PURPOSE: This study aimed to analyze the effect of screening by using endoscopy on the diagnosis and treatment of gastric cancer. MATERIALS AND METHODS: The clinicopathologic characteristics of gastric cancer were compared in individuals who underwent an endoscopy because of symptoms (non-screening group) or for screening purposes (screening group). The distributions of gastric cancer stages and treatment modalities in 2006 and 2011 were compared. RESULTS: The proportion of patients in the screening group increased from 45.1% in 2006 to 65.4% in 2011 (P<0.001). The proportion of stage I cancers in the entire patient sample also increased (from 60.5% in 2006 to 70.6% in 2011; P=0.029). In 2011, the percentages of patients with cancer stages I, II, III, and IV were 79.9%, 8.2%, 10.9%, and 1.1%, respectively, in the screening group, and 47.9%, 10.8%, 29.8%, and 11.5%, respectively, in the non-screening group. The proportion of laparoscopic and robotic surgeries increased from 9.6% in 2006 to 48.3% in 2011 (P<0.001), and endoscopic submucosal dissection increased from 9.8% in 2006 to 19.1% 2011 (P<0.001). CONCLUSIONS: The proportion of patients diagnosed with gastric cancer by using the screening program increased between 2006 and 2011. This increase was associated with a high proportion of early-stage cancer diagnoses and increased use of minimally invasive treatments.
Diagnosis ; Early Detection of Cancer ; Endoscopy ; Humans ; Mass Screening* ; Stomach Neoplasms*

Thyroid cancer is the most common malignancy in Korea; in 2012, about 44,000 new cases (19.6% of all malignancies) were registered and the estimated age-standardized incidence rate of thyroid cancer was 73.6 per 100,000 (17.3 and 88.6 per 100,000 in men and women, respectively). Despite the steep increase in its incidence, the age-standardized mortality rate of thyroid cancer has remained stable and 10-year relative survival rate is 99.2%. Increased detection using high-resolution ultrasonography may have contributed to the increased incidence of thyroid cancer if not all. However, the effectiveness of thyroid cancer screening using ultrasonography has not been fully evaluated as to whether screening and early diagnosis could decrease the morbidity or mortality of thyroid cancer. A multidisciplinary expert committee for developing a guideline for thyroid cancer screening was organized and established a recommendation for thyroid cancer screening using ultrasonography in Korea based on scientific evidence for the first time. In conclusion, the current evidence is insufficient to assess the balance of benefits and harms of the thyroid cancer screening by ultrasonography and the recommendation is that thyroid ultrasonography is not routinely recommended for healthy subjects.
Early Detection of Cancer ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Mortality ; Survival Rate ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonography

BACKGROUND/AIMS: Poor suction ability through a narrow working channel prolongs esophagogastroduodenoscopy (EGD). The aim of this study was to evaluate suction with a new ultrathin endoscope (EG-580NW2; Fujifilm Corp.) having a 2.4-mm working channel in clinical practice. METHODS: To evaluate in vitro suction, 200 mL water was suctioned and the suction time was measured. The clinical data of 117 patients who underwent EGD were retrospectively reviewed on the basis of recorded video, and the suction time was measured by using a stopwatch. RESULTS: In vitro, the suction time with the EG-580NW2 endoscope was significantly shorter than that with the use of an ultrathin endoscope with a 2.0-mm working channel (EG-580NW; mean +/- standard deviation, 22.7+/-1.1 seconds vs. 34.7+/-2.2 seconds; p<0.001). We analyzed the total time and the suction time for routine EGD in 117 patients (50 in the EG-580NW2 group and 67 in the EG-580NW group). In the EG-580NW2 group, the total time for EGD was significantly shorter than that in the EG-580NW group (275.3+/-42.0 seconds vs. 300.6+/-46.5 seconds, p=0.003). In the EG-580NW2 group, the suction time was significantly shorter than that in the EG-580NW group (19.2+/-7.6 seconds vs. 38.0+/-15.9 seconds, p<0.001). CONCLUSIONS: An ultrathin endoscope with a 2.4-mm working channel considerably shortens the routine EGD time by shortening the suction time, in comparison with an endoscope with a 2.0-mm working channel.
Diagnosis ; Early Detection of Cancer ; Endoscopes* ; Endoscopy, Digestive System* ; Humans ; Retrospective Studies ; Suction* ; Water

OBJECTIVE: To determine whether annual screening reduces ovarian cancer mortality in women with a family history of breast or ovarian cancer. METHODS: Data was obtained from the Prostate, Lung, Colorectal, and Ovarian cancer trial, a randomized multi-center trial conducted to determine if screening could reduce mortality in these cancers. The trial enrolled 78,216 women, randomized into either a screening arm with annual serum cancer antigen 125 and pelvic ultrasounds, or usual care arm. This study identified a subgroup that reported a first degree relative with breast or ovarian cancer. Analysis was performed to compare overall mortality and disease specific mortality in the screening versus usual care arm. In patients diagnosed with ovarian cancer, stage distribution, and survival were analyzed as a secondary endpoint. RESULTS: There was no significant difference in overall mortality or disease specific mortality between the two arms. Ovarian cancer was diagnosed in 48 patients in the screening arm and 44 patients in the usual care arm. Screened patients were more likely to be diagnosed at an earlier stage than usual care patients. Patients in the screening arm diagnosed with ovarian cancer experienced a significantly improved survival compared to patients in the usual care arm; relative risk 0.66 (95% CI, 0.47 to 0.93). CONCLUSION: Screening did not appear to decrease ovarian cancer mortality in participants with a family history of breast or ovarian cancer. Secondary endpoints, however, showed notable differences. Significantly fewer patients were diagnosed with advanced stage disease in the screening arm; and survival was significantly improved. Further investigation is warranted to assess screening efficacy in women at increased risk.
Aged ; Breast Neoplasms/*genetics ; *Early Detection of Cancer ; Female ; Humans ; Menopause ; Middle Aged ; Ovarian Neoplasms/diagnosis/*genetics

