Journal of Preventive Medicine and Public Health

Special Article

Current Status of the National Cancer Screening Program in Korea: History, Achievements, and Future Directions: Kyeongmin Lee, Mina Suh, Kui Son Choi; J Prev Med Public Health. 2025;58(4):337-347. Published online June 21, 2025; DOI: https://doi.org/10.3961/jpmph.25.268

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Abstract Summary PDF Supplementary Material

Cancer is the leading cause of morbidity and mortality worldwide. To reduce this burden, the Korean government established the National Cancer Screening Program (NCSP) in 1999, initially offering stomach, breast, and cervical cancer screening to Medical Aid Program (MAP) beneficiaries. By 2019, the NCSP had broadened both its eligible population and the range of cancers screened—stomach, liver, cervical, breast, colorectal, and lung—for both MAP recipients and health insurance beneficiaries. Since its inception, participation and adherence to recommended screening have risen steadily, driven by nationwide policy initiatives and expanded access. Over the past 2 decades, the NCSP has played a key role in reducing the incidence of stomach, liver, colorectal, and cervical cancers while increasing detection at precancerous stages, especially for cervical and colorectal cancers. Five-year relative survival rates for major cancers—most notably stomach, colorectal, and breast—have also improved substantially. Accumulated evidence, including cancer detection rates, stage distribution at diagnosis, and mortality reduction, underscores the program’s effectiveness in facilitating early detection and reducing cancer-specific deaths. Notably, Korea’s mortality-to-incidence ratio for major cancers remains well below the Organization for Economic Cooperation and Development average, illustrating the impact of the nation’s comprehensive cancer control strategies. Continued research, surveillance, and refinement of evidence-based screening guidelines will be critical to further enhancing the efficiency and effectiveness of the NCSP.

Summary

Korean summary
한국의 국가암검진 사업은 도입 이후 지난 20여 년간 암 발생률과 사망률 감소에 크게 기여해왔다. 본 연구에서는 한국의 국가암검진 프로그램의 도입 이후 발전과정을 살펴보고, 암 질병부담 감소에 기여한 주요성과들을 고찰하였다. 또한, 국가암검진의 효과성을 높이기 위해 근거에 기반한 암검진 권고안 개정의 필요성을 논의하고, 향후 국가암검진 사업의 지속적인 성과 향상을 위한 발전방안을 제시하였다.

Key Message
Since its inception, Korea’s National Cancer Screening Program (NCSP) has played a critical role in reducing cancer incidence and mortality over the past two decades. This study presents a comprehensive review of the NCSP’s development and its key contributions to alleviating the national cancer burden. In addition, it emphasizes the necessity of updating cancer screening guidelines in accordance with the latest scientific evidence and outlines strategic directions to further strengthen the program’s effectiveness and long-term outcomes.

Citations

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Practice of Cytopathology in Korea: A 40‐Year Evolution Through Standardization, Digital Transformation, and Global Partnership
Yosep Chong, Ran Hong, Hyeong Ju Kwon, Haeryoung Kim, Lucia Kim, Soon Jae Kim, Yoon Jung Choi
Diagnostic Cytopathology.2026; 54(2): 146. CrossRef
Colorectal cancer incidence, survival analysis and predictions (Monastir, Tunisia: 2002–2030)
Cyrine Bennasrallah, Amani Maatouk, Mariem Kacem, Wafa Dhouib, Hela Abroug, Manel Ben Fredj, Leila Safer, Sonia Zaied, Moncef Mokni, Ines Bouanène, Asma Belguith Sriha, Imen Zemni, Mohamed Ali Chaouch
PLOS One.2026; 21(1): e0339603. CrossRef
Strengthening colonoscopy screening in primary care: A preventive imperative before the coming surge
Manas Pustake, Raman Kumar
Journal of Family Medicine and Primary Care.2026; 15(1): 1. CrossRef
A Clinicopathologic, Molecular, and Prognostic Comparison Between Early- and Late-Onset Colorectal Cancer in Korea: A Single-Center Retrospective Cohort Study
Sung Bin Park, Hoon Sup Koo, Dae Sung Kim, Jieun Ryu, Jieun Shin, Jun Suk Oh, Kyu Chan Huh
Journal of Clinical Medicine.2026; 15(5): 1736. CrossRef
Inequalities in breast cancer incidence and mortality in women with and without disabilities in South Korea: A population-based cohort study
Hee-Yeon Kang, Eunjung Park, Thi Tra Bui, Byungmi Kim, Jin-Kyoung Oh
Preventive Medicine Reports.2025; 59: 103242. CrossRef
Enhancing cancer risk awareness and screening management through artificial intelligence: a narrative review
Jiaxuan Wu, Xiaolong Tang, Qian Zheng, Xinhang Gu, Li Ma, Jinghong Xian, Hui Mao, Jiadi Gan, Guiyi Ji
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Cohort Profile

