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5 "Mammography"
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Original Articles
Trends in breast cancer screening rates among Korean women: results from the Korean National Cancer Screening Survey, 2005-2020
Soo Yeon Song, Yun Yeong Lee, Hye Young Shin, Bomi Park, Mina Suh, Kui Son Choi, Jae Kwan Jun
Epidemiol Health. 2022;44:e2022111.   Published online November 24, 2022
DOI: https://doi.org/10.4178/epih.e2022111
  • 3,293 View
  • 147 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Since 2002, the Korean government has provided breast cancer screening as part of the National Cancer Screening Program. This study reported trends in the screening rate among Korean women from 2005 to 2020, including organized and opportunistic screening for breast cancer.
METHODS
Data from the Korean National Cancer Screening Survey, an annual cross-sectional nationwide survey, were collected using a structured questionnaire between 2005 and 2020. The study population included 23,702 women aged 40-74 years with no history of cancer. We estimated the screening rate based on the current recommendation of biennial mammographic screening for breast cancer. In addition, a joinpoint trend analysis was performed for breast cancer screening rates among various subgroups.
RESULTS
In 2020, the breast cancer screening rate was 63.5%, reflecting an annual increase of 7.72% (95% confidence interval 5.53 to 9.95) between 2005 and 2012, followed by non-significant trends thereafter. In particular, a significant decrease in the breast cancer screening rate was observed in the subgroups aged 50-59 years old, with 12-15 years of education, and living in rural areas.
CONCLUSIONS
Although there has been substantial improvement in breast cancer screening rates in Korean women, the trend has flattened in recent years. Therefore, continual efforts are required to identify subgroups with unmet needs and solve barriers to the uptake of breast cancer screening.
Summary
Korean summary
본 연구는 2005년에서 2020년까지 암검진수검행태조사 자료를 이용하여 40세 이상의 우리나라 여성의 유방암 검진 수검률이 추이에 대해 분석하였다. 우리나라 유방암 검진 수검률은 2020년 현재 63.5%이다. 하지만 지속적으로 증가하던 유방암 검진 수검률의 추이는 2012년 이후 정체되어 있으며 일부 사회경제적 계층에서는 감소하는 경향을 보였다.
Key Message
In Korea, despite of the high level of breast cancer screening rate, decreasing trends in some socioeconomic classes after 2012. Continual efforts are required to identify subgroup with unmet needs and barriers to the uptake of breast cancer screening.

Citations

Citations to this article as recorded by  
  • Why is the screening rate in lung cancer still low? A seven-country analysis of the factors affecting adoption
    Charlotte Poon, Tim Wilsdon, Iqra Sarwar, Alexander Roediger, Megan Yuan
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Mammographic Breast Density and Risk of Ovarian Cancer in Korean Women
    Thi Xuan Mai Tran, Soyeoun Kim, Boyoung Park
    Cancer Epidemiology, Biomarkers & Prevention.2023; 32(12): 1690.     CrossRef
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
  • 3,664 View
  • 162 Download
AbstractAbstract PDFSupplementary Material
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
Methods
Overdiagnosis: epidemiologic concepts and estimation
Jong-Myon Bae
Epidemiol Health. 2015;37:e2015004.   Published online February 10, 2015
DOI: https://doi.org/10.4178/epih/e2015004
  • 23,323 View
  • 238 Download
  • 15 Web of Science
  • 15 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Overdiagnosis of thyroid cancer was propounded regarding the rapidly increasing incidence in South Korea. Overdiagnosis is defined as ‘the detection of cancers that would never have been found were it not for the screening test’, and may be an extreme form of lead bias due to indolent cancers, as is inevitable when conducting a cancer screening programme. Because it is solely an epidemiological concept, it can be estimated indirectly by phenomena such as a lack of compensatory drop in post-screening periods, or discrepancies between incidence and mortality. The erstwhile trials for quantifying the overdiagnosis in screening mammography were reviewed in order to secure the data needed to establish its prevalence in South Korea.
Summary
Korean summary
최근 갑상선암의 발생 증가는 과진단에 기인한 것이란 주장이 제기되었다. 과진단은 ‘평생동안 몰랐을 암을 검진으로 알아낸 경우’로 정의하는 바, 예상보다 늦은 진행으로 예후가 더 좋고 치료를 안해도 사망률 변동을 만들지 못하는 암에 대하여 반복되는 암검진에 더 잘 진단되는 기간차이 바이어스가 개입되는 것을 제대로 통제하지 못해서 생긴 것이다. 검진을 더 이상 하지 않았을 경우 발생률이 본래대로 되돌아오지 않는 현상을 보이거나, 사망률과 발생률 간의 변동에서 큰 차이를 보일 때 과진단이 있다고 판단한다. 국내에서 발생하는 과진단의 크기를 측정하기 위한 방법들을 알아보기 위하여, 기존의 유방암 조기검진용 유방촬영술에 대한 과진단 크기를 알아낸 연구방법들을 살펴보았다.

