| Home | E-Submission | Sitemap | Contact Us |  
J Prev Med Public Health > Volume 47(4); 2014 > Article
Moore: Cancer Control Programs in East Asia: Evidence From the International Literature


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.


Cancer control programs must be based on specific plans backed up by legislation, and although there are ostensibly such plans drafted by almost all of the countries of Eastern Asia, only from Japan[1,2] and Korea[3] have they been published in detail in the PubMed accessible literature. Components of a National Cancer Control Program are 1) assessment of burden, 2) risk factor determination, 3) primary prevention, 4) secondary prevention, 5) therapeutic intervention, and 6) palliative care. The present review concerns the present status of such programs in the different countries of East Asia, with an especial focus on findings reported in PubMed accessible scientific journals. A very general idea of the trends in research in the different areas is given by the graphs of Figure 1, depicting change in numbers of citations for China, Taiwan, Korea, Japan, Thailand, and Australia, for comparison, found with key words of A) cancer registry, B) cancer risk factors, C) tobacco control, D) cancer screening, E) cancer treatment, and F) cancer palliative; limited to the Title/Abstract for five year periods (1995-2000, 2001-2005, 2006-2010, 2011-now). Although increase over time has been general, different countries appear to be placing different emphases in their research efforts, like Japan and China for registration, Korea for screening, China for smoking, and Japan for palliative care.
In the literature accessible, only Japan and Korea have published comprehensive details of their programs although other countries are in the process of doing so. Cancer has been the leading cause of death in Japan since 1981 and a Cancer Control Act was approved in June 2006, and the Basic Plan to Promote Cancer Control program was approved to cover 2007 to 2011. A Phase Two Basic Plan was approved by the Japanese Cabinet in June 2012. Although the first plan was limited to medicine or medical care, the second plan was broadened to include social undertakings such as patient support in terms of job acquisition or student education for an in-depth understanding of cancer[1,4].
Cancer has been the leading cause of death in Korea since 1983 and the government formulated its first 10-year plan for cancer control in 1996. In 2000, the National Cancer Center was created and the Cancer Control Division was set up within the Ministry of Health and Welfare. The Cancer Control Act was legislated in 2003[3], covering anti-smoking campaigns, hepatitis B virus (HBV) vaccination, cancer registration and networking, promotion of R&D activities for cancer control, education and training for cancer control and prevention, operation of the national cancer information center, operation of the mass screening program for five common cancers, management of cancer patients at home, financial support for cancer patients, and designation of regional cancer centers[3]. The government has also been very active in providing the necessary legal environment for cancer registration while safe-guarding the privacy of individual patients.
It is to be hoped that more emphasis will be placed in the future on open publication of national cancer control plans and programs for comparison and mutual assistance in efforts to control cancer. In addition, more stress could be placed on region-wide cooperation. For example with a stated-preference approach, clinical experts from Australia, China, Japan, Korea, Taiwan, and the United States valued dimensions of hepatocellular carcinoma control and stressed needs for greater political and public awareness and improved management of lifestyle risk factors across the region[5].


High quality population-based cancer registration data are the basis of any cancer control program and over the last 30 years a large number of registries have been set up which are considered adequate for inclusion in Cancer Incidence in Five Continents series[6-12]. Although the absolute number of such registries from East Asia has been increasing (Table 1) that of countries has not, reducing from eight in 1997 and 2002 to seven in 2007 and 2013, with no data included from Mongolia, Viet Nam, Laos, Cambodia, Myanmar, Indonesia or East Timor.
To a certain extent the Globocan effort of International Agency for Research on Cancer (IARC) provides a more comprehensive, if less accurate, picture[13-15] and other coordinated efforts have provided data for South-East Asia for example[16]. In addition, single papers have appeared in the literature for Laos[17], Indonesia[18], and Mongolia[19]. Results from Globocan for the five most prevalent cancers in males and females are compared with those from individual registries from Cancer Incidence in Five Continents (CIV) or individuals registries in Figure 2 for North-East Asia and Figures 3 and 4 for South-East Asia. As can be seen there is considerable variation among leading cancers, lung in males generally sharing first place with liver cancer in the mainland countries and more with colon and prostate in Peninsular and Island North-East Asia. Nasopharyngeal cancer is only within the first five cancers in Viet Nam, Brunei, Indonesia, and Malaysia. Of interest is the very low level of gastric cancer in Indonesia. In females almost everywhere in the South-East region, breast and cervical cancer occupy the first two spots, with the exception of Khon Kaen with high liver, Lampang with high lung and Hanoi with many stomach cancers in females. Especially within Thailand, there is major variation between regions, pointing to the necessity for local population-based cancer registration.
In North-East Asia (Figure 2), Korea and Japan continue to demonstrate high stomach cancer rates, not found in many Chinese registries, while liver is a major problem in China and Korea but not so prevalent in Japan, except in Osaka. Interestingly, in Chinese and Japanese males in Hawaii, as with Philippinos, prostate cancer is number one, as in the Western population.
In addition to the IARC related data, papers are regularly published for cancer incidence and mortality in China[20], Korea[21], and Japan, with emphasis on cohort effects[22,23]. For example, one recent publication covered the year 2009 for the Chinese National Central Cancer Registry 104 registries covering 85 470 522 people (57 489 009 in urban areas and 27 981 513 in rural areas)[20]. A recent focus has been on establishing more rural registries since estimated cancer mortality for all sites from national cancer registration was found to be representative for China, especially in urban areas, but mortality was over-estimated for rural areas, with large differences in some cancer site-specific mortalities[24]. Mortality data also available for Viet Nam[25] and Laos[26].
In Korea the coverage is nearly 100% and a comparison of the cancer incidence rates between the national cancer registry and insurance claims data generated very similar findings[27], while Japan is emphasizing hospital-based registries to provide a broad base picture of cancer statistics[28]. In Thailand there are now 6 population-based registries reporting to CIV[12] and the regional cancer centers are now coming on line so that the total population-based registries is now 16, with a plan for coverage of every region of the country. Unfortunately the situation remains less clear for the other countries of South-East Asia, where coverage by high quality registries remains relatively low. Very recently, Korean registry specialists have focused on generating a single measure of cancer burden by summing incidence and mortality scores[29].
Regional data for trends over time have been published for North-East Asia[30]; and South-East Asia[31,32] and in individual countries like Thailand for cancers overall[33]. Many papers have appeared documenting increase in cancers of the colorectum, urinary bladder and kidney, prostate, breast, endometrium and thyroid, and decrease in the oesophagus, stomach, liver and cervix[30-32,34-36]. With thyroid cancer the increase has been so marked that it is now the most common cancer in women in Korea[37]. In the oesophagus and lung cancer cases the situation is complicated by opposing tendencies for squamous cell carcinomas, generally decreasing, and adenocarcinomas, on the increase[30-32].
In recent years, more attention has been placed on survival, for example by a collaborative group in selected registries in East Asia[38]. Data on population based survival have been published from Japan[23,39] and Korea where cancer patients showed relatively favorable stage and 5-year survival, suggesting a potential contribution of the national cancer screening program (NCSP)[40]. No changes were detected in the mortality for colorectal, female breast or cervical cancers after the establishment of national screening programs for these cancers[36]. Secular trends in breast cancer mortality were compared for five East Asian populations: Hong Kong, Japan, Korea, Singapore, and Taiwan[41].
Other relatively new developments regarding cancer registries include focusing on clustering, for example of breast cancer in Japan[42] and colorectal cancer in Malaysia[43]. Demonstration of quality of care measurement using the Japanese liver cancer registry has been reported[44] and improving trends in ‘cure’ fraction from colorectal cancer by age and tumour stage between 1975 and 2000 was established using population-based data for Osaka[45]. In one cooperative effort, cancer registries from eight economies in the Asia-Pacific region—Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand— joined together to find ways that they can contribute to oncology drug access[46]. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes[47].
Clearly cancer registration is continuing to attract a great deal of research attention in all major countries of East Asia, with increasing rates of PubMed accessible papers over the last 17 years (Figure 1A).