Etiome Study Using Molecular Epigenetic Markers and Lung Organoid in Korean School Meal Service Workers (Etiome Study in S-meal Workers): Study Protocol: Sungji Moon, Soseul Sung, Sue K. Park; J Prev Med Public Health. 2025;58(3):231-240. Published online April 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.020

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Abstract Summary PDF Supplementary Material: School meal service workers may face an increased risk of lung cancer due to the nature of their work. This study aims to assess environmental exposure levels during occupational cooking among these workers in Seoul, Korea, and to examine the associations with carcinogen-associated biomarkers. Additionally, the study seeks to verify lung carcinogenesis through experiments using lung organoids treated with carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) and particulate matter. Here, we introduce the study protocol and outline our research strategies. This etiome study employs molecular epidemiological approaches involving at least 200 school meal service workers from 25-30 school cafeterias in Seoul, as well as in vitro lung organoid experiments. The study includes a questionnaire survey to analyze workers’ occupational environments, focusing on exposure to hazardous substances such as cooking oil fumes and assessing the use of personal protective equipment (e.g., masks) and the presence of ventilation systems. We measure molecular epigenomic biomarkers, including PAH adducts and metabolites along with methylation markers, in the exposure and control groups. Additionally, lung organoid experiments are performed to investigate the potential for lung cancer development due to respiratory carcinogen exposure in cooks. This study is expected to contribute to health risk assessments and the establishment of preventive strategies for meal service workers.; Summary

Korean summary
조리업 종사자의 폐암 발생 위험도가 높다고 보고되지만 실제 발암 물질에 어느정도 노출되어 있는지 전 세계적으로 아직까지 밝혀진 바 없습니다. 본 연구는 서울시내 학교 조리업 종사자 모집과 발암물질 노출 마커 측정 대한 방법론적인 논문이며 향후 추적 관찰할 수 있는 코호트 연구에 대한 초석 역할을 합니다.

Key Message
Although previous studies have reported an increased risk of lung cancer among cooking workers, the extent of their exposure to carcinogens has not yet been well characterized globally. This study presents the methodology for recruiting school cooking workers in Seoul and measuring biomarkers of carcinogen exposure. It serves as a foundational step toward establishing a prospective cohort for long-term follow-up.

Original Articles

Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer: Binh Thang Tran, Thanh Gia Nguyen, Dinh Duong Le, Minh Tu Nguyen, Nhan P. T. Nguyen, Minh Hanh Nguyen, The Due Ong; J Prev Med Public Health. 2024;57(4):407-419. Published online June 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.090

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Abstract Summary PDF Supplementary Material: Objectives
This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.
Methods
This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.
Results
The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.
Conclusions
FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.; Summary

Key Message
- This first large-scale analysis looks into the financial toxicity faced by patients with cancer in Vietnam, as an example of low- and middle-income countries.
- Financial toxicity was remarkably high prevalent and strongly associated with patient- level factors.
- Patients experiencing financial toxicity tend to use various cost-coping strategies.
- These findings underscore the need for routine screening for financial toxicity risk and interventions.

Health-related Quality of Life in Elderly Asian American and Non-Hispanic White Cancer Survivors: Suzanne Vang; J Prev Med Public Health. 2023;56(5):440-448. Published online September 13, 2023; DOI: https://doi.org/10.3961/jpmph.22.464

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Abstract Summary PDF

Objectives
The purpose of this study was to assess predictors of health-related quality of life (HRQoL) in elderly Asian American and non-Hispanic White cancer survivors.
Methods
We conducted cross-sectional secondary data analyses using the combined datasets from the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey.
Results
Elderly Asian American cancer survivors reported a lower mental HRQoL but a comparable physical HRQoL relative to elderly non-Hispanic White cancer survivors. Stress factors, such as comorbidities, difficulties with activities of daily living, and a history of depressive symptoms, along with coping resources like self-rated health and the ability to take the survey in English, were significantly associated with mental and physical HRQoL. Among elderly Asian American cancer survivors, a significantly lower mental HRQoL was observed among those taking the survey in the Chinese language.
Conclusions
The findings suggest that race exerts a differential impact on HRQoL. Interventions should be designed to address the distinct cultural, linguistic, and systemic needs of elderly Asian American cancer survivors. Such an approach could assist in reducing cancer-related health disparities.

