessary to educate individuals on the need for CS and to carry out a personalized CS program based on an individual’s demographic status and health behavior.
Summary
Korean summary
본 연구의 목적은 암 검진 행태와 관련된 요인들을 조사하는 것이다. 이를 위해 2014년 지역 사회 건강 조사 데이터를 활용하였으며, 건강 검진 행동에 영향을 미치는 건강 행동 및 지역 요인을 통제하기 위해 성향점수매칭 방법을 사용하였고, 통계 분석을 위해 카이 제곱 검정과 로지스틱 회귀 분석을 사용하였다. 성향점수 매칭 후 분석 결과에서 성별, 연령, 결혼 상태, 교육 수준, 월평균 가구 소득, 고용형태, 음주, 흡연, BMI 그룹, 만성 질환, 주관적 건강 상태가 암 검진 수진에 영향을 미치는 것으로 나타났다. 암 검진 수진을 향상시키기 위해서 암 검진의 필요성에 대한 교육과 개인의 인구사회학적, 건강 행태를 고려한 맞춤형 암 검진 프로그램이 필요하다. 본 연구는 성향점수 매칭을 이용하여 교란요인을 통제한 후 암 검진 수진의 영향을 살펴보았다는 데에 의의가 있다.
Key Message

Citations

Citations to this article as recorded by  
  • Income Disparities in Cancer Screening: A Cross-Sectional Study of the Korean National Health and Nutrition Examination Survey, 2013–2019
    Vasuki Rajaguru, Tae Hyun Kim, Jaeyong Shin, Sang Gyu Lee
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Predictors of non-communicable diseases screening behaviours among adult population in Brunei Darussalam: a retrospective study
    Ak Muhd Adiib Pg Suhaimi, Hanif Abdul Rahman, Sok King Ong, David Koh
    Journal of Public Health.2021; 29(6): 1303.     CrossRef
  • Older Adults’ Socio-Demographic Determinants of Health Related to Promoting Health and Getting Preventive Health Care in Southern United States: A Secondary Analysis of a Survey Project Dataset
    Huey-Ming Tzeng, Udoka Okpalauwaekwe, Chih-Ying Li
    Nursing Reports.2021; 11(1): 120.     CrossRef
  • The Association between Dietary Inflammatory Index (DII) and Cancer Risk in Korea: A Prospective Cohort Study within the KoGES-HEXA Study
    Injeong Ryu, Minji Kwon, Cheongmin Sohn, Nitin Shivappa, James R. Hébert, Woori Na, Mi Kyung Kim
    Nutrients.2019; 11(11): 2560.     CrossRef
Physician’s awareness of lung cancer screening and its related medical radiation exposure in Korea
Seri Hong, Suyeon Kim, Mina Suh, Boyoung Park, Kui Son Choi, Jae Kwan Jun
Epidemiol Health. 2018;40:e2018002.   Published online January 20, 2018
DOI: https://doi.org/10.4178/epih.e2018002
  • 11,939 View
  • 254 Download
  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Through a survey on perception of lung cancer screening and accompanying medical radiation exposure in Korea, the present study was to investigate its current situations and evaluate various perception of physicians regarding it in order to propose measures for improvements.
METHODS
Medical specialists in national cancer screening institutions selected through stratified random sampling were subjected to face-to-face interview using a structured questionnaire. We investigated physicians’ perception on effectiveness of lung cancer screening depending on screening modality, selection criteria for subjects of screening, types of equipment used to screen, and perception for seriousness of adverse effects following the test. In addition, odds ratios to underestimate risk of radiation exposure from screening were calculated through logistic regression analysis.
RESULTS
Each response that chest X-ray is effective for lung cancer screening and that smoking history is not considered prior to screening recommendation accounted for more than 60% of respondents, suggesting the chance of unnecessary screening tests. Regarding adverse effects of lung cancer screening, about 85% of respondents replied that false positive, radiation exposure, and overdiagnosis could be ignored. About 70% of respondents underestimated radiation dose from lung cancer screening, and a low proportion of physicians informed patients of radiation exposure risk.
CONCLUSIONS
It was found that most physicians underestimated harms of lung cancer screening including radiation exposure and were lack of awareness regarding lung cancer screening. It should be noted that physicians need to have proper perceptions about screening recommendation and accompanying possible harms, for successful implementation of the screening program.
Summary
Korean summary
전국 100여개 국가암검진 기관을 대상으로 폐암검진 관련 설문을 수행한 결과, 효과적인 폐암검진의 수단이나 방법에 대한 이해 및 검사에 수반되는 각종 부작용에 대한 의사들의 인식이 확연히 부족한 것으로 조사되었다. 그 중에서도 특히 의료방사선 노출에 대한 낮은 인지도는, 촬영 시 피폭량에 대한 전반적인 과소평가 및 방사선 노출 위험과 관련한 환자 교육의 부재를 통해 확인할 수 있었다. 인구집단 대상 선별검사의 도입에 따른 잠재적인 위해 가능성과 그 결과에 대한 고민은 반드시 필요하며, 이와 관련된 의료제공자들의 인식 개선을 촉구하는 본 연구는 정책 도입에 앞서 선결되어야 할 과제로서 공중보건학적 측면에서 중요한 의의를 지닌다.
Key Message