In general, evidence for risk and beneficial factors covered in reviews of North-east and South-East Asia[30-32] are in line with the data summarized in the World Cancer Research Fund/American Institute for Cancer Research (2007) report[48,49] (Table 2 for findings for the alimentary tract, lung and prostate cancer, and Table 3 for female cancers). Cancer risk factors also continue to be a major focus of research attention in all major countries of East Asia, with increasing rates of PubMed accessible papers over the last 17 years (Figure 1B).
In 2005, 55% of cancer among men was attributable to preventable risk factors in Japan. The corresponding figure was lower among women, but preventable risk factors still accounted for nearly 30% of cancer. In men, tobacco smoking had the highest population attributable fraction (30% for incidence and 35% for mortality, respectively) followed by infectious agents (23% and 23%). In women, in contrast, infectious agents had the highest PAF (18% and 19% for incidence and mortality, respectively) followed by tobacco smoking (6% and 8%)[50]. In Korea, fractions of all cancers attributable to infection were 25.1% and 16.8% for cancer incidence in men and women, and 25.8% and 22.7% of cancer mortality in men and women, respectively[51]. Among infection-related cancers, Helicobacter pylori was responsible for 56.5% of cases and 45.1% of deaths, followed by HBV (23.9% of cases and 37.5% of deaths) and human papillomavirus (HPV, 11.3% of cases and 6% of deaths) and then by hepatitis C virus (HCV, 6% of cases and 9% of deaths). The health burden of cancers due to smoking was 2038.9 disability adjusted life years (DALYs) per 100 000 individuals in men and 732.2 DALYs per 100 000 individuals in women, cancers of the trachea, lungs and bronchus are the leading causes of health and economic burden[52]. In Chinese males, 4.40% of all cancers due to alcohol, mostly in liver[53], and 30% to tobacco[54].

Organ Specific Factors

Oral cavity

Betel chewing and tobacco are the major risk factors. Given the role for tobacco, for a priori reasons vegetables should be protective, as concluded by the World Cancer Research Fund/American Institute for Cancer Research[48] but there is only limited information available in Asia. Alcohol is not a major influence. There is limited evidence of protection by coffee drinking. while hot drinks may confer some risk. A possible viral etiology has long been discussed and HPV-related sites like oropharynx increased significantly over the period 1999 to 2009, particularly in young men (30 to 59 years), whereas HPV-unrelated sites such as larynx and hypopharynx decreased markedly in both sexes[55].


The generally accepted risk factors are genetic and exposure to carcinogens through consumption of fish/However a recent paper did not support the idea that changes in salted fish consumption could explain secular trends of nasopharyngeal cancer rates in Hong Kong and worldwide, while emphasizing potentially protective effects of vegetable consumption[56].


Again betel chewing and tobacco, with vegetable and fruit intake as protective. Very hot drinks may confer some risk, as do other sources of trauma, including salt and grit, and deficiency in zinc or other metals in the diet. These factors all impact on squamous cell carcinoma development. In the adenocarcinoma case, obesity is the main risk determinant.


Atrophic gastritis due to heavy infection with Helicobacter pylori and high salt intake are established risk factors, with tobacco, while consumption of vegetables and fruits can be recommended. The very low incidence of gastric cancer in Indonesia has been attributed primarily to very low rates of infection with helicobacter[57]. Alcohol does not appear to be a major influence.

Colon and rectum

The obvious factors which need to be avoided as preventive measures are obesity and excessive alcohol consumption. Furthermore a diet high in meat and fat is detrimental, while consumption of vegetables and fish as well as physical exercise are protective. Tobacco and dietary carcinogens may be secondary risk factors.


Roles are established for carcinogen exposure and viral and parasite infection, with lesser roles for alcohol and tobacco. Vegetables and other dietary influences are generally protective. Due to the link with steatohepatitis, avoidance of overweight may also be recommended.


The obvious factors which need to be avoided as a preventive measure are tobacco and particulate matter that can be breathed in like cooking oils, coal dusts and asbestos, for example. Vegetables and fruits are protective.


There is no obvious factor which needs to be avoided, with the possible exception of dairy foods. Regarding prevention, consumption of soy products and vegetables, as well as fruit, would appear to warrant attention.


Post-menopausal obesity, early menarche and late menopause, and hormone therapy are risk factors. Tobacco and alcohol could play minor roles. The strongest protective factors would appear to be exercise, pregnancy, lactation, and consumption of soy products, followed by intake of fish and vegetables. Recently evidence has been present of pollution as a factor[58].


The obvious factors which need to be avoided as preventive measures are infection with high risk human papilloma viruses and smoking, and to a lesser extent sexually transmitted disease. Dietary factors appear to have marginal significance.



Awareness about cancer risk factors and symptoms varies greatly between and within societies in East Asia, and especially in countries like Malaysia and Indonesia where belief in faith healers remains strong. The situation in North-East Asia, Thailand, Singapore, and Viet Nam appears more promising however.


All of the countries of North-East and South-East Asia are implementing vaccination against HBV for control of liver cancer and practical evidence of efficacy has already been published for Taiwan[59] and Thailand[60], although in places like Mongolia where infection rates are high for HCV, for which there is no vaccine, the benefit may be limited[61].
With regard to high risk HPV vaccination the situation is fluid and most countries have yet to introduce a national program, at least as evidenced by the literature, an exception being Japan in 2011[62]. It also appears, however, to be part of the program in Malaysia, where a number of papers have appeared regarding willingness for parents to have their daughter vaccinated and positive attitudes of students themselves and medical personnel[63-65].

Tobacco Control

Some countries in Asia have a long history of tobacco control activities beginning in the 1970s, and World Health Organization (WHO)’s Western Pacific Region is still the only region where all countries have ratified WHO’s Framework Convention on Tobacco Control[66]. This is an epoch making event for the world tobacco control. However, in Japan, almost nothing has been changed due to the intrusion of the tobacco industry and Ministry of Finance. Similarly in Korea, smoking still is possible in public places like restaurants. The Japan Society for Tobacco Control has made a passive smoking prevention bill and presented a petition to the Minister of Health, Labor and Welfare with related 4 bills. Cooperation, money and champion are the three most important issues that must be pursued[67]. Kanagawa Prefecture became the first subnational government in Japan to implement an ordinance for the prevention of exposure to secondhand-smoke in public facilities, aiming to protect people from the negative health impacts of secondhand smoke; however, it has wide exemptions especially for hospitality and leisure business establishments[68]. China’s attitudes and actions in the negotiations: the aspiration to be a responsible power; concerns about sovereignty; and domestic political economy he Framework Convention on Tobacco Control[69]. China faces intractable political, structural, economic, and social barriers in tobacco control, which make the whole-hearted implementation of Framework Convention on Tobacco Control measures a painstaking process[70]. In Thailand, despite active anti-smoking policy measures[71], smoking prevalence among adolescents apparently increased from 2005 to 2008[72].
Where anti-smoking initiatives have taken hold however, incidence rates of lung cancer are declining as in Viet Nam[73]. Reducing the smoking prevalence from 35% in 2007 to 0% in 2017 in Japan was estimated to avoid 333 900 all-cancer deaths and 171 100 lung cancer deaths in 20 years[74]. In a recent review for China, Korea, and Japan[75] findings indicated an urgent need for the following set of policies: raise cigarette prices to increase the quit attempt rate, particularly among adult men; develop a multi-component quitting assistance system to provide adequate assistance for smoking cessation; implement effective smoke-free policies in workplaces and public places to reduce exposure to passive smoking; and rebuild the administrative structure to denormalise tobacco industry activities. Reducing tobacco use through raising tobacco taxes/prices in China needs to take into account cost/price-reducing behaviour[76].



