Bio

Professional Education


  • Doctor of Philosophy, National Cancer Center, Graduate School of Cancer Science and Policy, Public Health (2020)
  • Master of Public Health, National Cancer Center, Graduate School of Cancer Science and Policy, Public Health (2016)
  • Bachelor of Arts, Emory University, Economics, Theater Studies (2012)

Stanford Advisors


Publications

All Publications


  • Weight control behaviors according to body weight status and accuracy of weight perceptions among Korean women: a nationwide population-based survey SCIENTIFIC REPORTS Park, B., Cho, H., Choi, E., Seo, D., Kim, N., Park, E., Kim, S., Park, Y., Choi, K., Rhee, Y. 2019; 9: 9127

    Abstract

    This study aimed to identify associations among self-perceived weight status, accuracy of weight perceptions, and weight control behaviors, including both healthy and unhealthy behaviors, in a large, nationally representative sample from an East Asian country. Data were collected from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide survey. Accurate weight perceptions were investigated by comparing body mass index (BMI) categories, based on self-reported height and weight, and weight perceptions. Weight control behaviors over the previous 12 months were additionally surveyed. Odds ratios (ORs) and 95% confidence intervals (CIs) are presented as an index of associations. Among normal weight, overweight, and obese women, 12.8%, 44.3%, and 17.4% under-assessed their weight; 17.9% of normal weight women over-assessed their weight. Both weight status according to BMI category and weight perceptions were strongly associated with having tried to lose weight. Exercise and diet (ate less) were the most commonly applied weight control behaviors. Misperception of weight was related to more unhealthy weight control behaviors and less healthy behaviors: Women who under-assessed their weight showed a lower tendency to engage in dieting (OR?=?0.57, 95% CI?=?0.43-0.75) and a greater tendency to fast/skip meals (OR?=?1.47, 95% CI?=?1.07-1.99). Meanwhile, normal weight or overweight women who over-assessed their weight were more likely to have engaged in fasting/skipping meals or using diet pills (OR?=?5.72, 95% CI?=?2.45-13.56 for fasting/skipping meal in overweight women; OR?=?1.62, 95% CI?=?1.15-2.29 and OR?=?3.16, 95% CI?=?1.15-8.23 for using diet pills in normal and overweight women). Inaccuracy of weight perceptions in any direction (over/under) were related to more unhealthy weight control behaviors and less healthy weight control behaviors, especially in normal and overweight women.

    View details for DOI 10.1038/s41598-019-45596-z

    View details for Web of Science ID 000472597400030

    View details for PubMedID 31235742

    View details for PubMedCentralID PMC6591250

  • Determinants of undergoing thyroid cancer screening in Korean women: a cross-sectional analysis from the K-Stori 2016 BMJ OPEN Cho, H., Choi, E., Seo, D., Park, B., Park, S., Cho, J., Kim, S., Park, Y., Rhee, Y., Choi, K. 2019; 9 (4): e026366

    Abstract

    Thyroid cancer is the most common cancer among Korean women. Studies suggest that the incidence of thyroid cancer might be associated with overdiagnosis resulting from thyroid cancer screening. The objective of this study was to identify the determinants of participation in thyroid cancer screening in Korean women.Data were obtained from the 2016 Korean Study of Women's Health-Related Issues, a nationwide cross-sectional survey of women according to the reproductive life cycle. A total of 8697 cancer-free women of ages between 20 and 79 years were included for analysis. Multivariable logistic regression analysis was applied to analyse factors associated with adherence to thyroid cancer screening based on Andersen's health behavioural model.Over the last 2 years, the rate of thyroid cancer screening was 39.2%. In multivariable models, older age, higher household income, high school education level and higher perceived risk of cancer were positively associated with thyroid cancer screening participation. Moreover, women who underwent cervical cancer screening (adjusted OR [aOR] 3.67; 95% CI 2.90 to 4.64) and breast cancer screening (aOR 10.91; 95% CI 8.41 to 14.14) had higher odds of attending thyroid cancer screening than women who did not attend cancer screening.These findings highlight the need to increase awareness of different recommendations on screening for various cancers to improve cost-effectiveness and to prevent unnecessary treatments.

