박진균1, 박현아2

1서울대학교 의과대학 서울대학교병원 내과, 2인제대학교 의과대학 서울백병원 가정의학과


Background: With the number of cancer survivors increasing, follow-up care to deal with problems related to their original cancer is needed. One of these is screening for a second primary cancer as cancer survivors are one of the high-risk groups for cancer occurrence. The purpose of this study was to assess the screening rates of major cancers in patients with a history of cancer in Korea.
Methods: Our data were from the 4th Korea National Health and Nutrition Examination Survey. We narrowed the data to include 11,169 adults aged 40 and 80 years. Participants were grouped according to their history of cancer and the time since cancer diagnosis into no cancer group (no cancer diagnosis), cancer survivor group (cancer diagnosis ≥5 years ago), and cancer follow-up group (cancer diagnosis <5 years ago). We estimated the screening acceptance rates of major cancers according to the cancer history and assessed the relationships between them.
Results: The cancer screening rates of stomach, breast, cervix, and colon were 42.4±4.9%, 45.5±5.6%, 42.1±6.4%, and 24.1±3.8% for the cancer survivor group and 45.6±5.2%, 61.9±6.2%, 48.8±7.0%, and 20.8±4.3% for the cancer follow-up group. A history of cancer diagnosis was not related to the acceptance rate of stomach and cervical cancer screening. Breast cancer screening (odd ratio [OR], 1.783; 95% confidence interval [CI], 1.044-3.048) increased only in the cancer follow-up group. At 5 years after a cancer diagnosis, only the screening rate for colon cancer (OR, 1.701; 95% CI, 1.119-2.588) persistently increased compared to individuals without a history of cancer.
Conclusions: The screening for breast cancer was the only screening examination whose rate increased in the cancer follow-up group, with the significance disappearing in the cancer survivor group. Our results demonstrate that the screening rate for secondary cancers is below optimal in cancer patients in Korea.

Korean J Health Promot 2012;12(2):67-74

Keywords: Cancer, Screening, Survivors