Clearly, the level of importance of a particular cancer in any given country will depend on the prevalence, as well as emotional and treatment costs. In Korea, mean financial 5-year net costs per patient were found to vary widely, from 5647 US dollars for thyroid cancer to 20 217 US dollars for lung cancer, advanced stage at diagnosis being associated with a 1.8-2.5-fold higher total cost[77], so that early detection and down-staging of cancers is of obvious importance. On way to improve early detection and presentation is by increasing awareness of the general public about warning signs and symptoms and the efficacy of timely treatment, so that delay in presentation does not occur. This may be especially important in countries like Malaysia where belief in spiritual healers is very strong and can cause delay in seeking help from hospital-based clinicians[78,79]. The other is by population-based screening.
Whether screening will be beneficial and cost-effective is often unclear but the country with the most highly developed and attended screening program in East Asia, Korea, has generated compelling evidence that cost for life year saved is below the per capita gross domestic product for most major cancers[80-82].
Population-based programs have now been described in the literature for Japan, Korea, Taiwan, Singapore, and Thailand, and are beginning in other countries like China (Figure 2). The literature is rapidly increasing (Figure 1D), especially in Korea, where lifetime screening rates for gastric, liver, colorectal, breast, and cervical cancers were 77.9%, 69.9%, 65.8%, 82.9%, and 77.1%, respectively[83]. Lower rates generally prevail in Japan, but one problem with all Asian countries is that there is almost no focus on any negative consequences of screening, in terms of overdiagnosis and distress, and more emphasis needs to be placed on actual practical benefit and relative costs of screening and awareness programs to increase early detection of tumours[84].
Lack of trust in the NCSP and cancer screening units; fear of being diagnosed with cancer; discomfort or pain from the screening procedure; lack of time, lack of knowledge about cancer screening or lack of awareness of the existence of the NCSP; physical disability or underlying disease; and logistic barriers are the most common reasons for failure to follow advice and guidelines for screening along with no symptoms[85]. Client reminders for breast and cervical cancer screening increased attendance rates in smaller municipalities in Japan[86] and removing out-of-pocket costs improves female cancer screening uptake in Japan but may not be cost-saving[87]. Interventions such as individualized counseling, letters and reminders, or other individual-targeted strategies, especially for those with lower socioeconomic status are required to increase participation and reduce disparities in cancer screening[88,89]. A very brief coverage of recent findings at the organ-tissue level is given below.


Valuation of plasma Epstein-Barr virus DNA load to distinguish nasopharyngeal carcinoma patients from healthy high-risk populations in Southern China was found to have limited value in screening patients who have early stage nasopharyngeal cancer and predicting nasopharyngeal cancer development[90].


While there are no country-wide population-based screening for esophageal cancer, estimating the costs of early diagnosis and treatment with screening in three high risk areas in China did reveal great cost savings[91].


Endoscopic screening for gastric cancer is reported to give a higher sensitivity than radiographic screening[92]. In South Korea, endoscopy was the most cost-effective strategy[80] sensitivity being better with equal specificity to upper-gastrointestinal series[93]. The fluoro-D-glucose positron emission tomography (FDG-PET) screening program in Japan detected some cases of early-stage gastric cancer, but this was not achieved using FDG-PET alone but in combination with gastric endoscopy[94]. In a health economic assessment for screening of gastric cancer in a high risk population in northeastern China was demonstrated to be cost-effective[95].


Based on the American Cancer Society recommendations, a fecal occult blood test every year should be performed. However, among East-Asian country, this test was most popular in only Japan (76.9%) and Indonesia, sigmoidoscopy every 5 years and total colonoscopy every 10 years being the most popular methods[96]. In a multi-center study of adults 50 years and older, 27% had undergone previous colorectal cancer testing; the Philippines (69%), and Japan (38%) had the highest participation rates, whereas Malaysia (3%), Indonesia (3%), and Brunei (13.7%) had the lowest rates[97]. Organised colorectal cancer screening in Lampang Province, Thailand has generated preliminary results which should lead to introduction of a national program[98] .
Recently, attention has concentrated on FDG-PET screening but this modality alone cannot detect all colon lesions[99]. One problem with all methods is compliance with follow-up tests after a positive result. In Korea, after positive fecal occult blood test, colonoscopy rates increased from 17.9% in 2004 to 27.6% in 2008, while double contrast barium enema decreased from 43.4% in 2004 to 11.0% in 2008, showing that endoscopy is preferred[100].


In Korea, the screening of liver cancer is recommended to those aged 40 or old who are HBs-antigen or anti-HCV positive or have liver cirrhosis[101]. An ultrasonographic examination and alpha-feto protein test is done every 6 months for these high risk groups. In Chinese high risk groups, extensive use of des-γ-carboxyprothrombin screening of HBV-related chronic liver disease promoted the early detection of hepatocellular carcinoma[102].


Although presently limited to Japan, results suggest that wide implementation of low-dose chest computed tomography screening may decrease lung cancer mortality[103].


While most results indicate prostate cancer screening to be not cost-effective, those patients diagnosed by Prostate-Specific Antigen testing have better prognosis than those with symptoms[104].


Although breast self examination is generally recommended to increase awareness, there are doubts as to whether it is efficacious in reducing mortality[105]. Furthermore, limited effectiveness of screening mammography in addition to clinical breast examination by trained nurse midwives was found in rural Jakarta, Indonesia[106] because of barriers to appropriate treatment of women who are identified as having breast cancer, as reported earlier in the Philippines[107]. While breast cancer screening participation rates are high in Koreans, they are lower elsewhere and in Chinese women they vary greatly by age, region, and insurance status[108]. In order to improve the mammographic screening rate in Japan, quality-controlled mammography as a stand-alone examination should be promoted, and performed biennially for women aged 50 to 74 years[109].
Regarding alternative methodology, ultrasonography may be more sensitive than mammography in detecting breast cancer in women, especially in those with high-density and relatively small breasts[110]. However, this was not confirmed in Thailand[111]. Cost-effectiveness needs to be improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits[82].


The Pap smear is generally applied in Eastern Asian countries for cervical cancer screening and in Thailand it has recently achieved excellent coverage[112]. However, women who have been screened multiple times are at substantially lower risk than those only screened a few times suggesting that the quality of the screening could be improved[113]. An alternative for low-middle income countries is visual inspection with acetic acid and in a large project involving 45 000 women in Indonesia, 83.1% of visual inspection acetic acid-positive women sought cryotherapy[114]. Recent interest has focused on two HPV DNA tests-care HPV and Hybrid Capture 2[115] and detection of 14 high-risk HPVs with HPV 16 and HPV 18 genotyping by polymerase chain reaction[116].
Three strategies to expand screening coverage and ensure prompt treatment for cervical cancer have been proposed: strengthening community mobilization and advocacy activities, modifying the service delivery model to encourage a single visit approach to screening and treatment, and working to gain men’s support[117].


In many countries of East Asia the clinical emphasis within cancer control programs is for better access to treatment and diagnostic services outside of the major cities so that specialist cancer hospitals are being designated, as in Japan, or regional cancer centers established, as in China, Korea, Thailand, and Viet Nam. There is a great deal of research continuing to be performed (Figure 1E) and there is now a need to measure a wide range of outcomes, including quality of care and quality of life measures. One recent multinational focus has been on cost-effectiveness in cancer treatment[118].


