Abstract

Public health centers in Korea play an important role at the community level in encouraging residents to participate in cancer screening, usually by sending reminders in the mail and by making phone calls. However, there have not been any studies on the effectiveness of these interventions by public health centers in Korea. The purpose of this study was to evaluate this question. The study was limited to male subjects aged 50-59 years living in one district of Daegu, Korea. A total of 923 subjects were selected for the study among the target population for gastric and colorectal cancer screening as part of the National Cancer Screening Program in 2012. The subjects were randomly assigned to one of four groups: control, postal intervention, telephone intervention, and telephone and postal intervention. Three months after the interventions, the results were confirmed by the National Health Insurance Corporation. Logistic regression analyses were performed to find differences in participation rates in cancer screening for each group. Men who received telephone and postal intervention were most likely (40.5%) to undergo gastric cancer screening, in comparison to the men who received telephone intervention only (31.7%), postal intervention only (22.2%) and those in the control group (17.9%). Also, men who received telephone and postal intervention were most likely (27.8%) to participate in colorectal cancer screening, followed by the men who received telephone intervention only (24.3%), postal intervention only (16.5%), and men in the control group (13.5%). Combined telephone and postal intervention and telephone only intervention as well produced significantly increased rates of participation in cancer screening in comparison to the control group. There was no significant difference, however, between the postal intervention only and control groups for either colorectal or gastric cancer screening.

Highlights

  • According to the 2014 Annual Report of Cancer Facts and Figures of the Republic of Korea, gastric cancer was the most frequently occurring cancer in males, accounting for 19.4% of all cases, followed by colorectal cancer (15.6% of cases) in 2011

  • Subjects who participated in stomach or colorectal cancer screening were identified by the National Health Insurance Corporation (NHIC) in March, 2013 because clinics or hospitals that are certified as National Cancer Screening Programme (NCSP) screening centers usually enter the results onto the web-based database of the NHIC within one or two months

  • The mailing sent to the study subjects included the following information: i) the subject is eligible to participate in stomach and colorectal cancer screening without charge, ii) stomach and colorectal cancers are the most and the second most common cancers in Korean men, but these cancers are curable if detected at early stages by cancer screening, iii) information about the procedures of stomach and colorectal cancer screening; it was especially emphasized that the fecal occult blood test (FOBT) is simple, effective and used worldwide, iv) information about financial aid programs for cancer patients when detected through the NCSP v) information about the clinics and hospitals in the district that are certified as screening centers of the NCSP

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Summary

Introduction

According to the 2014 Annual Report of Cancer Facts and Figures of the Republic of Korea, gastric cancer was the most frequently occurring cancer in males, accounting for 19.4% of all cases, followed by colorectal cancer (15.6% of cases) in 2011. Gastric cancer and colorectal cancer were the third and fourth leading causes, respectively, of death by cancer in 2012 (Korea Ministry of Health and Welfare and Korea National Cancer Center, 2014). Detections of cancer are the key component of an overall cancer control plan. It enables cancers to be detected at earlier stages, when treatments are more effective and there are greater chances to be cured (World Health Organization, 2007). It is known that early detection and screening of gastric cancer improve the 5-year survival rate and reduce mortality (Fukao et al, 1995; Tsubono and Hisamichi, 2000). Regular screenings have benefits in reducing mortality rates of colorectal cancer (American Cancer Society, 2013)

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