    View details for DOI 10.1136/bmjopen-2018-026366

    View details for Web of Science ID 000471157200180

    View details for PubMedID 30948602

    View details for PubMedCentralID PMC6500224

  • Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women's Health-Related Issues EPIDEMIOLOGY AND HEALTH Choi, E., Cho, H., Seo, D., Park, B., Park, S., Cho, J., Kim, S., Park, Y., Choi, K., Rhee, Y. 2019; 41: e2019005

    Abstract

    While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.Data were derived from the 2016 Korean Study of Women's Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (?25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.

    View details for DOI 10.4178/epih.e2019005

    View details for Web of Science ID 000463224900001

    View details for PubMedID 30917463

    View details for PubMedCentralID PMC6446067

  • Self-perceptions of body weight status according to age-groups among Korean women: A nationwide population-based survey PLOS ONE Park, B., Cho, H., Choi, E., Seo, D., Kim, S., Park, Y., Choi, K., Rhee, Y. 2019; 14 (1): e0210486

    Abstract

    While numerous studies have investigated body image, including body weight perception, most of which have focused on adolescents or young women, few studies have attempted to evaluate body weight perceptions in adult women according to age groups. This study was conducted to investigate the accuracy of self-perceived weight and actual body mass index (BMI) values among adult Korean women according to age. We used data from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide, cross-sectional survey. BMI was calculated from self-reported weight and height. Participants were asked to describe their body image by choosing one of the following descriptions: very underweight, underweight, about right, overweight, or obese. The proportions of women aged 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years who underestimated their body weight relative to their actual BMI category were 12.6%, 15.1%, 22.2%, 34.0%, 45.6%, and 50.7%, respectively; those who overestimated their body weight comprised 18.7%, 17.8%, 14.3%, 10.8%, and 7.4%. In all BMI categories, the proportion of those who overestimated their weight status increased as age decreased, while those who underestimated their weight status increased as age increased. After adjusting for possible covariates, age was strongly associated with both underestimation and overestimation. The odds ratio for underestimating one's weight status among women aged 70-79 yeas was 2.96 (95% CI: 2.10-4.18), and that for overestimation was 0.52 (95% CI: 0.35-0.79), compared to women aged 20-29 years. Age is the most important factor associated with weight perceptions among Korean women, affecting both underestimation and overestimation of weight status.

    View details for DOI 10.1371/journal.pone.0210486

    View details for Web of Science ID 000456015500042

    View details for PubMedID 30653596

    View details for PubMedCentralID PMC6336301

  • Socioeconomic Inequalities in Colorectal Cancer Screening in Korea, 2005-2015: After the Introduction of the National Cancer Screening Program YONSEI MEDICAL JOURNAL Mai, T., Lee, Y., Suh, M., Choi, E., Lee, E., Ki, M., Cho, H., Park, B., Jun, J., Kim, Y., Oh, J., Choi, K. 2018; 59 (9): 1034?40

    Abstract

    This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups.Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year.CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance.Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

    View details for DOI 10.3349/ymj.2018.59.9.1034

    View details for Web of Science ID 000447631100004

    View details for PubMedID 30328317

    View details for PubMedCentralID PMC6192887

  • Socioeconomic Inequalities in Cervical and Breast Cancer Screening among Women in Korea, 2005-2015 YONSEI MEDICAL JOURNAL Choi, E., Lee, Y., Suh, M., Lee, E., Tran Thi Xuan Mai, Ki, M., Oh, T., Cho, H., Park, B., Jun, J., Kim, Y., Choi, K. 2018; 59 (9): 1026?33

    Abstract

    Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprived women. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalities among Korean women from 2005 to 2015.Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey, were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income status were estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percent changes (APCs), to show trends in cancer screening rates.Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to 61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of household income and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooled SII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening were shown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educational inequalities appeared to diminish over the study period for both cervical and breast cancer screening.Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancer screening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these were constant from 2005 to 2015 for both cervical and breast cancer screening.