Generally palliative care has lagged behind other areas of cancer control programs, although the literature from Japan in particular has been rapidly increasing over the last 12 years (Figure 1F). Two areas deserve particular attention, access to pain control and availability of specialised trained staff. While a lack of both health care personnel fully trained in palliative care and specialist palliative care services has been reported in Thailand[119] with difficulties in opioid access[120], Japan has been successful in increasing full-time palliative care physicians and nurses and the median number of annual referrals[121]. Although late referral to palliative care services has been described as one problem in Korea[122], long-term cancer survivors can benefit from the Health Partner Program to become health coaches[123]. There are reported to be physician-related and population-related barriers which impede palliative care development in China[124].
There is a need to measures a wide range of outcomes, including quality of care and quality of life measures specifically designed for palliative care populations, whether patients died where they actually preferred, the changes in physicians and nurses at a regional level; adopts qualitative studies along with quantitative evaluations; and the intervention is without a fundamental change in health care systems[125].


Cancer control programs require a great deal of resources, both financial and human, and the evidence-base for particular measures must be efficiently generated and evaluated in order for governments to give the necessary emphasis within their Health Ministries. This author has repeatedly argued for the population-based regional cancer registry as a hub for research to all aspects of cancer control, from incidence through to clinical epidemiology and palliative care[126,127]. The essential expertise in epidemiological methods and statistical analysis are at hand and generally also the human contacts within different hospital departments without which it is impossible to collect reliable registry data. The local cancer registry research centre can offer a location for training with input from International organizations like WHO and Union for International Cancer Control, providing research capacity and the essential data collection potential, not only for incidence, mortality and survival but also for assessment of risk factors, efficacy, barriers and facilitators of screening, prognostic factors in clinical cases, and satisfaction with palliative and other services. It is to be hoped that special publications for cancer registration or other areas of cancer control can be organized as a follow-up to the ‘Cancer registration in Asia in the year 2000: past, present and future’ earlier produced with input from the IARC[128]. Provision of up-to-date information to the local community in laymens language should also assist in transferring messages concerning national cancer control programs, at whatever stage in the processes contributing to neoplasia (Figure 5). In addition, data linkage units may be used to link cancer registry data with administrative data on vaccinations, cancer screening, co-morbidity and treatment, which significantly increases the linked data available for routine cancer surveillance[47].
Clinical registries, where they exist, provide fundamental data that can be used to validate administrative data for evaluation of treatment and population-based surveillance.
How the cancer control programs in East Asia develop in future will be greatly influenced by the research work conducted to answer specific questions. Reviews like the present brief introduction will hopefully contribute to this important aim.

Conflict of Interest

The author has no conflicts of interest with the material presented in this paper.

Figure 1.
Results of literature searches of PubMed for selected countries. (A) Cancer registration, (B) cancer risk factors, (C) cancer tobacco control, (D) cancer screening, (E) cancer treatment, and (F) cancer palliation.
Figure 2.
Percentage data for the five most prevalent cancers in populations of mainland North-East Asia. Country data are from Globocan 2002 and individual registry data from Curado et al., 2007[11] (after Moore et al., 2009[1]).
Figure 3.
Percentage data for the five most prevalent cancers in countries of mainland South-East Asia. Country data are from Globocan 2002 (Ferlay et al., 2004[13], 1Curado et al., 2007[11], and 2Parkin et al., 2002[10]) after Moore et al., 2009[1].
Figure 4.
Percentage data for the five most prevalent cancers in countries of peninsular and island South-East Asia. Country data are from 1Globocan 2002 (Ferlay et al., 2004[13]), others Curado et al., 2007[11]; 2Nyunt et al., personal communication (after Moore et al., 2009[1]).
Figure 5.
Stages in processes contributing to neoplasia and cancer control programs.
Table 1.
Numbers of East Asian registries in the Cancer Incidence in Five Continents series of International Agency for Research on Cancer
 Beijing/Changle/Cixian/Wuhan 1 1
 Guangzhou/Harbin 1
 Hainin/Jiaxing/Macao/Yangchen/Yanting/Zhongshan 1
 Hong Kong/Shanghai 1 1 1 1 1 1 1
 Jiashan 1 1 1
 Qidong 1 1 1 1
 Tianjin 1 1 1 1
 Aichi/Fukui 1 1
 Hiroshima 1 1 1 1 1 1
 Miyagi/Osaka 1 1 1 1 1 1 1
 Nagasaki 1 1 1 1 1 1
 Saga 1 1 1 1
 Yamagata 1 1 1
 Busan/Daegu/Seoul 1 1 1
 Daejeon/Gwangju/Inchon/Ulsan/Jeju 1 1
 Kanghwa 1 1
 Penang 1 1
 Sarawak 1
 Manila 1 1 1 1 1
 Rizal 1 1 1 1
Singapore1 1 1 1 1 1 1 1
 Chiang Mai 1 1 1 1 1
 Chonburi 1
 Lampang 1 1 1
 Khon Kaen 1 1 1 1
 Bangkok 1 1
 Songkhla 1 1 1
Viet Nam
 Ho Chi Minh City 1
 Hanoi 1 1
Total 4 8 16 17 28 26 32

1 National Cancer Registry: Chinese, Malay, and Indian.

Table 2.
East Asian evidence for modifying factors for the alimentary tract, lung, and prostate
SE NE World1 SE NE World1 SE NE World1 SE NE World1 SE NE World1 SE NE World1
 Carcinogens ++2 + NA ND +2 NA ++3 ++3 NA + + NA ++4 ++4 NA ND ND NA
 Tobacco ++ ++ NA + ++ NA + ++ NA + + NA +++ +++ NA ND ND NA
 Alcohol ND ++ +++ ND ++ +/- ND + +/- ND + + ND +/- +/- ND ND +/-
 Obesity ND + +/- ND + +/- ND + +/- ND + +++ ND ND +/- ND + +/-
 Exercise ND ND +/- ND -- +/- ND - +/- ND -- --- ND ND - ND - +/-
 Vegetables ND ND -- ND -- -- -- -- -- -- -- - - -- - ND -- --
 Fruits ND ND -- ND - -- - - -- - - - - - -- ND - -
 Fat ND ND +/- ND -- +/- ND ++ +/- ND ++ + ND ND + ND + +/-
 Meat ND ND +/- ND ND + ND ND + + + +++ ND ND + ND ND +/-
 Fish ND ND +/- ND ND + ND -- + ND -- - ND - +/- ND - +/-
 Tea/coffee ND - +/- ND - +/- ND +/- +/- ND - NA ND - +/- ND - +/-

SE, South-East; NE, North-East; NA, not applicable; ND, no data; -/--, slight/weak protection; +/-, no effect; +/++/+++, slight, weak, strong risk.

1 World Cancer Research Fund, American Institute for Cancer Research 2007.

2 Betel/human papillomavirus.

3 Helicobacter pylori.

4 Asbestos/particles.

Table 3.
Asian evidence for modifying factors for breast and cervix
Breast cancer
Cervical cancer
SE NE World1 SE NE World1
 Carcinogens ND + NA +++2 +++2 +++2
 Tobacco ND + NA ++ ++ ++
 Alcohol + ND +++ ND ND +/-
 Obesity ND ++ ++ ND ND +/-
 Exercise ND -- - ND ND +/-
Reproductive factors
 Menarche + ++ NA ND ND NA
 Menopause + ++ NA ND ND NA
 Hormones + + NA ND ND NA
 Pregnancy - -- NA + + NA
 Lactation -- -- -- ND ND +/-
 Vegetables - - +/- - ND -
 Fat ND + + ND ND +/-
 Fish ND -- +/- ND -- +/-
 Soy food -- -- NA ND ND +/-

SE, South-East; NE, North-East; ND, no data; NA, not applicable; -/--, slight/weak protection; +/-, no effect; +/++/+++, slight, weak, strong risk.