Citations

Citations to this article as recorded by  
  • Why clinicians overtest: development of a thematic framework
    Justin H. Lam, Kristen Pickles, Fiona F. Stanaway, Katy J. L. Bell
    BMC Health Services Research.2020;[Epub]     CrossRef
Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009
Kumban Walter Chuck, Minji Hwang, Kui Son Choi, Mina Suh, Jae Kwan Jun, Boyoung Park
Epidemiol Health. 2017;39:e2017036.   Published online August 10, 2017
DOI: https://doi.org/10.4178/epih.e2017036
  • 10,499 View
  • 231 Download
  • 13 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes.
METHODS
Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes.
RESULTS
Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9).
CONCLUSIONS
The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.
Summary
Korean summary
기존의 여러 연구에서 당뇨병이 있는 사람에서 당뇨병이 없는 경우에 비해 암 발생의 위험이 증가하는 것이 확인되었다. 본 연구에서 당뇨병이 있는 사람과 없는 사람에서 암 수검률을 비교했을 때, 당뇨병이 있는 사람의 위암, 유방암, 자궁경부암의 평생 수검률과 권고안 이행 수검률은 모두 낮았다. 당뇨병 환자가 암 발생의 고위험군임을 고려하였을 때 이들을 대상으로 암 검진 수검률을 높이려는 노력이 필요하다.
Key Message

