Cancer screening in Koreans: a focus group approach

Shin-Young Lee,Eunice E Lee

doi:10.1186/s12889-018-5147-9

Shin-Young Lee, Eunice E Lee

Open Access

https://doi.org/10.1186/s12889-018-5147-9

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Abstract

BackgroundCancer is the greatest disease burden in Korea. Cancer screening can reduce the burden of cancer but cancer screening rates among Koreans remain low. The purposes of this study were to a) understand Koreans’ beliefs and knowledge about cancer screening, and b) explore preferred strategies for increasing cancer screening utilization.MethodsWe conducted a descriptive, qualitative study using eight face-to-face focus groups with a total of 64 Koreans aged 40 and over. Participants answered semi-structured, open-ended questions assessing their experiences with, and beliefs, knowledge, and opinions about, cancer screening. All interview data were recorded and analyzed in the context of the health belief model (HBM).ResultsThe most important themes that emerged from the focus group data were (a) perceived susceptibility (most of the participants believed they were not susceptible to cancer; those who perceived themselves susceptible to cancer were reluctant to express it); (b) perceived benefits (early detection and feelings of relief after cancer screening were benefits; participants had screening because they wanted to take advantage of the Korean government’s Medical Payment Support program for cancer patients who have participated in the National Cancer Screening program); (c) perceived barriers (no symptoms; self-care when having symptoms; widespread distrust of tests, doctors, and hospitals; unkind health care providers; the financial burdens of advanced cancer screening tests; and the discomfort during cancer screening); and (d) knowledge of the causes of cancer (incorrect knowledge including beliefs that stress, personality, and body overuse cause cancer). Almost all of the participants were very knowledgeable about the seriousness of cancer and were confident that they were able to have cancer screening. Participants preferred strategies of cancer screening using group interventions with family or friends; various information delivery methods; information emphasizing the importance of cancer prevention; convenient, free, or inexpensive services; and kind health care providers.ConclusionsThis HBM-based research suggests that beliefs in low susceptibility to cancer, many barriers to cancer screening, and incorrect knowledge should be the foci for increasing cancer screening rates in Koreans. Interventions could change individual cultural beliefs and increase knowledge as well as the quality of health care for Koreans.

Highlights

Cancer is the greatest disease burden in Korea
Recent data on cancer screening rates in 2012 among Korean men aged 40 years and older and women aged 30 years and older show that the lifetime screening rates for breast, cervical, gastric, colorectal, and liver cancers were 82.9%, 77.1%, 77.9%, 65.8%, and 69.9%, respectively [4]; and the rates for breast, cervical, gastric, colorectal, and liver cancers screening according to the recommended guidelines were 70.9%, 67.9%, 70.9%, 44.7%, and 21.5%, respectively [4]
A qualitative study using focus groups found that Koreans’ cultural beliefs (e.g., Korean women’s discomfort with male physicians) and issues related to the health care system were barriers to cervical cancer screening procedures such as the Pap test [10]. Another focus group study revealed that one of barriers to cancer screening for Medical Aid Program recipients was lack of trust in the National Cancer Screening program participants because they believed that the free screening services were low quality [16]. These findings indicate that cultural beliefs and health care system issues need to be deeply explored to improve cancer screening utilization among Koreans

Summary

Introduction

Cancer is the greatest disease burden in Korea. Cancer screening can reduce the burden of cancer but cancer screening rates among Koreans remain low. In an effort to reduce the burden of cancer, the Korean National Health Insurance Service has provided National Health Insurance beneficiaries and Medical Aid recipients with screening for five types of cancer (breast, cervical, gastric, colorectal, and liver) at low cost or free through the National Cancer Screening Program since 2005 [3]. This program includes the following tests: (a) breast cancer screening with mammograms every 2 years. Recent data on cancer screening rates in 2012 among Korean men aged 40 years and older and women aged 30 years and older show that the lifetime screening (ever having had screening) rates for breast, cervical, gastric, colorectal, and liver cancers were 82.9%, 77.1%, 77.9%, 65.8%, and 69.9%, respectively [4]; and the rates for breast, cervical, gastric, colorectal, and liver cancers screening according to the recommended guidelines were 70.9%, 67.9%, 70.9%, 44.7%, and 21.5%, respectively [4]

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Conclusion