    View details for DOI 10.3349/ymj.2018.59.9.1026

    View details for Web of Science ID 000447631100003

    View details for PubMedID 30328316

    View details for PubMedCentralID PMC6192888

  • Socioeconomic Inequalities in Stomach Cancer Screening in Korea, 2005-2015: After the Introduction of the National Cancer Screening Program YONSEI MEDICAL JOURNAL Lee, E., Lee, Y., Suh, M., Choi, E., Tran Thi Xuan Mai, Cho, H., Park, B., Jun, J., Kim, Y., Oh, J., Ki, M., Choi, K. 2018; 59 (8): 923?29

    Abstract

    This study aimed to investigate socioeconomic inequalities in stomach cancer screening in Korea and trends therein across income and education groups.Data from the Korean National Cancer Screening Survey, a nationwide cross-sectional survey, were utilized. A total of 28913 men and women aged 40 to 74 years were included for analysis. Prior experience with stomach cancer screening was defined as having undergone either an endoscopy or gastrointestinal series within the past two years. The slope index of inequality (SII) and relative index of inequality (RII) were evaluated to check inequalities.Stomach cancer screening rates increased from 40.0% in 2005 to 74.8% in 2015, with an annual percent change of 5.8% [95% confidence interval (CI) 4.2 to 7.5]. Increases in stomach cancer screening rates were observed for all age, education, and household income groups. Inequalities in stomach cancer screening were noted among individuals of differing levels of education, with a pooled SII estimate of 6.14% (95% CI, 3.94 to 8.34) and RII of 1.26 (95% CI, 1.12 to 1.40). Also, income-related inequalities were observed with an SII of 6.93% (95% CI, 4.89 to 8.97) and RII of 1.30 (95% CI, 1.17 to 1.43). The magnitude of inequality was larger for income than for education.Both education and income-related inequalities were found in stomach cancer screening, despite a continuous increase in screening rate over the study period. Income-related inequality was greater than education-related inequality, and this was more apparent in women than in men.

    View details for DOI 10.3349/ymj.2018.59.8.923

    View details for Web of Science ID 000443831900003

    View details for PubMedID 30187698

    View details for PubMedCentralID PMC6127424

  • Associations of perceived risk and cancer worry for colorectal cancer with screening behaviour JOURNAL OF HEALTH PSYCHOLOGY Choi, E., Lee, Y., Suh, M., Park, B., Jun, J., Kim, Y., Choi, K. 2018; 23 (6): 840?52

    Abstract

    We investigated the associations of perceived risk and cancer worry with colorectal cancer screening by the faecal occult blood test, colonoscopy or both. This study was based on the 2013 Korean National Cancer Screening Survey, including 2154 randomly selected, cancer-free and over 50-year-old adults. Individuals with higher cancer worry were 1.53 times more likely to undergo colorectal cancer screening, influenced by emotional reaction; individuals with greater perceived risk were 1.61 times more, affected by subjective awareness. However, cancer worry was only associated with the faecal occult blood test. Better understanding of cancer worry and perceived risk on screening behaviours may help to increase colorectal cancer screening rates.

    View details for DOI 10.1177/1359105316679721

    View details for Web of Science ID 000430332700008

    View details for PubMedID 27872387

  • Inhibition of BMP signaling overcomes acquired resistance to cetuximab in oral squamous cell carcinomas CANCER LETTERS Yin, J., Jung, J., Choi, S., Kim, S., Oh, Y., Kim, T., Choi, E., Lee, S., Kim, H., Kim, E., Lee, Y., Chang, H., Park, J., Kim, Y., Yun, T., Heo, K., Kim, Y., Kim, H., Kim, Y., Park, J., Choi, S. 2018; 414: 181?89