Summary

Key Message
Secondary data analyses of the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey combined datasets reveal that elderly Asian American cancer survivors had poorer mental health-related quality of life (HRQoL) compared to their non-Hispanic White counterparts. Elderly Asian American cancer survivors who did not complete the survey in English had significantly worse mental HRQoL than their Asian American counterparts who did. These findings point to the need for increased research to identify and address the distinct cultural, linguistic, and system-related needs of elderly Asian American cancer survivors in order to optimize HRQoL in this population.

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Association of quality of life in older patients with breast cancer: a cross-sectional study from China
Min Xiao, Lei Ji, Xiaoyan Qian, Xi Chen, Meng Xiu, Zhuoran Li, Heng Cao, Shanshan Chen, Qing Li, Qiao Li, Xiang Wang, Jiani Wang, Yiqun Li, Xiaojuan Zheng, Jintao Zhang, Pin Zhang
BMJ Open.2025; 15(1): e085842. CrossRef
Quality of life in older patients with cancer and related unmet needs: a scoping review
Franziska Springer, Ayumu Matsuoka, Kyoko Obama, Anja Mehnert-Theuerkauf, Yosuke Uchitomi, Maiko Fujimori
Acta Oncologica.2025; 64: 516. CrossRef
Equitable Aging Among Migrants: A Concept Analysis and Model Development for Transcultural Nursing Care
Areej Al-Hamad, Yasin M. Yasin, Sepali Guruge, Kateryna Metersky, Lu Wang, Cristina Catallo, Hasina Amanzai, Zhixi Cecilia Zhuang, Rezwana Rahman, Andy Zhang
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Effectiveness of self-reported management program of cancer patients
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Operational Definitions of Colorectal Cancer in the Korean National Health Insurance Database: Hyeree Park, Yu Rim Kim, Yerin Pyun, Hyundeok Joo, Aesun Shin; J Prev Med Public Health. 2023;56(4):312-318. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.033

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Abstract Summary PDF Supplementary Material

Objectives
We reviewed the operational definitions of colorectal cancer (CRC) from studies using the Korean National Health Insurance Service (NHIS) and compared CRC incidence derived from the commonly used operational definitions in the literature with the statistics reported by the Korea Central Cancer Registry (KCCR).
Methods
We searched the MEDLINE and KoreaMed databases to identify studies containing operational definitions of CRC, published until January 15, 2021. All pertinent data concerning the study period, the utilized database, and the outcome variable were extracted. Within the NHIS-National Sample Cohort, age-standardized incidence rates (ASRs) of CRC were calculated for each operational definition found in the literature between 2005 and 2019. These rates were then compared with ASRs from the KCCR.
Results
From the 62 eligible studies, 9 operational definitions for CRC were identified. The most commonly used operational definition was “C18-C20” (n=20), followed by “C18-C20 with claim code for treatment” (n=3) and “C18-C20 with V193 (code for registered cancer patients’ payment deduction)” (n=3). The ASRs reported using these operational definitions were lower than the ASRs from KCCR, except for “C18-C20 used as the main diagnosis.” The smallest difference in ASRs was observed for “C18-C20,” followed by “C18- C20 with V193,” and “C18-C20 with claim code for hospitalization or code for treatment.”
Conclusions
In defining CRC patients utilizing the NHIS database, the ASR derived through the operational definition of “C18-C20 as the main diagnosis” was comparable to the ASR from the KCCR. Depending on the study hypothesis, operational definitions using treatment codes may be utilized.

Summary

Korean summary
- 국민건강보험공단 자료 기반 연구에서 사용된 대장암의 조작적 정의를 검토하고 각 조작적 정의에 따른 대장암의 연령표준화발생률을 중앙암등록본부에서 보고한 수치와 비교하였다. - 62개의 출판된 문헌을 검토하여 9개의 조작적 정의를 확인하였고 이 중 "C18-C20"이 가장 일반적으로 사용되었다. - "C18-C20"을 주진단으로 정의한 경우의 연령표준화발생률은 중앙암등록본부에서 보고한 연령표준화발생률과 가장 유사하였다.

