Journal of Preventive Medicine and Public Health

Review

Cancer Control Programs in East Asia: Evidence From the International Literature: Malcolm A. Moore; J Prev Med Public Health. 2014;47(4):183-200. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.183

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Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.

Summary

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Original Article

Proportion of Death Certificates Issued by Physicians and Associated Factors in Korea, 1990-2002.: Min Woo Jo, Young Ho Khang, Sungcheol Yun, Jin Yong Lee, Moo Song Lee, Sang Il Lee; J Prev Med Public Health. 2004;37(4):345-352. Published online November 30, 2004

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Abstract PDF: OBJECTIVES
Previous studies showed that death certification by physicians was an important predictor to improve the quality of death certificate data in South Korea. This study was conducted to examine the proportion of death certificates issued by physicians and associated factors in South Korea from 1990 to 2002. METHODS: Data from 3, 110, 883 death certificates issued between 1990 and 2002, available to the public from the National Statistical Office of Korea, were used to calculate the proportion of death certificates issued by physicians and to examine associated factors with logistic regression analysis. RESULTS: The overall proportion of death certificates issued by physicians increased from 44.6% in 1990 to 77.6% in 2002 (mean: 63.5%). However, the proportion was greatly influenced by the deceased's age. In 2002, more than 90% of the deceased aged 51 or less were certified by physicians. A higher proportion was found among deceased who had tertiary education (college or higher) living in more developed urban areas. CONCLUSION: The information regarding the cause of death for younger, well-educated deceased in urban areas of South Korea may show a higher level of accuracy. Epidemiologic research using information on causes of death may well benefit from the continually increasing proportion of death certificates issued by physicians in the future in South Korea.; Summary

Validation Studies

Construction and Validation of Hospital-Based Cancer Registry Using Various Health Records to Detect Patients with Newly Diagnosed Cancer: Experience at Asan Medical Center.: Hwa Jung Kim, Jin Hee Cho, Yongman Lyu, Sun Hye Lee, Kyeong Ha Hwang, Moo Song Lee; J Prev Med Public Health. 2010;43(3):257-264.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.257

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Abstract PDF

OBJECTIVES
An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. METHODS: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. RESULTS: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. CONCLUSIONS: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.

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Jihyun An, Seheon Chang, Ha Il Kim, Gi‐Won Song, Ju Hyun Shim
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English Abstract

Cancer Registration in Korea: The Present and Furtherance.: Yoon Ok Ahn; J Prev Med Public Health. 2007;40(4):265-272.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.265

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Abstract PDF

It was not until 1975 that cancer registration was initiated in Korea; voluntary registration of cancer patients of training hospitals throughout the country began under the auspices of the Korean Cancer Society(KCS). However, an official cancer registration, the Korea Central Cancer Registry(KCCR), began on July 1st, 1980. Forty-five training and two non-training hospitals throughout the country initiated registration of patients in whom neoplasms had been found. Data related to case information specified are to be sent to the KCCR at the National Medical Center(it moved at National Cancer Center in 2000). The initial cancer registration of KCS was merged to the KCCR in 1980. Although the KCCR covers most all the large training hospitals in Korea, it cannot provide incidence data. It is, however, the only of its kind in the world, being neither hospital nor population based. The first population based cancer registry(PBCR) was launched in a small county, Kangwha(it has around 80,000 inhabitants), by Yonsei University Medical College in 1983. All data were collected by active methods, and incidence statistics for 1986-1992 appeared in Vol VII of the CI5. Another PBCR, Seoul Cancer Registry(SCR), started in 1991. It was supported by a civilian foundation, the Korean Foundation for Cancer Research. The basic idea of case registration of SCR was the incorporation of KCCR data to PBCR, e. g. dual sources of case registration, i.e., from the KCCR and also including cases diagnosed in small hospitals and other medical facilities. Assessing completeness and validity of case registration of SCR, the program and methodology used by the SCR was later extended to other large cities and areas in Korea, and the PBCR in each area was established. Cancer incidence statistics of Seoul for 1993- 1997, Busan for 1996-1997, and Daegu for 1997-1998, as well as Kangwha for 1993-1997, appeared eventually in Vol VIII of the CI5. The Korean or 'pillar' model for a PBCR is a new one. The KCCR data file is a reliable basis, as a pillar, for a PBCR in each area. The main framework of the model for such a registry is the incorporation of a KCCR data file with data from additionally surveyed cases; the data related to cancer deaths, medical insurance claims, and visit-and abstract surveillance of non-KCCR medical facilities. Cancer registration has been adopted as a national cancer control program by Korean government in 2004 as the Anti-Cancer Act was enacted. Since then, some officers have tried to launch a nation-wide PBCR covering whole country. In the meantime, however, cancer registration was interrupted and discontinued for years due to the Privacy Protection Law, which was solved by an amendment of the Anti-Cancer Act in 2006. It would be premature to establish the nation-wide PBCR in Korea. Instead, continuous efforts to improve the completeness of registration of the KCCR, to progress existing PBCRs, and to expand PBCRs over other areas are still to be devoted. The nation-wide PBCR in Korea will be established eventually with summation of the PBCRs of the Korean model.