    Abstract

    Despite expressing high levels of the epidermal growth factor receptor (EGFR), a majority of oral squamous cell carcinoma (OSCC) patients show limited response to cetuximab and ultimately develop drug resistance. However, mechanism underlying cetuximab resistance in OSCC is not clearly understood. Here, using a mouse orthotopic xenograft model of OSCC, we show that bone morphogenic protein-7-phosphorylated Smad-1, -5, -8 (BMP7-p-Smad1/5/8) signaling contributes to cetuximab resistance. Tumor cells isolated from the recurrent cetuximab-resistant xenograft models exhibited low EGFR expression but extremely high levels of p-Smad1/5/8. Treatment with the bone morphogenic protein receptor type 1 (BMPRI) inhibitor, DMH1 significantly reduced cetuximab-resistant OSCC tumor growth, and combined treatment of DMH1 and cetuximab remarkably reduced relapsed tumor growth in vivo. Importantly, p-Smad1/5/8 level was elevated in cetuximab-resistant patients and this correlated with poor prognosis. Collectively, our results indicate that the BMP7-p-Smad1/5/8 signaling is a key pathway to acquired cetuximab resistance, and demonstrate that combination therapy of cetuximab and a BMP signaling inhibitor as potentially a new therapeutic strategy for overcoming acquired resistance to cetuximab in OSCC.

    View details for DOI 10.1016/j.canlet.2017.11.013

    View details for Web of Science ID 000419810900019

    View details for PubMedID 29154973

  • Transglutaminase 2 Inhibition Reverses Mesenchymal Transdifferentiation of Glioma Stem Cells by Regulating C/EBP beta Signaling CANCER RESEARCH Yin, J., Oh, Y., Kim, J., Kim, S., Choi, E., Kim, T., Hong, J., Chang, N., Cho, H., Sa, J. K., Kim, J., Kwon, H., Park, S., Lin, W., Nakano, I., Gwak, H., Yoo, H., Lee, S., Lee, J., Kim, J., Kim, S., Nam, D., Park, M., Park, J. 2017; 77 (18): 4973?84

    Abstract

    Necrosis is a hallmark of glioblastoma (GBM) and is responsible for poor prognosis and resistance to conventional therapies. However, the molecular mechanisms underlying necrotic microenvironment-induced malignancy of GBM have not been elucidated. Here, we report that transglutaminase 2 (TGM2) is upregulated in the perinecrotic region of GBM and triggered mesenchymal (MES) transdifferentiation of glioma stem cells (GSC) by regulating master transcription factors (TF), such as C/EBP?, TAZ, and STAT3. TGM2 expression was induced by macrophages/microglia-derived cytokines via NF-?B activation and further degraded DNA damage-inducible transcript 3 (GADD153) to induce C/EBP? expression, resulting in expression of the MES transcriptome. Downregulation of TGM2 decreased sphere-forming ability, tumor size, and radioresistance and survival in a xenograft mouse model through a loss of the MES signature. A TGM2-specific inhibitor GK921 blocked MES transdifferentiation and showed significant therapeutic efficacy in mouse models of GSC. Moreover, TGM2 expression was significantly increased in recurrent MES patients and inversely correlated with patient prognosis. Collectively, our results indicate that TGM2 is a key molecular switch of necrosis-induced MES transdifferentiation and an important therapeutic target for MES GBM. Cancer Res; 77(18); 4973-84. ©2017 AACR.

    View details for DOI 10.1158/0008-5472.CAN-17-0388

    View details for Web of Science ID 000410945700021

    View details for PubMedID 28754668

  • Trends in Participation Rates for the National Cancer Screening Program in Korea, 2002-2012 CANCER RESEARCH AND TREATMENT Suh, M., Song, S., Cho, H., Park, B., Jun, J., Choi, E., Kim, Y., Choi, K. 2017; 49 (3): 798?806