1 World Cancer Research Fund, American Institute for Cancer Research 2007.

2 Human papillomavirus.


1. Moore MA, Sobue T. Cancer research and control activities in Japan: contributions to international efforts. Asian Pac J Cancer Prev 2009;10(2):183-200.

2. Tanaka H. Advances in cancer epidemiology in Japan. Int J Cancer 2014;134(4):747-754.
crossref pmid
3. Yoo KY. Cancer control activities in the Republic of Korea. Jpn J Clin Oncol 2008;38(5):327-333.
crossref pmid
4. Monden M. The basic plan to promote cancer control in Japan. Gan To Kagaku Ryoho 2013;40(5):559-564 (Japanese).
5. Bridges JF, Joy SM, Gallego G, Kudo M, Ye SL, Han KH, et al. Needs for hepatocellular carcinoma control policy in the Asia-Pacific region. Asian Pac J Cancer Prev 2011;12(10):2585-2591.
6. Waterhouse JA, Muir CS, Powell J, Shanmugaratnam K, Peacham D, Whelan S, et al. Cancer incidence in five continent. Vol. IV. Lyon: International Agency for Research on Cancer; 1982.

7. Muir CS, Waterhouse J, Mack T, Powell J, Whelan SL. Cancer incidence in five continents. Lyon: International Agency for Research on Cancer; 1987.

8. Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J. Cancer incidence in five continent. Vol. IV. Lyon: International Agency for Research on Cancer; 1992.

9. Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer incidence in five continent. Vol. VII. Lyon: International Agency for Research on Cancer; 1997.

10. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB. Cancer incidence in five continent. Vol. VIII. Lyon: International Agency for Research on Cancer; 2002.

11. Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer incidence in five continent. Vol. IX. Lyon: International Agency for Research on Cancer; 2007.

12. Forman D, Bray F, Brewster DH, Gombe Mbalawa C, Kohler B, Pineros M, et al. Cancer incidence in five continent. Vol. X; [cited 2014 Jul 21]. Available from: http://ci5.iarc.fr.

13. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: cancer incidence, mortality and prevalence worldwide. Lyon: IARCPress; 2004.

14. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0. Cancer incidence and mortality worldwide: IARC CancerBase No. 11 [cited 2014 Jul 21]. Available from: http://globocan.iarc.fr.

15. Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer 2013;132(5):1133-1145.
crossref pmid
16. Kimman M, Norman R, Jan S, Kingston D, Woodward M. The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev 2012;13(2):411-420.
crossref pmid
17. Chaleunvong K, Kamsa-Ard S, Suwanrungruang K, Wiangnon S, Sychareun V, Alounlangsy P, et al. Retrospective appraisal of cancer patients from Vientiane Capital City, Lao People’s Democratic Republic (PDR), seeking treatment in Thailand. Asian Pac J Cancer Prev 2013;14(9):5435-5440.
crossref pmid
18. Wahidin M, Noviani R, Hermawan S, Andriani V, Ardian A, Djarir H. Population-based cancer registration in Indonesia. Asian Pac J Cancer Prev 2012;13(4):1709-1710.
crossref pmid
19. Sandagdorj T, Sanjaajamts E, Tudev U, Oyunchimeg D, Ochir C, Roder D. Cancer incidence and mortality in Mongolia: National Registry Data. Asian Pac J Cancer Prev 2010;11(6):1509-1514.
20. Chen W, Zheng R, Zhang S, Zhao P, Li G, Wu L, et al. The incidences and mortalities of major cancers in China, 2009. Chin J Cancer 2013;32(3):106-112.
crossref pmid pmc
21. Jung KW, Won YJ, Kong HJ, Oh CM, Seo HG, Lee JS. Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010. Cancer Res Treat 2013;45(1):1-14.
crossref pmid pmc pdf
22. Utada M, Ohno Y, Soda M, Kamo K. Estimation of cancer incidence in Japan with an age-period-cohort model. Asian Pac J Cancer Prev 2010;11(5):1235-1240.
23. Ito Y, Nakayama T, Miyashiro I, Ioka A, Tsukuma H. Conditional survival for longer-term survivors from 2000-2004 using population-based cancer registry data in Osaka, Japan. BMC Cancer 2013;13: 304.
crossref pmid pmc
24. Li GL, Chen WQ. Representativeness of population-based cancer registration in China: comparison of urban and rural areas. Asian Pac J Cancer Prev 2009;10(4):559-564.

25. Ngoan le T, Lua NT, Hang LT. Cancer mortality pattern in Viet Nam. Asian Pac J Cancer Prev 2007;8(4):535-538.

26. Nguyen TL, Nguyen DC, Nguyen TH, Vu TT, Lai TM, Le TL, et al. Survey-based cancer mortality in the Lao PDR, 2007-08. Asian Pac J Cancer Prev 2011;12(10):2495-2498.
27. Seo HJ, Oh IH, Yoon SJ. A comparison of the cancer incidence rates between the national cancer registry and insurance claims data in Korea. Asian Pac J Cancer Prev 2012;13(12):6163-6168.
crossref pmid
28. Higashi T, Nakamura F, Shibata A, Emori Y, Nishimoto H. The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan. Jpn J Clin Oncol 2014;44(1):2-8.
crossref pmid
29. Cho KH, Park S, Lee KS, Jang SI, Yoo KB, Kim JH, et al. A single measure of cancer burden in Korea from 1999 to 2010. Asian Pac J Cancer Prev 2013;14(9):5249-5255.
crossref pmid
30. Long N, Moore MA, Chen W, Gao CM, Lai MS, Mizoue T, et al. Cancer epidemiology and control in north-East Asia: past, present and future. Asian Pac J Cancer Prev 2010;(11 Suppl 2):107-148.

31. Moore MA, Attasara P, Khuhaprema T, Le TN, Nguyen TH, Raingsey PP, et al. Cancer epidemiology in mainland South-East Asia: past, present and future. Asian Pac J Cancer Prev 2010;(11 Suppl 2):67-80.

32. Moore MA, Manan AA, Chow KY, Cornain SF, Devi CR, Triningsih FX, et al. Cancer epidemiology and control in peninsular and island South-East Asia: past, present and future. Asian Pac J Cancer Prev 2010;(11 Suppl 2):81-98.

33. Sriplung H, Wiangnon S, Sontipong S, Sumitsawan Y, Martin N. Cancer incidence trends in Thailand, 1989-2000. Asian Pac J Cancer Prev 2006;7(2):239-244.