Summary

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Original Articles

The Efficient Methods of Population-based Cancer Registration in Daegu City.: Dae Gu Jin, Sin Kam, Byung Yeol Chun, Soon Ki Ahn, Jong Yeon Kim; Korean J Prev Med. 2002;35(4):322-330.

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Abstract PDF: OBJECTIVE
This study was conducted to automatically improve the completeness and validity of the Daegu Cancer Registry, using cross record linkage of many data sources, and to develop a computerized patient enrollment system for efficient communication among cancer researchers via the internet. METHOD: We analyzed 10,229 cancer patients who were reported in the National Cancer Registry, and from pathological reports, health insurance cancer claims lists, cancer patient records at hospital information centers and death certificates from the Korea National Statistical Office. RESULT: We confirmed 4,624 cancer patients and found 897 of new cases from a review of medical chart. The new cases were detected efficiently using cross record linkage. We developed a computerized patient enrollment system, based on a client-server model, for the input of cancer patients, and then developed a web-based reporting homepage and patient enrollment system for the internet. CONCLUSION: This system could manage cancer databases systematically, and could be given to other researchers as a basic database.; Summary

Accuracy of the Registered Cause of Death in a County and its Related Factors.: Eun Kyung Chung, Hee Young Shin, Jun Ho Shin, Hae Sung Nam, So Yeon Ryu, Jeong Soo Im, Jung Ae Rhee; Korean J Prev Med. 2002;35(2):153-159.

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Abstract PDF: OBJECTIVES
To evaluate the accuracy of the registered cause of death in a county and its related factors. METHODS: The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. RESULTS: 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI= 0.12-0.78). CONCLUSIONS: The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.; Summary

Completeness Estimation of the Population-based Cancer Registration with Capture-Recapture Methods.: Jeong Soo Im, Sun Seog Kweon, Sang Yong Kim, Kyeong Soo Park, Seok Joon Sohn, Jin Su Choi; Korean J Prev Med. 2000;33(1):31-35.

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Abstract PDF: OBJECTIVES
This study aimed to estimate the completeness of cancer registration with Capture-recapture method. METHODS: The study was conducted in the population based cancer registry of Kwangju, Korea, for which there are three main sources of notification: reports by Korean Central Cancer Registry, reports by pathology data, and the others reports by radiology data, death certificates, etc. The defined cases in three sources were matched by 13 digits Resident Register Number. To derive an estimates, log-linear models were applicated. RESULTS: Overall completeness was estimated to be around 93%. There was some variation with age(consistently high levels below age group 60-74 years, a minimum of 88.6% above 75 years). Among the most common cancer sites, estimates of completeness were highest for thyroid cancer(97.1%), while lower estimates of completeness were derived for stomach cancer(92.3%), liver cancer(92.6%). CONCLUSIONS: Careful application of Capture-recapture method may provide an alternative to traditional approaches for estimating the completeness of cancer registration in Kwangju city.; Summary

A Telephone Survey on the Opinions about Family Doctor.: Hong Gwan Seo, Jae Heon Kang, Cheol Hwan Kim, Seong Won Kim; Korean J Prev Med. 1998;31(2):310-322.