    Abstract

    The National Cancer Screening Program (NCSP) in Korea supports cancer screening for stomach, liver, colorectal, breast, and cervical cancer. This study was conducted to assess trends in participation rates among Korean men and women invited to undergo screening via the NCSP as part of an effort to guide future implementation of the program in Korea.Data from the NCSP for 2002 to 2012 were used to calculate annual participation rates with 95% confidence intervals (CI) by sex, insurance status, and age group for stomach, liver, colorectal, breast, and cervical cancer screening.In 2012, participation rates for stomach, liver, colorectal, breast, and cervical cancer screening were 47.3%, 25.0%, 39.5%, 51.9%, and 40.9%, respectively. The participation rates increased annually by 4.3% (95% CI, 4.0 to 4.6) for stomach cancer, 3.3% (95% CI, 2.5 to 4.1) for liver cancer, 4.1% (95% CI, 3.2 to 5.0) for colorectal cancer, 4.6% (95% CI, 4.1 to 5.0) for breast cancer, and 0.9% (95% CI, -0.7 to 2.5) for cervical cancer from 2002 to 2012.Participant rates for the NCSP for the five above-mentioned cancers increased annually from 2002 to 2012.

    View details for DOI 10.4143/crt.2016.186

    View details for Web of Science ID 000405537800025

    View details for PubMedID 27857022

    View details for PubMedCentralID PMC5512374

  • The Korean Study of Women's Health-Related Issues (K-Stori): Rationale and Study Design BMC PUBLIC HEALTH Cho, H., Choi, E., Seo, D., Suh, M., Lee, H., Park, B., Park, S., Cho, J., Kim, S., Park, Y., Lim, J., Ahn, Y., Park, H., Choi, K., Rhee, Y. 2017; 17: 609

    Abstract

    Measures to address gender-specific health issues are essential due to fundamental, biological differences between the sexes. Studies have increasingly stressed the importance of customizing approaches directed at women's health issues according to stages in the female life cycle. In Korea, however, gender-specific studies on issues affecting Korean women in relation to stages in their life cycle are lacking. Accordingly, the Korean Study of Women's Health-Related Issues (K-Stori) was designed to investigate life cycle-specific health issues among women, covering health status, awareness, and risk perceptions.K-Stori was conducted as a nationwide cross-sectional survey targeting Korean women aged 14-79 years. Per each stage in the female life cycle (adolescence, childbearing age, pregnancy & postpartum, menopause, and older adult stage), 3000 women (total 15,000) were recruited by stratified multistage random sampling for geographic area based on the 2010 Resident Registration Population in Korea. Specialized questionnaires per each stage (total of five) were developed in consultation with multidisciplinary experts and by reflecting upon current interests into health among the general population of women in Korea. This survey was conducted from April 1 to June 31, 2016, at which time investigators from a professional research agency went door-to-door to recruit residents and conducted in-person interviews.The study's findings may help with elucidating health issues and unmet needs specific to each stage in the life cycle of Korean women that have yet to be identified in present surveys.

    View details for DOI 10.1186/s12889-017-4531-1

    View details for Web of Science ID 000405870800006

    View details for PubMedID 28662652

    View details for PubMedCentralID PMC5492879

  • Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries EPIDEMIOLOGY AND HEALTH Choi, E., Lee, S., Nhung, B., Suh, M., Park, B., Jun, J., Choi, K. 2017; 39: e2017006

    Abstract

    Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country.The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable.The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening.The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.

    View details for DOI 10.4178/epih.e2017006

    View details for Web of Science ID 000439454900006

    View details for PubMedID 28171715

    View details for PubMedCentralID PMC5434228

  • Responses to Overdiagnosis in Thyroid Cancer Screening among Korean Women CANCER RESEARCH AND TREATMENT Lee, S., Lee, Y., Yoon, H., Choi, E., Suh, M., Park, B., Jun, J., Kim, Y., Choi, K. 2016; 48 (3): 883?91

    Abstract

    Communicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon.Data were acquired from subjects included in the 2013 Korean National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey. Of the 4,100 respondents in the 2013 KNCSS, women were randomly subsampled and an additional face-to-face interview was conducted. Finally, a total of 586 female subjects were included in this study. Intention to undergo thyroid cancer screening was assessed before and after receiving information on overdiagnosis.Prior awareness of overdiagnosis in thyroid cancer screening was 27.8%. The majority of subjects intended to undergo thyroid cancer screening before and after receiving information on overdiagnosis (87% and 74%, respectively). Only a small number of subjects changed their intention to undergo thyroid cancer screening from positive to negative after receiving information on overdiagnosis. Women of higher education level and Medical Aid Program recipients reported being significantly more likely to change their intention to undergo thyroid cancer screening afterreceiving information on overdiagnosis,whilewomen with stronger beliefs on the efficacy of cancer screening were less likely to change their intention.Women in Korea appeared to be less concerned about overdiagnosis when deciding whether or not to undergo thyroid cancer screening.