Gastric cancer is the most common cancer in Korea and has overall survival rate of around 50%. Gastric cancer detected in early stage can be cured by endoscopic resection or less invasive surgical treatment and the subsequent prognosis is excellent. National cancer screening program for gastric cancer has been available for several years. The evaluation for efficacy of our screening strategy is strongly needed in terms of mortality reduction and cost-effectiveness. Accurate diagnosis and staging evaluation is important for proper management and prediction of a patient's prognosis. It is recommended to understand the advantages and limitations of currently available guidelines and diagnostic modalities. The 7th edition of gastric cancer staging system from AJCC may have significant effect on our knowledge and patient management.
*Early Detection of Cancer ; Humans ; Medical Records/standards ; Neoplasm Staging ; Stomach Neoplasms/*diagnosis/pathology/radiography

The objective of cancer screening is to reduce the risk of death, i.e., mortality from cancer among individuals subjected to screening. For cervical and colorectal cancer, the screening test is aimed at detection of preinvasive lesions. Therefore, reduction in the incidence of invasive disease also results from screening. In a national cancer control program, the programs should be orgainzed to ensure that a large proportion of the target group is screened and that those individuals in whom abnormalities are abserved receive appropriate diagnosis and therapy. Agreement should be reached on guidelines to be applied in the national cancer control program. When establishing appropriate cancer screening recommendations several factors should be considered. ① For establishing the starting age, age-specific incidence and mortality rate, life lost person-years, and cost-effectiveness can be considered. ② For frequency of screening, it is necessary to understand the natural history of disease. ③ For choosing the best test tool, sensitivity and specificity, compliance, cost, and adverse effects can be considered. It seems that doctors' willingness to participate is essential for a successful cancer screening program. They should understand the rationale of cancer secreening, its effectiveness, and the risk.
Colorectal Neoplasms ; Compliance ; Diagnosis ; Early Detection of Cancer ; Incidence ; Korea ; Mass Screening ; Mortality ; Natural History ; Sensitivity and Specificity

OBJECTIVES: We propose an automatic breast mass detection algorithm in three-dimensional (3D) ultrasound (US) images using the Hough transform technique. METHODS: One hundred twenty-five cropped images containing 68 benign and 60 malignant masses are acquired with clinical diagnosis by an experienced radiologist. The 3D US images are masked, subsampled, contrast-adjusted, and median-filtered as preprocessing steps before the Hough transform is used. Thereafter, we perform 3D Hough transform to detect spherical hyperplanes in 3D US breast image volumes, generate Hough spheres, and sort them in the order of votes. In order to reduce the number of the false positives in the breast mass detection algorithm, the Hough sphere with a mean or grey level value of the centroid higher than the mean of the 3D US image is excluded, and the remaining Hough sphere is converted into a circumscribing parallelepiped cube as breast mass lesion candidates. Finally, we examine whether or not the generated Hough cubes were overlapping each other geometrically, and the resulting Hough cubes are suggested as detected breast mass candidates. RESULTS: An automatic breast mass detection algorithm is applied with mass detection sensitivity of 96.1% at 0.84 false positives per case, quite comparable to the results in previous research, and we note that in the case of malignant breast mass detection, every malignant mass is detected with false positives per case at a rate of 0.62. CONCLUSIONS: The breast mass detection efficiency of our algorithm is assessed by performing a ROC analysis.
Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Computer-Assisted ; Early Detection of Cancer ; Image Processing, Computer-Assisted ; Masks ; ROC Curve ; Ultrasonography*

No abstract available.
*Colposcopes ; Early Detection of Cancer/*instrumentation ; Female ; Humans ; Optical Imaging/*instrumentation ; Uterine Cervical Dysplasia/*diagnosis ; Uterine Cervical Neoplasms/*diagnosis

The 5-year survival rate of pancreatic cancer is extremely low till now, because resectable cases are less than 20% and 5-year survival rate after surgical resection is only 10-20%. Early detection and curative surgery are important to prolong the survival which was well proved by colon cancer screening test in general population. However, screening test for general population can not prove the survival benefit in pancreatic cancer. So, many studies were performed for the development of screening strategies in high-risk groups of pancreatic cancer. The following were current candidates for screening: first-degree relatives of patients with pancreatic cancer from a familial pancreatic cancer kindred with at least two affected first-degree relatives; patients with Peutz-Jeghers syndrome; and p16, BRCA2 and hereditary non-polyposis colorectal cancer mutation carriers with > or = 1 affected first-degree relative. The recommended screening tests are endoscopic ultrasonography and magnetic resonance cholangiopancreatography. Screening is recommended at age 50 or 10 year earlier than the onset age of pancreatic cancer among family. However, the screening interval is not established and there is great disagreement as to which screening abnormalities were of sufficient concern to for surgery to be recommended.
Age of Onset ; Cholangiopancreatography, Magnetic Resonance ; Colonic Neoplasms ; Colorectal Neoplasms ; Early Detection of Cancer ; Early Diagnosis ; Endosonography ; Humans ; Mass Screening ; Pancreatic Neoplasms* ; Peutz-Jeghers Syndrome ; Survival Rate

Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.
Colonoscopy ; Colorectal Neoplasms ; Consensus ; Early Detection of Cancer* ; Early Diagnosis ; Endoscopy* ; Endoscopy, Gastrointestinal ; Expert Testimony ; Gastroscopy ; Korea* ; Mass Screening ; Outcome Assessment (Health Care) ; Quality Improvement* ; Stomach