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Abstract PDF: In order to reinforce the role of primary care physician and to improve doctor-patient relationship, the Korean government tried to introduce 'Family Doctor Registration Program' into Seocho-Gu in Seoul, Ansung-Gun and Paju city in Kyunggi-Do in Oct. 1996. Community residents and doctors in those area did not show much interest in this project because of low incentives. We have done this study to see how much people know 'Family Doctor Registration Program' and what is people's real needs about 'Family Doctor Registration Program. We selected l,800 telephone numbers in Seoul, Chongju city, and Ansung-Gun by multi-stage stratified random sampling. Three trained survey personnels called them and got answers to the premade questionnaire until they completed the questionnaires of 200 persons in each community. The calling time was 7-9 p.m. from Monday to Friday, 3-9 p.m. on Saturday, and 9 a.m. to 9 p.m. on Sunday. We dropped out the persons who did not respond 3 times. The subjects consisted of 222 male and 367 female residents. Their ages ranged from 20 to 78: 24.8% in their 30s, 23.4% in their 20s, 22.5% in their 40s in male, and 35.2% in their 30s, 22.5% in their 40s, 18.5% in their 20s in female. 9.9% of male and 13.2% of female had their Family Doctors. The specialties of their Family, Doctors were internists in 56.2%, general surgeons in ll.0%. The persons who did not have their family, doctors were asked which doctors they would prefer if they had choices of family doctor. The results were internists in 50.3%, family physicians in 13.0%, pediatricians in 4.8%. Only 16.0% residents knew that government tried to introduce Family Doctor Registration Program. The 'Family Doctor Registration Program' was not well known to people. The results of our study showed that more effective incentives and public notifications are needed to activate this program.; Summary

Birth Registration Rate and Accuracy of Reported Birth Date in Rural Area.: Jung Han Park, Chang Yik Lee, Jang Rak Kim, Jung Hup Song, Min Hae Yeh, Seong Eok Cho; Korean J Prev Med. 1988;21(1):70-81.

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Abstract PDF: To measure the birth registration rate and the validity of birth registration data in rural area, all of the 4,014 married women under 49 years of age who had not been sterilized in Gunwee county of Kyungpook province were followed by Myun health workers for 2 years from April 1, 1985 to March 31, 1987 and 766 births were detected. All of the birth registration records of Myun offices were reviewed on September 30, 1987 and 944 births which occurred within the above mentioned period were found. Actual birth date obtained by follow-up study were compared with the birth date on registration card. Among 766 births detected by follow-up study, 576 births(75.2%) which were reported within 6 months after birth were ascertained on the official registration records and 96 births(12.5%) were not found on the records although mother stated that the birth was registered. The registration rate within legal due date was 61.3% among 576 births detected by follow-up study and also ascertained on the official records. The registration rate within legal due date was lower in mothers under 20 years of age and above 35 years and in mothers who had only primary education. It was decreased as the birth order increased. The registration rate was higher in births occurred from October to March than births occurred from April to September. All of the births of 7 neonatal deaths were not reported. The registered birth date was consistent with the actual birth date in 78.0%. Birth date on record was earlier than the actual birth date in 6.8% and later in 15.3%. The consistency rate was lower in mothers above 35 years of age(54.5%), and in infants of 4th birth order and above(56.3%). The rate was increased as the maternal education level increased. The rate of boys was higher than that of girls. A higher percentage(17.4%) of infants born in March was registered with earlier date than the actual birth date and most of these registered birth dates were lunar calendar date. This might be related with the age for entering the primary school. The study findings revealed that the birth registration rate within legal due date and accuracy of report have been increased in recent years, but the infant mortality rate derived from the birth registration seems to be very inaccurate. It is suggested to let the medical personnel who delivered the baby report the birth by mail directly to the current address of parent while infants delivered at home without professional attendant may comply with the present registration system.; Summary

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