    View details for DOI 10.4143/crt.2015.218

    View details for Web of Science ID 000380496900002

    View details for PubMedID 26727718

    View details for PubMedCentralID PMC4946348

  • A qualitative study of women's views on overdiagnosis and screening for thyroid cancer in Korea BMC CANCER Park, S., Lee, B., Lee, S., Choi, E., Choi, E., Yoo, J., Jun, J., Choi, K. 2015; 15: 858

    Abstract

    The incidence of thyroid cancer in Korea has increased by about 25 % every year for the past 10 years. This increase is largely due to a rising incidence in papillary thyroid cancer, which is associated with an overdiagnosis of small tumors that may never become clinically significant. This study was conducted to explore Korean women's understanding of overdiagnosis and to investigate changes in screening intention in response to overdiagnosis information.Focus group interviews were conducted among women of ages 30-69 years, who are commonly targeted in Korea for cancer screening. Women were divided into four groups according to thyroid cancer screening history and history of thyroid disease. Of 51 women who were contacted, 29 (57 %) participated in the interviews.Prior awareness of thyroid cancer overdiagnosis was minimal. When informed about the risks of overdiagnosis, the participants were often surprised. Overcoming initial malcontent, many women remained skeptic about overdiagnosis and trusted in the advice of their physicians. Meanwhile, some of the study participants found explanations of overdiagnosis difficult to understand. Further, hearing about the risks of overdiagnosis had limited impact on the participants' attitudes and intentions to undergo thyroid cancer screening, as many women expressed willingness to undergoing continued screening in the future.A large majority of Korean women eligible for and had undergone thyroid cancer screening were unaware of the potential for overdiagnosis. Nevertheless, overdiagnosis information generally had little impact on their beliefs about thyroid cancer screening and their intentions to undergo future screening. Further research is needed to determine whether these findings could be generalized to the wider Korean population.

    View details for DOI 10.1186/s12885-015-1877-6

    View details for Web of Science ID 000365267500003

    View details for PubMedID 26546276

    View details for PubMedCentralID PMC4635590

  • Relationship between Cancer Worry and Stages of Adoption for Breast Cancer Screening among Korean Women PLOS ONE Choi, E., Lee, Y., Yoon, H., Lee, S., Suh, M., Park, B., Jun, J., Kim, Y., Choi, K. 2015; 10 (7): e0132351

    Abstract

    The possibility of developing breast cancer is a concern for all women; however, few studies have examined the relationship between cancer worry and the stages of adoption for breast cancer screening in Korea. Here, we investigated the associations between cancer worry, the stages of adopting breast cancer screening, and socio-demographic factors known to influence screening behaviors.This study was based on the 2013 Korean National Cancer Screening Survey, an annual cross-sectional survey that utilized nationally representative random sampling to investigate cancer screening rates. Data were analyzed from 1,773 randomly selected women aged 40-74 years. Chi-squared tests and multinomial logistic analyses were conducted to determine the associations between cancer worry and the stages of adoption for breast cancer screening and to outline the factors associated with each stage.Korean women were classified into the following stages of adoption for breast cancer screening: pre-contemplation (24.7%), contemplation (13.0%), action/maintenance (50.8%), relapse risk (8.9%), and relapse (2.6%). Women in the action/maintenance stages reported more moderate to higher levels of worry about getting cancer than those in the pre-contemplation stage. Further, age of 40-49 years and having private cancer insurance were associated with women in the action/maintenance stages.Interventions to address breast cancer worry may play an important role in increasing participation and equity in breast cancer screening.

    View details for DOI 10.1371/journal.pone.0132351

    View details for Web of Science ID 000358198700039

    View details for PubMedID 26186652

    View details for PubMedCentralID PMC4506072

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