34. Zhao J, He YT, Zheng RS, Zhang SW, Chen WQ. Analysis of esophageal cancer time trends in China, 1989- 2008. Asian Pac J Cancer Prev 2012;13(9):4613-4617.
crossref pmid
35. Gao J, Xie L, Chen WQ, Zhang SW, Wu QJ, Yang Y, et al. Rural-urban, sex variations, and time trend of primary liver cancer incidence in China, 1988-2005. Eur J Cancer Prev 2013;22(5):448-454.
crossref pmid
36. Katanoda K, Matsuda T, Matsuda A, Shibata A, Nishino Y, Fujita M, et al. An updated report of the trends in cancer incidence and mortality in Japan. Jpn J Clin Oncol 2013;43(5):492-507.
crossref pmid
37. Kweon SS, Shin MH, Chung IJ, Kim YJ, Choi JS. Thyroid cancer is the most common cancer in women, based on the data from population-based cancer registries, South Korea. Jpn J Clin Oncol 2013;43(10):1039-1046.
crossref pmid
38. Tanaka H, Tanaka M, Chen W, Park S, Jung KW, Chiang CJ, et al. Proposal for a cooperative study on population-based cancer survival in selected registries in East Asia. Asian Pac J Cancer Prev 2009;10(6):1191-1198.
39. Matsuda T, Ajiki W, Marugame T, Ioka A, Tsukuma H, Sobue T, et al. Population-based survival of cancer patients diagnosed between 1993 and 1999 in Japan: a chronological and international comparative study. Jpn J Clin Oncol 2011;41(1):40-51.
crossref pmid
40. Jung KW, Won YJ, Kong HJ, Oh CM, Shin A, Lee JS. Survival of korean adult cancer patients by stage at diagnosis, 2006-2010: national cancer registry study. Cancer Res Treat 2013;45(3):162-171.
crossref pmid pmc pdf
41. Shin HR, Masuyer E, Ferlay J, Curado MP; Asian Contributors to CI5 IX4. Cancer in Asia: incidence rates based on data in cancer incidence in five continents IX (1998-2002). Asian Pac J Cancer Prev 2010;(11 Suppl 2):11-16.

42. Katayama K, Yokoyama K, Yako-Suketomo H, Okamoto N, Tango T, Inaba Y. Breast cancer clustering in kanagawa, Japan: a geographic analysis. Asian Pac J Cancer Prev 2014;15(1):455-460.
crossref pmid
43. Shah SA, Neoh HM, Rahim SS, Azhar ZI, Hassan MR, Safian N, et al. Spatial analysis of colorectal cancer cases in Kuala Lumpur. Asian Pac J Cancer Prev 2014;15(3):1149-1154.
crossref pmid
44. Higashi T, Hasegawa K, Kokudo N, Makuuchi M, Izumi N, Ichida T, et al. Demonstration of quality of care measurement using the Japanese liver cancer registry. Hepatol Res 2011;41(12):1208-1215.
crossref pmid
45. Ito Y, Nakayama T, Miyashiro I, Sugimoto T, Ioka A, Tsukuma H, et al. Trends in ‘cure’ fraction from colorectal cancer by age and tumour stage between 1975 and 2000, using population-based data, Osaka, Japan. Jpn J Clin Oncol 2012;42(10):974-983.
crossref pmid
46. Soon SS, Lim HY, Lopes G, Ahn J, Hu M, Ibrahim HM, et al. Roles of cancer registries in enhancing oncology drug access in the Asia-Pacific region. Jpn J Clin Oncol 2012;42(10):974-983.
47. Roder D. What roles should population-based cancer registries be playing in the 21st century? Reflections on the Asian Cancer Registry Forum, Bangkok, February 2014. Asian Pac J Cancer Prev 2014;15(5):1895-1896.

48. American Institute for Cancer Research; World Cancer Research Fund. Food, nutrition, physical activity and the prevention of cancer: a global perspective. Washington, DC: American Institute for Cancer Research; 2007.

49. Moore MA, Sobue T. Strategies for cancer control on an organ-site basis. Asian Pac J Cancer Prev 2010;(11 Suppl 2):149-164.

50. Inoue M, Sawada N, Matsuda T, Iwasaki M, Sasazuki S, Shimazu T, et al. Attributable causes of cancer in Japan in 2005: systematic assessment to estimate current burden of cancer attributable to known preventable risk factors in Japan. Ann Oncol 2012;23(5):1362-1369.
crossref pmid
51. Shin A, Park S, Shin HR, Park EH, Park SK, Oh JK, et al. Population attributable fraction of infection-related cancers in Korea. Ann Oncol 2011;22(6):1435-1442.
crossref pmid
52. Oh IH, Yoon SJ, Yoon TY, Choi JM, Choe BK, Kim EJ, et al. Health and economic burden of major cancers due to smoking in Korea. Asian Pac J Cancer Prev 2012;13(4):1525-1531.
crossref pmid
53. Liang H, Wang J, Xiao H, Wang D, Wei W, Qiao Y, et al. Estimation of cancer incidence and mortality attributable to alcohol drinking in China. BMC Public Health 2012;10: 730.
54. Wang JB, Jiang Y, Wei WQ, Yang GH, Qiao YL, Boffetta P. Estimation of cancer incidence and mortality attributable to smoking in China. Cancer Causes Control 2010;21(6):959-965.
crossref pmid
55. Shin A, Jung YS, Jung KW, Kim K, Ryu J, Won YJ. Trends of human papillomavirus-related head and neck cancers in Korea: national cancer registry data. Laryngoscope 2013;123(11):E30-E37.
crossref pmid
56. Lau HY, Leung CM, Chan YH, Lee AW, Kwong DL, Lung ML, et al. Secular trends of salted fish consumption and nasopharyngeal carcinoma: a multi-jurisdiction ecological study in 8 regions from 3 continents. BMC Cancer 2013;13: 298.
crossref pmid pmc
57. Tokudome S, Samsuria Soeripto WD, Triningsih FX, Suzuki S, Hosono A, Triono T, et al. Helicobacter pylori infection appears essential for stomach carcinogenesis: observations in Semarang, Indonesia. Cancer Sci 2005;96(12):873-875.
crossref pmid
58. Bilyalova Z, Igissinov N, Moore M, Igissinov S, Sarsenova S, Khassenova Z. Epidemiological evaluation of breast cancer in ecological areas of Kazakhstan: association with pollution emissions. Asian Pac J Cancer Prev 2012;13(5):2341-2344.
crossref pmid
59. Chang MH, You SL, Chen CJ, Liu CJ, Lee CM, Lin SM, et al. Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: a 20-year follow-up study. J Natl Cancer Inst 2009;101(19):1348-1355.
crossref pmid
60. Wichajarn K, Kosalaraksa P, Wiangnon S. Incidence of hepatocellular carcinoma in children in Khon Kaen before and after national hepatitis B vaccine program. Asian Pac J Cancer Prev 2008;9(3):507-509.

61. Dondog B, Lise M, Dondov O, Baldandorj B, Franceschi S. Hepatitis B and C virus infections in hepatocellular carcinoma and cirrhosis in Mongolia. Eur J Cancer Prev 2011;20(1):33-39.
crossref pmid
62. Hayashi Y, Shimizu Y, Netsu S, Hanley S, Konno R. High HPV vaccination uptake rates for adolescent girls after regional governmental funding in Shiki City, Japan. Vaccine 2012;30(37):5547-5550.
crossref pmid
63. Al-Naggar RA, Bobryshev YV, Al-Jashamy K, Al-Musli M. Practice of HPV vaccine and associated factors among school girls in Melaka, Malaysia. Asian Pac J Cancer Prev 2012;13(8):3835-3840.
crossref pmid
64. Ezat SW, Hod R, Mustafa J, Mohd Dali AZ, Sulaiman AS, Azman A. National HPV immunisation programme: knowledge and acceptance of mothers attending an obstetrics clinic at a teaching hospital, Kuala Lumpur. Asian Pac J Cancer Prev 2013;14(5):2991-2999.
crossref pmid
65. Rashwan HH, Saat NZ, Abd Manan DN. Knowledge, attitude and practice of malaysian medical and pharmacy students towards human papillomavirus vaccination. Asian Pac J Cancer Prev 2012;13(5):2279-2283.
crossref pmid
66. Mackay J, Ritthiphakdee B, Reddy KS. Tobacco control in Asia. Lancet 2013;381(9877):1581-1587.
67. Sakuta M. Tobacco control in Japan: what it is, and what it should be. Nihon Rinsho 2013;71(3):399-405.
68. Kashiwabara M, Armada F, Yoshimi I. Kanagawa, Japan’s tobacco control legislation: a breakthrough. Asian Pac J Cancer Prev 2011;12(8):1909-1916.
69. Huang Y. China’s position in negotiating the Framework Convention on Tobacco Control and the revised International Health Regulations. Public Health 2014;128(2):161-166.
crossref pmid
70. Hu TW, Lee AH, Mao Z. WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations. Glob Health Promot 2013;20(4):13-22.
crossref pmid pmc
71. Kengkarnpanich M, Termsirikulchai L, Benjakul S. Policy measures on strengthening and developing capabilities for national tobacco control in Thailand. J Med Assoc Thai 2012;(95 Suppl 6):S61-S70.

