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Korean Journal of Epidemiology 1984;6(1): 100-111.
강화군 암등록 사업에 관한 1차보고
김일순, 김한중, 오희철, 김병수, 이윤
The cancer registry program in Kangwha County: The first report (July 1982- June 1984)
Il Soon Kim, Han Joong Kim, Hee Chul Oh, Byong Soo Kim, Yoon Lee
Abstract
The Cancer Registry Program in Kangwha County, the firs community based cancer registry program in Korea, has been launched since July 1, 1982. Two factors made it possible to develop this program in Kangwha County. One is that the county-wide compulsory health insurance program initiated by the government has been implemented in the county as an experiment from July 1, 1982. This health insurance program has largely removed the economic barrier of the people in the medical care utilization and also under the health insuraance program the medical utilization records are being piled up in the office of health insurance cooperatives in the form of the bill requested by the clinics and hospitals after they treat patients. The second factor is the availability of the community hospital in the county, which has been serving the Kangwha population for the past 5 years. This means that cancer patients in the county can easily seek medical care and their medical records re easily available. Since early 1970’s the mortality patterns of the Korean population has been changed from the infection diseases to the non-infections chronic diseases. Among chronic diseases stroke and malignant neoplasms have been reported to be the leading causes of death. It is, therefore, urgent for epidemiologist to collect very basic information on the magnitude and incidence of various such diseases for the epidemiologic studies and disease control as well. The first systematic step to challenge the cancer should be the cancer registry program. The number of target population of the Cancer Registry Program in Kangwha County is 88,851 as of December 31, 1983. The initial detection of cancer was made by reviewing all the bills requested from the various clinics and hospitals compiled in the office of the Regional Health Insurance Cooperatives. All the malignant neoplosms (ICD 140-208 in 9th edition) were included in the program. The diagnosis of cancer was confirmed by a team of physician and a nurse with the medical records kept in the clinics and hospitals based on the diagnostic criteria recommended by WHO. Home visitings were also made to those of cancer cases confirmed in every 6 months for the follow up and for the collection of relevant information directly from the patients. 223 cancer cases were registered during the first two years of the program. The annual incidence rate adjusted by the world population for male was 147.6 and for female 99.8 per 100,000 population. The most common cancer was the stomach cancer which comprised 37.7% of total cancer cases in both sexes. The annual incidence rate of the stomach cancer was 64.9 in male and 30.6 in female per 100,000 population. The lung cancer (24.3) and liver cancer(13.9) were the next common cancer in mate. The cervical cancer (19.7) was the second commonest cancer in female. The survival rates of patients with cancer after the appearance of the first symptom and also after the diagnosis were low in general due to the delayed detection and inadequate treatment. The medical seeking patterns were also studied. The small number of the target population appears to be one of the weak points of the Program. The complete follow up with home visiting is identified as the strong point of the program.
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