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Projection of Cancer Incidence and Mortality From 2020 to 2035 in the Korean Population Aged 20 Years and Older: Youjin Hong, Sangjun Lee, Sungji Moon, Soseul Sung, Woojin Lim, Kyungsik Kim, Seokyung An, Jeoungbin Choi, Kwang-Pil Ko, Inah Kim, Jung Eun Lee, Sue K. Park; J Prev Med Public Health. 2022;55(6):529-538. Published online October 17, 2022; DOI: https://doi.org/10.3961/jpmph.22.128

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to identify the current patterns of cancer incidence and estimate the projected cancer incidence and mortality between 2020 and 2035 in Korea.
Methods
Data on cancer incidence cases were extracted from the Korean Statistical Information Service from 2000 to 2017, and data on cancer-related deaths were extracted from the National Cancer Center from 2000 to 2018. Cancer cases and deaths were classified according to the International Classification of Diseases, 10th edition. For the current patterns of cancer incidence, age-standardized incidence rates (ASIRs) and age-standardized mortality rates were investigated using the 2000 mid-year estimated population aged over 20 years and older. A joinpoint regression model was used to determine the 2020 to 2035 trends in cancer.
Results
Overall, cancer cases were predicted to increase from 265 299 in 2020 to 474 085 in 2035 (growth rate: 1.8%). The greatest increase in the ASIR was projected for prostate cancer among male (7.84 vs. 189.53 per 100 000 people) and breast cancer among female (34.17 vs. 238.45 per 100 000 people) from 2000 to 2035. Overall cancer deaths were projected to increase from 81 717 in 2020 to 95 845 in 2035 (average annual growth rate: 1.2%). Although most cancer mortality rates were projected to decrease, those of breast, pancreatic, and ovarian cancer among female were projected to increase until 2035.
Conclusions
These up-to-date projections of cancer incidence and mortality in the Korean population may be a significant resource for implementing cancer-related regulations or developing cancer treatments.

Summary

Korean summary
최근 고령화 시대로 접어들고 암의 위험요인들에 대한 노출률이 변화함에 따라 암의 발생률 및 사망률에 대해서 관찰하는 것은 중요한 일이 되었다. 따라서, 본 연구는 한국인에서 2035년까지의 암에 대한 발생률과 사망률을 Joinpoint regression 모델을 이용하여 예측하였다. 남성에서는 전립선암, 여성에서는 유방암이 연령표준화 발생률이 가장 높았으며 대부분의 연령표준화 사망률은 감소하는 것으로 예상되지만 여성의 유방암, 췌장암, 난소암이 증가될 것으로 예상된다.

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Woojin Lim, Soseul Sung, Youjin Hong, Sungji Moon, Sangjun Lee, Kyungsik Kim, Jung Eun Lee, Inah Kim, Kwang-Pil Ko, Sue K. Park
Cancer Research and Treatment.2025; 57(3): 635. CrossRef
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The Association Between Metabolic Syndrome and Colorectal Cancer Risk by Obesity Status in Korean Women: A Nationwide Cohort Study: Seong-geun Moon, Boyoung Park; J Prev Med Public Health. 2022;55(5):475-484. Published online September 21, 2022; DOI: https://doi.org/10.3961/jpmph.22.286

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to determine the association between metabolic syndrome (MetS) and the incidence of colorectal cancer (CRC) in Korean women with obesity.
Methods
Cancer-free women (n=6 142 486) aged 40-79 years, who underwent National Health Insurance Service health examinations in 2009 and 2010 were included. The incidence of CRC was followed until 2018. The hazard ratio (HR) of MetS for the incidence of colon and rectal cancer was analyzed according to body mass index (BMI) categories, adjusting for confounders such as women’s reproductive factors. In addition, the heterogeneity of associations across BMI categories was assessed.
Results
Women with MetS were at increased risk of colon and rectal cancer compared to women without MetS (HR, 1.20; 95% confidence interval [CI], 1.16 to 1.23 and HR,1.15; 95% CI, 1.11 to 1.20), respectively. The HR of MetS for colon cancer across BMI categories was 1.12 (95% CI, 1.06 to 1.19), 1.14 (95% CI, 1.08 to 1.20), and 1.16 (95% CI, 1.12 to 1.21) in women with BMIs <23.0 kg/m², 23.0-24.9 kg/m², and ≥25.0 kg/m², respectively. The HR of MetS for rectal cancer across corresponding BMI categories was 1.16 (95% CI, 1.06 to 1.26), 1.14 (95% CI, 1.05 to 1.23), and 1.13 (95% CI, 1.06 to 1.20). The heterogeneity of associations across BMI categories was not significant in either colon or rectal cancer (p=0.587 for colon cancer and p=0.927 for rectal cancer).
Conclusions
Women with MetS were at increased risk of colon and rectal cancer. Clinical and public health strategies should be considered for primary CRC prevention with an emphasis on improving women’s metabolic health across all BMI groups.