72. Sirirassamee T, Sirirassamee B. Trends in tobacco use among Thai adolescents. J Med Assoc Thai 2013;(96 Suppl 1):S78-S84.

73. Katanoda K, Saika K, Yamamoto S, Tanaka S, Oshima A, Nakamura M, et al. Projected cancer mortality among Japanese males under different smoking prevalence scenarios: evidence for tobacco control goal setting. Jpn J Clin Oncol 2011;41(4):483-489.
crossref pmid
74. Ngoan le T. Anti-smoking initiative and decline in incidence rates of lung cancer in Viet Nam. Asian Pac J Cancer Prev 2006;7(3):492-494.

75. Katanoda K, Jiang Y, Park S, Lim MK, Qiao YL, Inoue M. Tobacco control challenges in East Asia: proposals for change in the world’s largest epidemic region. Tob Control 2014;23(4):359-368.
crossref pmid pmc
76. Huang J, Zheng R, Chaloupka FJ, Fong GT, Li Q, Jiang Y. Chinese smokers’ cigarette purchase behaviours, cigarette prices and consumption: findings from the ITC China Survey. Tob Control 2014;(23 Suppl 1):i67-i72.
77. Shin JY, Kim SY, Lee KS, Lee SI, Ko Y, Choi YS, et al. Costs during the first five years following cancer diagnosis in Korea. Asian Pac J Cancer Prev 2012;13(8):3767-3772.
crossref pmid
78. Norsa’adah B, Rahmah MA, Rampal KG, Knight A. Understanding barriers to Malaysian women with breast cancer seeking help. Asian Pac J Cancer Prev 2012;13(8):3723-3730.
crossref pmid
79. Merriam S, Muhamad M. Roles traditional healers play in cancer treatment in Malaysia: implications for health promotion and education. Asian Pac J Cancer Prev 2013;14(6):3593-3601.
crossref pmid
80. Cho E, Kang MH, Choi KS, Suh M, Jun JK, Park EC. Cost-effectiveness outcomes of the national gastric cancer screening program in South Korea. Asian Pac J Cancer Prev 2013;14(4):2533-2540.
crossref pmid
81. Cho E, Kang MH, Choi KS, Suh M, Jun JK, Park EC. Cost-effectiveness of Korea’s National Cervical Cancer Screening Program. Asian Pac J Cancer Prev 2013;14(7):4329-4334.
crossref pmid
82. Kang MH, Park EC, Choi KS, Suh M, Jun JK, Cho E. The National Cancer Screening Program for breast cancer in the Republic of Korea: is it cost-effective? Asian Pac J Cancer Prev 2013;14(3):2059-2065.
crossref pmid
83. Suh M, Choi KS, Lee YY, Jun JK. Trends in cancer screening rates among Korean men and women: results from the Korean National Cancer Screening Survey, 2004-2012. Cancer Res Treat 2013;45(2):86-94.
crossref pmid pmc pdf
84. Moore MA, Kunimoto T, Tsuda H. Cancer screening literature in the period 2000-2002: pointers to future research avenues. Asian Pac J Cancer Prev 2003;4(1):57-60.

85. Komoto S, Nishiwaki Y, Okamura T, Tanaka H, Takebayashi T. Effect size and cost-effectiveness estimates of breast and cervical cancer screening reminders by population size through complete enumeration of Japanese local municipalities. BMC Public Health 2013;14: 14-43.
86. Suh M, Choi KS, Lee YY, Park B, Jun JK. Cancer screening in Korea, 2012: results from the Korean National Cancer Screening Survey. Asian Pac J Cancer Prev 2013;14(11):6459-6463.
crossref pmid
87. Tabuchi T, Hoshino T, Nakayama T, Ito Y, Ioka A, Miyashiro I, et al. Does removal of out-of-pocket costs for cervical and breast cancer screening work? A quasi-experimental study to evaluate the impact on attendance, attendance inequality and average cost per uptake of a Japanese government intervention. Int J Cancer 2013;133(4):972-983.