Citations

Citations to this article as recorded by  
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    Nicole E. Rich, Amit G. Singal
    Hepatology.2022; 75(3): 740.     CrossRef
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    Hyun Jung Koo, Chang-Min Choi, Sojung Park, Han Na Lee, Dong Kyu Oh, Won-Jun Ji, Seulgi Kim, Mi Young Kim
    Lung Cancer.2019; 128: 120.     CrossRef
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    Ho-Sun Lee, Yunkyeong Kang, Kyung Tae, Gyu-Un Bae, Jong Y. Park, Yoon Hee Cho, Mihi Yang
    Cancer Research and Treatment.2018; 50(1): 111.     CrossRef
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    Shunichi Yamashita, Shinichi Suzuki, Satoru Suzuki, Hiroki Shimura, Vladimir Saenko
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    Louise Davies, Diana B. Petitti, Lynn Martin, Meghan Woo, Jennifer S. Lin
    Annals of Internal Medicine.2018; 169(1): 36.     CrossRef
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    Bjørn Hofmann
    Journal of Evaluation in Clinical Practice.2018; 24(5): 983.     CrossRef
  • The Use of International Classification of Diseases Codes to Identify Patients with Pancreatitis: A Systematic Review and Meta-analysis of Diagnostic Accuracy Studies
    Amy Y. Xiao, Marianne L. Tan, Maria N. Plana, Dhiraj Yadav, Javier Zamora, Maxim S. Petrov
    Clinical and Translational Gastroenterology.2018; 9(10): e191.     CrossRef
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    Caroline Saint-Martin, Moustapha Dramé, Sandrine Dabakuyo, Lukshe Kanagaratnam, Patrick Arveux, Claire Schvartz
    Annales d'Endocrinologie.2017; 78(1): 27.     CrossRef
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    Shunichi Yamashita, Vladimir A. Saenko
    Thyroid.2017; 27(5): 595.     CrossRef
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    Jong-Myon Bae
    Journal of Preventive Medicine and Public Health.2017; 50(4): 217.     CrossRef
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    I.J. Nixon, C. Suárez, R. Simo, A. Sanabria, P. Angelos, A. Rinaldo, J.P. Rodrigo, L.P. Kowalski, D.M. Hartl, M.L. Hinni, J.P. Shah, A. Ferlito
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    Curtis E. Margo
    Cancer Control.2016; 23(2): 90.     CrossRef
  • Epidemiological evidences on overdiagnosis of prostate and kidney cancers in Korean
    Jong-Myon Bae
    Epidemiology and Health.2015; 37: e2015015.     CrossRef
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    Jong-Myon Bae
    Epidemiology and Health.2015; 37: e2015018.     CrossRef
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    Jong-Myon Bae
    Journal of the Korean Medical Association.2015; 58(9): 833.     CrossRef
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
  • 16,722 View
  • 140 Download
  • 14 Web of Science
  • 12 Crossref
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

Citations

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    Jing Chen, Zhibin Huang, Hui Luo, Guoqiu Li, Zhimin Ding, Hongtian Tian, Shuzhen Tang, Sijie Mo, Jinfeng Xu, Huaiyu Wu, Fajin Dong
    Postgraduate Medical Journal.2024;[Epub]     CrossRef
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Hypothesis
Two hypotheses of dense breasts and viral infection for explaining incidence of breast cancer by age group in Korean women
Jong-Myon Bae
Epidemiol Health. 2014;36:e2014020.   Published online September 26, 2014
DOI: https://doi.org/10.4178/epih/e2014020
  • 20,714 View
  • 139 Download
  • 11 Web of Science
  • 13 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
Breast cancer, the second leading type of cancer in Korean women, has shown increasing incidence over the past 10 years. However, the curves of incidence by age group cast doubt on the birth cohort effect hypothesis. To explain the curves, here I suggest two alternative hypotheses of breast density and viral infection based on pre-existing evidences. Evaluating these hypotheses would require important clues to find unknown risk factors of breast cancer and to plan more effective strategies for breast cancer control in Korean women.
Summary

Citations

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    Jong-Myon Bae, Eun Hee Kim
    Archives of Clinical Infectious Diseases.2016;[Epub]     CrossRef
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    Jong-Myon Bae, Eun Hee Kim
    Journal of Preventive Medicine and Public Health.2016; 49(6): 367.     CrossRef
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    Jong-Myon Bae, Eun Hee Kim
    Journal of Preventive Medicine and Public Health.2015; 48(5): 225.     CrossRef
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    Jong-Myon Bae
    Epidemiology and Health.2015; 37: e2015047.     CrossRef
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    Jong-Myon Bae
    Epidemiology and Health.2015; 37: e2015005.     CrossRef
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    Jong-Myon Bae, Eun Hee Kim
    Epidemiology and Health.2015; 37: e2015052.     CrossRef
  • Distribution of Dense Breasts using Screening Mammography in Korean Women: a Retrospecitive Observational Study
    Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nma Kim, Chung Mo Nam
    Epidemiology and Health.2014; : e2014027.     CrossRef

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