Summary

Korean summary
한국 여성에서 대사증후군은 대장암 발생과 직장암 발생에 유의한 위험요인으로 보인다. 이는 체질량지수를 층화하고 여성력과 관련된 요인들을 보정하더라도 유의했다. 한국 여성의 대장암 및 직장암 예방을 위해 비만도에 관계 없이 대사증후군 요소를 관리하는 것이 필요하다.

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Special Article

Statin Intake and Gastric Cancer Risk: An Updated Subgroup Meta-analysis Considering Immortal Time Bias: Jong-Myon Bae; J Prev Med Public Health. 2022;55(5):424-427. Published online August 18, 2022; DOI: https://doi.org/10.3961/jpmph.22.209

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Abstract Summary PDF

A retrospective record-linkage study (RLS) based on medical records containing drug prescription histories involves immortal time bias (ITB). Thus, it is necessary to control for this bias in the research planning and analysis stages. Furthermore, a summary of a metaanalysis including RLSs that did not control for ITB showed that specific drugs had a preventive effect on the occurrence of the disease. Previous meta-analytic results of three systematic reviews evaluating the association between statin intake and gastric cancer risk showed that the summary hazard ratio (sHR) of the RLSs was lower than 1 and was statistically significant. We should consider the possibility of ITB in the sHR of RLSs and interpret the results carefully.

Summary

Korean summary
이차자료를 활용하여 구축한 코호트 추적연구는 immortal time bias가 개입될 개연성을 염두에 두어야 한다. 이들 연구결과들을 제외한 메타분석 결과 스타닌 복용에 따른 위암발생 위험 감소는 관련성이 없다는 결과를 도출하였다.

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Statin repurposing in gastrointestinal cancer: from metabolic reprogramming to immunoregulation
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Journal of Leukocyte Biology.2025;[Epub] CrossRef
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Shih-Wei Lai, Bing-Fang Hwang, Yu-Hung Kuo, Chiu-Shong Liu, Kuan-Fu Liao
Frontiers in Endocrinology.2023;[Epub] CrossRef

Original Articles

Estimation of Utility Weights for Prostate-related Health States in Korea: Seon-Ha Kim, Minsu Ock, Min-Woo Jo, Sungchan Park; J Prev Med Public Health. 2022;55(3):243-252. Published online May 4, 2022; DOI: https://doi.org/10.3961/jpmph.21.426

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Abstract Summary PDF Supplementary Material

Objectives
Very limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method.
Methods
Seven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state.
Results
The mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis.
Conclusions
Our findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.

Summary

Korean summary
이 연구는 일반인구집단을 대상으로 7개의 전립선 암 상태와 전립선 비대증, 발기부전상태의 효용값을 표준기회선택법을 이용하여 산출하였다. 전립선암 상태에 따라 평균 효용값은 0.281에서 0.779범위였다. 연구 결과는 전립선 관련 상태의 중재의 효용 계산이나 경제성 평가에 활용할 수 있을 것이다.

Citations

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Improving Collaborative Engagement in Health State Valuation: A Scoping Review of Current Practices and Emerging Recommendations
Philip A. Powell, Victoria Gale, Gurdas Singh, Anthea Sutton, Janine Verstraete, Nancy Devlin, Michael Herdman, Simone Schieskow, Jill Carlton
PharmacoEconomics.2026; 44(2): 141. CrossRef
Systematic literature review and meta-analysis of health state utility values in metastatic castration-resistant prostate cancer
Elena Castro, Rhett Figliuzzi, Sarah Walsh, Samantha Craigie, Jonathan Nazari, Alexander Niyazov, Imtiaz A Samjoo
The Oncologist.2025;[Epub] CrossRef

Lung Cancer Screening With Low-dose Chest Computed Tomography: Experience From Radon-contaminated Regions in Kazakhstan: Alexandra Panina, Dilyara Kaidarova, Zhamilya Zholdybay, Akmaral Ainakulova, Jandos Amankulov, Dias Toleshbayev, Zhanar Zhakenova, Arman Khozhayev; J Prev Med Public Health. 2022;55(3):273-279. Published online April 14, 2022; DOI: https://doi.org/10.3961/jpmph.21.600

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