88. Lee MH, Lee YY, Jung da W, Park B, Yun EH, Lee HY, et al. Effectiveness of interventions to increase the participation rate of gastric cancer screening in the Republic of Korea: a pilot study. Asian Pac J Cancer Prev 2012;13(3):861-866.
crossref pmid
89. Lee YY, Jun JK, Suh M, Park BY, Kim Y, Choi KS. Barriers to cancer screening among medical aid program recipients in the Republic of Korea: a qualitative study. Asian Pac J Cancer Prev 2014;15(2):589-594.
crossref pmid
90. Ji MF, Huang QH, Yu X, Liu Z, Li X, Zhang LF, et al. Evaluation of plasma Epstein-Barr virus DNA load to distinguish nasopharyngeal carcinoma patients from healthy high-risk populations in Southern China. Cancer 2014;120(9):1353-1360.
crossref pmid
91. Yang J, Wei WQ, Niu J, He YT, Liu ZC, Song GH, et al. Estimating the costs of esophageal cancer screening, early diagnosis and treatment in three high risk areas in China. Asian Pac J Cancer Prev 2011;12(5):1245-1250.
92. Hamashima C, Okamoto M, Shabana M, Osaki Y, Kishimoto T. Sensitivity of endoscopic screening for gastric cancer by the incidence method. Int J Cancer 2013;133(3):653-659.
crossref pmid
93. Choi KS, Jun JK, Park EC, Park S, Jung KW, Han MA, et al. Performance of different gastric cancer screening methods in Korea: a population-based study. PLoS One 2012;7(11):e50041.
crossref pmid pmc
94. Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Inoue T. Detection of colorectal cancer and adenomas by FDG-PET cancer screening program: results based on a nationwide Japanese survey. Ann Nucl Med 2014;28(3):212-219.
crossref pmid
95. Zhou L, Guan P, Sun LP, He QC, Yuan Y, Zhou BS. Health economic assessment for screening of gastric cancer in a high risk population in northeastern china. Chin J Cancer Res 2011;23(1):21-24.
crossref pmid pmc
96. Naito Y, Uchiyama K, Kinoshita Y, Fukudo S, Joh T, Suzuki H, et al. A questionnaire-based survey on screening for gastric and colorectal cancer by physicians in East Asian countries in 2010. Digestion 2012;86(2):94-106.
crossref pmid
97. Koo JH, Leong RW, Ching J, Yeoh KG, Wu DC, Murdani A, et al. Knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the Asia-Pacific region: a multicenter study. Gastrointest Endosc 2012;76(1):126-135.
crossref pmid
98. Khuhaprema T, Sangrajrang S, Lalitwongsa S, Chokvanitphong V, Raunroadroong T, Ratanachu-Ek T, et al. Organised colorectal cancer screening in Lampang Province, Thailand: preliminary results from a pilot implementation programme. BMJ Open 2014;4(1):e003671.
crossref pmid pmc
99. Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Inoue T. Performance profile of a FDG-PET cancer screening program for detecting gastric cancer: results from a nationwide Japanese survey. Jpn J Radiol 2014;32(5):253-259.
crossref pmid
100. Choi KS, Lee HY, Jun JK, Shin A, Park EC. Adherence to follow-up after a positive fecal occult blood test in an organized colorectal cancer screening program in Korea, 2004-2008. J Gastroenterol Hepatol 2012;27(6):1070-1077.
crossref pmid
101. Kim Y, Jun JK, Choi KS, Lee HY, Park EC. Overview of the National Cancer screening programme and the cancer screening status in Korea. Asian Pac J Cancer Prev 2011;12(3):725-730.
102. Song P, Feng X, Zhang K, Song T, Ma K, Kokudo N, et al. Screening for and surveillance of high-risk patients with HBV-related chronic liver disease: promoting the early detection of hepatocellular carcinoma in China. Biosci Trends 2013;7(1):1-6.
crossref pmid
103. Nawa T, Nakagawa T, Mizoue T, Kusano S, Chonan T, Hayashihara K, et al. A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan. Lung Cancer 2012;78(3):225-228.
crossref pmid
104. Kitagawa Y, Mizokami A, Namiki M. Trends of clinical symptoms and prognosis of middle-aged prostate cancer patients after instigation of prostate specific antigen-based population screening. Prostate Int 2013;1(2):65-68.
crossref pmid pmc
105. Thomas DB, Gao DL, Ray RM, Wang WW, Allison CJ, Chen FL, et al. Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst 2002;94(19):1445-1457.
crossref pmid
106. Kardinah D, Anderson BO, Duggan C, Ali IA, Thomas DB. Short report: limited effectiveness of screening mammography in addition to clinical breast examination by trained nurse midwives in rural Jakarta, Indonesia. Int J Cancer 2014;134(5):1250-1255.
crossref pmid
107. Pisani P, Parkin DM, Ngelangel C, Esteban D, Gibson L, Munson M, et al. Outcome of screening by clinical examination of the breast in a trial in the Philippines. Int J Cancer 2006;118(1):149-154.
crossref pmid
108. Wang B, He M, Wang L, Engelgau MM, Zhao W, Wang L. Breast cancer screening among adult women in China, 2010. Prev Chronic Dis 2013;10: E183.
crossref pmid pmc
109. Morimoto T, Tangoku A, Yamakawa T, Tsuruno M, Takashima S. Promotion of quality-controlled mammography alone as a screening modality in Japan. Breast Cancer 2014;21(4):435-441.
crossref pmid
110. Wang FL, Chen F, Yin H, Xu N, Wu XX, Ma JJ, et al. Effects of age, breast density and volume on breast cancer diagnosis: a retrospective comparison of sensitivity of mammography and ultrasonography in China’s rural areas. Asian Pac J Cancer Prev 2013;14(4):2277-2282.
crossref pmid
111. Boonlikit S. Comparison of mammography in combination with breast ultrasonography versus mammography alone for breast cancer screening in asymptomatic women. Asian Pac J Cancer Prev 2013;14(12):7731-7736.
crossref pmid
112. Khuhaprema T, Attasara P, Srivatanakul P, Sangrajrang S, Muwonge R, Sauvaget C, et al. Organization and evolution of organized cervical cytology screening in Thailand. Int J Gynaecol Obstet 2012;118(2):107-111.
crossref pmid
113. Kasinpila C, Promthet S, Vatanasapt P, Sasieni P, Parkin DM. Evaluation of the nationwide cervical screening programme in Thailand: a case-control study. J Med Screen 2011;18(3):147-153.
crossref pmid
114. Kim YM, Ati A, Kols A, Lambe FM, Soetikno D, Wysong M, et al. Influencing women’s actions on cervical cancer screening and treatment in Karawang District, Indonesia. Asian Pac J Cancer Prev 2012;13(6):2913-2921.
crossref pmid
115. Qiao YL, Jeronimo J, Zhao FH, Schweizer J, Chen W, Valdez M, et al. Lower cost strategies for triage of human papillomavirus DNA-positive women. Int J Cancer 2014;134(12):2891-2901.
crossref pmid
116. Bian ML, Cheng JY, Ma L, Cong X, Liu J, Chen Y, et al. Evaluation of the detection of 14 high-risk human papillomaviruses with HPV 16 and HPV 18 genotyping for cervical cancer screening. Exp Ther Med 2013;6(5):1332-1336.
crossref pmid pmc
117. Kim YM, Lambe FM, Soetikno D, Wysong M, Tergas AI, Rajbhandari P, et al. Evaluation of a 5-year cervical cancer prevention project in Indonesia: opportunities, issues, and challenges. J Obstet Gynaecol Res 2013;39(6):1190-1199.
crossref pmid
118. Akaza H, Kawahara N, Roh JK, Inoue H, Park EC, Lee KS, et al. Japanese Cancer Association Meeting UICC International session: what is cost-effectiveness in cancer treatment. Asian Pac J Cancer Prev 2014;15(1):3-10.
crossref pmid
119. Phungrassami T, Thongkhamcharoen R, Atthakul N. Palliative care personnel and services: a national survey in Thailand 2012. J Palliat Care 2013;29(3):133-139.
120. Thongkhamcharoen R, Phungrassami T, Atthakul N. Regulation of opioid drugs in thai government hospitals: Thailand national survey 2012. Indian J Palliat Care 2014;20(1):6-11.
crossref pmid pmc
121. Maeda I, Tsuneto S, Miyashita M, Morita T, Umeda M, Motoyama M, et al. Progressive development and enhancement of palliative care services in Japan: nationwide surveys of designated cancer care hospitals for three consecutive years. J Pain Symptom Manage 2014. http://dx.doi.org/10.1016/j.jpainsymman.2013.09.017 .
122. Baek YJ, Shin DW, Choi JY, Kang J, Mo HN, Kim YH, et al. Late referral to palliative care services in Korea. J Pain Symptom Manage 2011;41(4):692-699.
crossref pmid
123. Yun YH, Lee MK, Bae Y, Shon EJ, Shin BR, Ko H, et al. Efficacy of a training program for long-term disease- free cancer survivors as health partners: a randomized controlled trial in Korea. Asian Pac J Cancer Prev 2013;14(12):7229-7235.
crossref pmid
124. Li J, Davis MP, Gamier P. Palliative medicine: barriers and developments in mainland China. Curr Oncol Rep 2011;13(4):290-294.
crossref pmid
125. Morita T, Miyashita M, Yamagishi A, Akizuki N, Kizawa Y, Shirahige Y, et al. A region-based palliative care intervention trial using the mixed-method approach: Japan OPTIM study. BMC Palliat Care 2012;11: 2.
crossref pmid pmc
126. Moore MA, Shin HR, Curado MP, Sobue T. Establishment of an Asian Cancer Registry Network: problems and perspectives. Asian Pac J Cancer Prev 2008;9(4):815-832.

127. Moore MA. What and where for publications by cancer registries in the Asian Pacific?: roles for the APJCP in the future. Asian Pac J Cancer Prev 2013;14(8):4939-4942.
crossref pmid
128. Parkin DM, Vatanasapt V. Cancer registration in Asia in the year 2000: past present and future. Asian Pac J Cancer Prev 2001;2(IACR Suppl):S1-S89.

Editorial Office
#203, 92 Wangsan-ro, Dongdaemun-gu, Seoul 02585, Korea
Tel : +82-2-740-8328   Fax : +82-2-764-8328   E-mail: jpmph@prevmed.or.kr
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © 2023 by Korean Society for Preventive Medicine.                 Developed in M2PI