Citations

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  • Increased Breast and Colorectal Cancer Risk in Type 2 Diabetes: Awareness Among Adults With and Without Diabetes and Information Provision on Diabetes Websites
    Laura Ashley, Kathryn A Robb, Daryl B O’Connor, Rebecca Platt, Mollie Price, Olivia Robinson, Elizabeth Travis, Lorraine Lipscombe, Ramzi Ajjan, Rebecca Birch
    Annals of Behavioral Medicine.2023; 57(5): 386.     CrossRef
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    Jae Won Hong
    The Journal of Korean Diabetes.2023; 24(1): 12.     CrossRef
  • Do diabetic complications influence cancer-related events in people with type 2 diabetes? A cohort approach
    Evelyne Liuu, Pierre-Jean Saulnier, Elise Gand, Gautier Defossez, Amélie Jamet, Stéphanie Ragot, Marc Paccalin, Samy Hadjadj
    Diabetes & Metabolism.2022; 48(2): 101289.     CrossRef
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    Ji‐Bin Li, Keng‐Jian Ke, Wei‐Li Zhang, Ling‐Yan Wang, Yan‐Ping Wu, Fan Weng, Huan Tian, Zhi‐Yu Qiu, Yin Li, Shi‐Yong Lin, Mei‐Xian Ye, Qing‐Jian Ou, Cheng‐Hua Gong, Zhen‐Hai Lu, Zhi‐Zhong Pan, De‐Sen Wan, Jian‐Hong Peng, Yu‐Jing Fang
    Cancer Medicine.2022; 11(22): 4321.     CrossRef
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    Hans Scherübl
    Zeitschrift für Gastroenterologie.2022;[Epub]     CrossRef
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    Yong Whi Jeong, Yeojin Jung, Hoyeon Jeong, Ji Hye Huh, Ki-Chul Sung, Jeong-Hun Shin, Hyeon Chang Kim, Jang Young Kim, Dae Ryong Kang
    Diagnostics.2022; 12(8): 1967.     CrossRef
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    Hans Scherübl
    Diabetes aktuell.2022; 20(06): 287.     CrossRef
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    Chin-Hsiao Tseng
    Biomolecules.2021; 11(7): 1022.     CrossRef
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    Christian von Wagner, Dorina Cadar, Ruth A Hackett, Panayotes Demakakos, Rebecca J Beeken, Stacy Cooper Bailey, Michael Wolf, Andrew Steptoe, Cristina Renzi, Sandro T Stoffel
    Journal of Medical Screening.2020; 27(1): 25.     CrossRef
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    Dominika Bhatia, Iliana C. Lega, Wei Wu, Lorraine L. Lipscombe
    Diabetologia.2020; 63(1): 34.     CrossRef
  • Review: Diabetes, Obesity, and Cancer—Pathophysiology and Clinical Implications
    Iliana C Lega, Lorraine L Lipscombe
    Endocrine Reviews.2020; 41(1): 33.     CrossRef
  • The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study
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    Journal of Korean Medical Science.2019;[Epub]     CrossRef
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    Diabetes & Metabolism Journal.2019; 43(6): 733.     CrossRef
Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries
Eunji Choi, Sangeun Lee, Bui Cam Nhung, Mina Suh, Boyoung Park, Jae Kwan Jun, Kui Son Choi
Epidemiol Health. 2017;39:e2017006.   Published online February 5, 2017
DOI: https://doi.org/10.4178/epih.e2017006
  • 14,687 View
  • 425 Download
  • 57 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Summary
Korean summary
Key Message

Citations

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Methods
Development and application of patient decision aids
Jong-Myon Bae
Epidemiol Health. 2015;37:e2015018.   Published online April 8, 2015
DOI: https://doi.org/10.4178/epih/e2015018
  • 16,046 View
  • 151 Download
  • 7 Citations
AbstractAbstract PDFSupplementary Material
Abstract
With the current overdiagnosis of thyroid cancer resulting from routine screening in Korea, it is necessary to educate the public that not all cancers are malignant. The exposure to patient decision aids (PtDAs) compared to usual care reduced the number of people choosing to undergo prostate-specific antigen screening. This article introduces the definition, usefulness, and developmental processes of PtDAs and suggests the urgent need for a Korean PtDA related to thyroid cancer screening.
Summary
Korean summary
Key Message

Citations

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Original Article
Distribution of dense breasts using screening mammography in Korean women: a retrospective observational study
Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nam Kim, Chung Mo Nam
Epidemiol Health. 2014;36:e2014027.   Published online November 4, 2014
DOI: https://doi.org/10.4178/epih/e2014027
  • 14,387 View
  • 134 Download
  • 11 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
This retrospective observational study evaluated the distribution of dense breasts by age group among healthy Korean women.
METHODS
Participants were women aged 30 years and older who voluntarily underwent screening mammography between January 2007 and December 2011. Women who received the Breast Imaging Reporting and Data System for mammographic density of 3 or 4 were defined as having dense breasts. The proportion of women with dense breasts (PDB, %) was calculated by dividing the number of participants with dense breasts by the total number of participants.
RESULTS
Among the 231,058 women who participated, 78.15% were classified as having dense breasts. PDB was highest in the youngest age group (PDB=94.87%) and lowest in the oldest age group. The greatest difference in PDB between adjacent age groups was observed in the group aged 60-64 years.
CONCLUSIONS
The results show that the proportion of dense breasts by age group increased in all age groups, except in those aged 35-39 years. These findings suggest an association between the age distribution of dense breasts and trends in breast cancer incidence. Further studies are needed to estimate the change in breast cancer incidence rate by age and the accumulation of fatty breast tissue in Korean women.
Summary
Korean summary
Key Message

Citations

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