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Kyeongmin Lee 3 Articles
Effect of Pap smears on the long-term survival of cervical cancer patients: a nationwide population-based cohort study in Korea
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, kyu-won Jung, Myong Cheol Lim, Kui Son Choi
Epidemiol Health. 2022;44:e2022072.   Published online September 7, 2022
DOI: https://doi.org/10.4178/epih.e2022072
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate the effect of cervical cancer screening by Papanicolaou (Pap) smears on the long-term survival of cervical cancer patients.
METHODS
We constructed a retrospective cohort of 14,903 women diagnosed with invasive cancer or carcinoma in situ in 2008 and 2009 and followed up until December 31, 2019, by using individual-level data from 3 national databases of the Korean National Cancer Screening Program, the Korean Central Cancer Registry, and death certificates. Cox proportional-hazards regression was used to investigate the effect of cervical cancer screening on mortality.
RESULTS
In total, 12,987 out of 14,867 patients (87.4%) were alive at the end of the follow-up period (median: 10.5 years). Screened patients had a 38% lower risk of cervical cancer death than never-screened patients (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.54 to 0.70). Screening was associated with 59% and 35% lower risks of death, respectively, in screened patients with localized and regional stages. Furthermore, lower HRs among women who received screening were observed in all age groups, especially women aged 50–59 years (HR, 0.54; 95% CI, 0.42 to 0.69). The lowest HR for cervical cancer death was reported among patients screened within the past 2 years (HR, 0.54; 95% CI, 0.47 to 0.63), and the HRs increased with increasing time intervals.
CONCLUSIONS
Pap smear screening significantly reduced the risk of cervical cancer-specific death in Korean women across all cancer stages.
Summary
Korean summary
한국은 자궁경부암 발생과 사망을 낮추기 위하여 국가암검진사업으로 자궁경부암 검진을 실시하고 있다. 이 연구는 2008-2009년 자궁경부암 진단을 받은 30세-79세 14,903명을 대상으로 과거 자궁경부세포검진 여부에 따른 장기생존율을 추적 조사하였다. 그 결과 자궁경부암 검진을 받은 환자에서 사망 위험비가 약 38% 낮았으며, 2년 이내에 검진을 받은 환자군에서 사망 위험이 가장 낮았다.
Key Message
The Korean National Cancer Screening Program (KNCSP) has provided cervical cancer screening by Pap smear test. However, the survival, particularly long-term survival of cervical cancer patients, has never been evaluated in the KNCSP. This study reports a significant improvement in the long-term survival of screened cervical cancer patients, which persist in subgroup analysis by cancer stage. Patients who were screened within two years before the diagnosis had the best survival.
Effect of mammography screening on the long-term survival of breast cancer patients: results from the National Cancer Screening Program in Korea
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu-Won Jung, Kui Son Choi
Epidemiol Health. 2022;44:e2022094.   Published online October 26, 2022
DOI: https://doi.org/10.4178/epih.e2022094
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study investigated the effect of mammography screening on the long-term survival of breast cancer (BC) patients aged 40 years or older according to their screening history and duration since screening.
METHODS
The study cohort was organized from 3 nationwide databases of the Korean National Cancer Screening Program, the Korean Central Cancer Registry, and death certificates. We included 24,387 women diagnosed with invasive BC or ductal carcinoma in situ in 2008 and 2009 and followed up until December 31, 2019. Cox proportional-hazards regression was used to investigate the effect of BC screening on the risk of death.
RESULTS
Overall, 20,916 of 24,387 patients (85.8%) were alive at the end of the follow-up period (median: 10.5 years). The long-term survival rate was significantly lower in the never-screened group (80.3%) than in the screened group (88.9%) (p<0.001). A 35% reduction in the risk of BC death (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.60 to 0.70) from screening was observed. A subgroup analysis according to the cancer stage showed 62%, 36%, and 24% lower risks of BC death for the localized stage, regional stage, and distant stage, respectively. Women aged 40-49 years received the least benefit from BC screening (HR, 0.71; 95% CI, 0.62 to 0.81).
CONCLUSIONS
Mammography screening was effective in reducing the risk of BC-specific death in Asian women across all cancer stages. However, this effect was relatively small among women in their 40s, suggesting that more detailed and specialized screening strategies are needed for that age group.
Summary
Korean summary
Key Message
The classification capability of the Asia Pacific Colorectal Screening score in Korea: an analysis of the Cancer Screenee Cohort
Xuan Quy Luu, Kyeongmin Lee, Jeongseon Kim, Dae Kyung Sohn, Aesun Shin, Kui Son Choi
Epidemiol Health. 2021;43:e2021069.   Published online September 16, 2021
DOI: https://doi.org/10.4178/epih.e2021069
  • 4,483 View
  • 197 Download
  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to validate a simple risk assessment tool for estimating the advanced colorectal neoplasia (ACN) risk at colonoscopy screenings and potential factors relevant for implementing this tool in the Korean population.
METHODS
Our study analyzed data from the Cancer Screenee Cohort Study conducted by the National Cancer Center in Korea. The risk level was assessed using the Asia Pacific Colorectal Screening (APCS) score developed by the Asia-Pacific Working Group on Colorectal Cancer. Logistic regression models were used to examine the associations between colorectal-related outcomes and the risk level by APCS score. The discriminatory performance of the APCS score for various colorectal-related outcomes was assessed using C-statistics.
RESULTS
In 12,520 individuals, 317 ACN cases and 4,528 adenoma cases were found. The APCS tool successfully classified the study population into different risk groups, and significant differences in the ACN rate and other outcomes were observed. The APCS score demonstrated acceptable discrimination capability with area under the curve values ranging from 0.62 to 0.65 for various outcomes. The results of the multivariate logistic regression model revealed that the high-risk group had a 3.1-fold higher risk of ACN (95% confidence interval, 2.08 to 4.67) than the average-risk group. Body mass index (BMI) was identified as a significant predictor of ACN in both multivariate and subgroup analyses.
CONCLUSIONS
Our study highlighted significant differences in colorectal-related screening outcomes by colorectal risk level measured using the APCS score, and BMI could be used to improve the discriminatory capability of the APCS score.
Summary
Korean summary
검진의 위해성을 줄이면서 동시에 이득을 최대화할 수 있는 최적의 검진 프로그램은 암 발생 위험도를 고려하는 것이다. 이 연구는 Asia-Pacific Working Group on Colorectal Cancer에서 제안한 “Asia Pacific Colorectal Screening Score (APCS)”가 한국인에서 대장암 발생 위험도를 선별적으로 잘 구분해 낼 수 있음을 보여주었다. 나아가 대장암의 위험도 점수를 산출하는데 체질량지수가 중요한 예측 변수라는 것을 확인하였고, 한국인에서 대장암 발생 위험도의 변별력을 향상시키기 위해 기존의 APCS에 체질량지수를 추가할 것을 제안하였다.
Key Message
This study highlighted that the Asia Pacific Colorectal Screening Score by the Asia-Pacific Working Group on Colorectal Cancer could successfully classify Korean screenees into different risk groups with acceptable discriminatory capability. Furthermore, our study results also suggest that BMI is a significant predictor of colorectal-related health outcomes, which could be potentially added to the original APCS score for improving its discriminatory power.

Citations

Citations to this article as recorded by  
  • A scoping review of risk-stratified bowel screening: current evidence, future directions
    J. M. Cairns, S. Greenley, O. Bamidele, D. Weller
    Cancer Causes & Control.2022; 33(5): 653.     CrossRef

Epidemiol Health : Epidemiology and Health