Gap between Perceived eHealth Literacy and Ability to Use Online Cancer-Related Information

Background@#The effective evaluation of health information available online is an important skill. However, consumers' self-perceptions of their eHealth literacy levels do not reflect their actual capabilities. The goal of this experimental study of online search behavior is to identify differences between self-perceived eHealth literacy and actual ability to use the accuracy of cancer information available online. @*Methods@#Thirty-one adults participated in the study conducted on July 15 and 16, 2017. We first measured perceived eHealth literacy and then asked participants 5 questions concerning cancer. Bandicam (v3.3.0) and BrowsingHistoryView were used to record search behavior and uniform resource locators, respectively. A Mann-Whitney U test and Fisher's exact test were performed. @*Results@#The results showed that participants most frequently searched for cancer information on blogs and café websites. Regarding search behavior, those who perceived higher knowledge in available resources tended to solve the given problem with significantly smaller number of webpages to answer a weight management question. Participants who perceived higher knowledge in helpfulness of information tended to use significantly smaller number of webpages to answer questions on red ginseng's preventive effects on caner and weight management. However, there was no proof that the high eHealth literacy group had significantly higher rates of correct answers than the low eHealth literacy group. Further, regarding cancer screening, the rates of correct answers were low for groups who considered their ability higher to find helpful resources and perceived higher knowledge in helpfulness of information. @*Conclusion@#There is a gap between perceived eHealth literacy and the actual ability to use online cancer-related information. To fundamentally improve eHealth literacy, it is important to evaluate the actual abilities concerning each eHealth literacy component and to provide customized education.

The Fear of Cancer from the Standpoint of Oneself, the Opposite Sex and the Fear of Side Effects of Cancer Treatment / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#It is important to understand the differences between men and women when it comes to attitudes and risk perception toward disease. This study aimed to explore the fear of cancer from the standpoint of themselves and the opposite sex by cancer type. @*Materials and Methods@#A cross-sectional survey with a representative sample was conducted. @*Results@#The least and the most feared cancers in men were thyroid cancer and lung cancer, respectively. When men assumed the perspective of women, the least and the most feared cancer were thyroid cancer and stomach cancer, respectively. The least and the most feared cancers in women were thyroid cancer and stomach cancer, respectively. When women assumed the perspective of men, the least and the most feared cancer were prostate cancer and lung cancer, respectively. When both men and women assume the perspective of the opposite sex, the fear of sex-specific cancer was relatively low compared to the actual responses of both men and women. The top six of the most feared side effects of cancer treatment were pain, psychological problems, general weakness, digestive dysfunction, fatigue, and appearance change. These were the same between men and women. @*Conclusion@#Health care providers and caregivers in the family should provide care with more attention to the differences in thoughts about cancer between men and women. Health care providers should provide care with more attention to the differences in these problems between men and women.

Socioeconomic Burden of Cancer in Korea from 2011 to 2015 / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Though the socioeconomic burden of cancer on patients is increasing in South Korea, there is little research regarding the type of cancer that incurs the highest costs. This study analyzed the socioeconomic burden on cancer patients from 2011 to 2015 according to sex and age. @*Materials and Methods@#A prevalence-based approach was applied utilizing claim data of the National Health Insurance Service in Korea to estimate the socioeconomic burden of cancer on patients. Patients who received treatment for cancer from 2011 to 2015 were the study subjects. The total socioeconomic burden of their disease and treatment was divided into direct and indirect costs. @*Results@#There was an increase of 50.7% for 5 years, from 821,525 to 1,237,739 cancer patients. The cancer costs for men and women increased $8,268.4 million to $9,469.7 million and $3,626.5 million to $4,475.6 million, respectively. Furthermore, the 50-59-year-old age group accounted for a large portion of the total disease cost. Liver, lung, stomach, and colorectal cancers created the heaviest economic burdens on patients. @*Conclusion@#Overall, this study indicates new policies for cancer prevention, early detection, and postcancer treatment management are necessary to help limit the costs associatedwith cancer, especially in the elderly, and provides a foundation for establishing cancer-related health care policies, particularly by defining those cancers with heavier disease burdens.

What We Talk about When We Talk about Caregiving: The Distribution of Roles in Cancer Patient Caregiving in a Family-Oriented Culture / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: When it comes to cancer care, the psychological well-being of family caregivers has gotten its deserved attention. However, the specific roles that the family caregivers take have not been examined as much. The current study aimed to investigate the distribution of family caregivers' roles, particularly in a family-oriented culture, Korea. MATERIALS AND METHODS: A sample of 439 participants was recruited from 11 national and regional cancer centers in Korea. The participants who were 60 years old or above went through treatments for their gastric, colorectal, or lung cancer. The individual survey included questions regarding the family type, living arrangement, and the sources of support when it comes to their physical, emotional, financial, and decision-making needs. RESULTS: The responses from the participants showed that cancer caregiving is shared by multiple family caregivers; the major source of support for elderly cancer patients on diverse domains was their spouse; patients' reliance on their daughter(s) increased for emotional support; and patients' reliance on their son(s) stood out for financial support and decision-making support. Also, the older the patients were, the heavier their reliance was on the adult children, including sons, daughters, and daughters-in-law. CONCLUSION: Future support programs for elderly cancer patients are suggested to involve multiple family caregivers to encourage effective and efficient intervention. Also, the limitations of the current study and the suggestions for future research are discussed.

Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: As the recent term of “financial toxicity” implies, cancer causes a treatment-related financial harm. Financial Aid Program for Cancer Patient (FAPCP) is a government’s financial support for low-income patients in the Republic of Korea. This study aimed to describe FAPCP applicants’ condition and to investigate factors influencing financial burden, which would provide the basis for implementing a strategy for FAPCP administration. MATERIALS AND METHODS: The telephone survey results from 2,700 FAPCP participants were analyzed, including demographic, socioeconomic, and disease characteristics and experiences associated with financial burden and the actions or measures to cope with them. RESULTS: Overall, 87.6% experienced financial burden more than moderate degree, 39.2% got financial help/a loan, 17.8% disposed of their property, and 10.2% changed or stopped treatment owing to medical costs. Monthly household income was connected to financial burden, and the highest income group was associated with the lowest financial burden (odds ratio [OR], 0.21; 95% confidence interval [CI], 0.11 to 0.38) and the lowest rate of changing/stopping care (OR, 0.23; 95% CI, 0.05 to 1.00). Parents of childhood cancer patients got financial help/a loan (OR, 2.24; 95% CI, 1.03 to 4.88) and disposed of their property (OR, 3.18; 95% CI, 1.40 to 7.22) more frequently, and Medical Aids applicants showed the highest rate of changing/stopping care (OR, 3.01; 95% CI, 1.89 to 4.78). CONCLUSION: FAPCP targets low income groups; however, financial burden and the consequent actions taken still exist disproportionately, depending on the income of the applicants. FAPCP should focus on more vulnerable groups including Medical Aid applicants and parents of childhood cancer patients, by increasing funds and expanding their support coverage.

Income Difference in Attitudes towards Cancer in General Population: Findings from a National Survey

BACKGROUND: To better understand cancer-related health behaviors, it is critical to know how general populations with different socioeconomic and demographic backgrounds perceive cancer. The current paper explored differences in general attitudes and beliefs towards cancer among Koreans. METHODS: A cross-sectional national survey was conducted for 1,000 Korean participants who were not cancer patients and did not have immediate family members with cancer via proportional quota random sampling. General attitudes and beliefs about cancer were measured by face-to-face interview using the awareness and beliefs about cancer (ABC) measure. RESULTS: Most respondents (84.8%–88.5%) had optimistic attitudes towards cancer. However, 35.6% to 87.7% agreed with negative cancer beliefs across all age groups simultaneously. Socioeconomic disparity of positive cancer beliefs was not evident. Unexpectedly, the highest income group agreed more strongly with the negatively framed statements that cancer treatment is worse than the cancer itself (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.31–5.53), that they would not want to know if they have cancer (OR, 1.61; 95% CI, 0.94–2.75), and that a cancer diagnosis is a death sentence (OR, 2.32; 95% CI, 1.34–4.01), than the lowest income group. CONCLUSION: The present results imply a complicated context of cancer beliefs in Korea, unlike those shown in the studies of western populations. While the contradictory attitudes toward cancer can be attributable to the dual nature of information processing, social environment might have played a role. The association between socioeconomic status and negative attitudes toward cancer may vary depending on the diversity of the contexts.

Patient's Cognitive Function and Attitudes towards Family Involvement in Cancer Treatment Decision Making: A Patient-Family Caregiver Dyadic Analysis / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and family caregivers preferences for family involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and family members agree on preferences. MATERIALS AND METHODS: A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forfamily involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment). RESULTS: Both patients and family caregivers preferred greater family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment. CONCLUSION: Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing family involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.

Analysis of Hospital Volume and Factors Influencing Economic Outcomes in Cancer Surgery: Results from a Population-based Study in Korea

OBJECTIVES: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. METHODS: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles. RESULTS: Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy. CONCLUSION: Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals’ cost of care and risk-adjusted mortality.

News Portrayal of Cancer: Content Analysis of Threat and Efficacy by Cancer Type and Comparison with Incidence and Mortality in Korea

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.

News Portrayal of Cancer: Content Analysis of Threat and Efficacy by Cancer Type and Comparison with Incidence and Mortality in Korea

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.

Happiness and health behaviors in South Korean adolescents: a cross-sectional study / 한국역학회지

OBJECTIVES: We examined the associations between happiness and a wide range of health behaviors in South Korean adolescents. METHODS: Study data were derived from the ninth Korea Youth Risk Behavior Web-based Survey administered from June to July 2013. In addition to happiness levels, the questionnaire included items on sociodemographics and health-related lifestyle factors (smoking, drinking, eating breakfast, fruit and vegetable consumption, physical activity, sedentary behavior, and hours of sleep). RESULTS: The multivariate analysis revealed that higher levels of happiness were associated with not smoking or drinking, eating breakfast, eating fruits daily, vegetable consumption, participating in at least 60 minutes of physical activity a day, avoiding sedentary behavior, and hours of sleep. Additionally, sex differences were found in relationships between happiness and eating fruit daily, participation in physical activity, and sedentary behavior. CONCLUSIONS: These results encourage public health professionals to consider the psychological aspects of adolescent life in working to improve their health behaviors and outcomes.

Terminal Versus Advanced Cancer: Do the General Population and Health Care Professionals Share a Common Language? / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients' cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general population and determined associated socio-demographic factors. MATERIALS AND METHODS: A total of 2,000 persons from the general population were systematically recruited. We used a clinical vignette of a hypothetical advanced breast cancer patient, but whose cancer was not considered terminal. After presenting the brief history of the case, we asked respondents to choose the correct cancer stage from a choice of early, advanced, terminal stage, and don't know. Multinomial logistic regression analysis was performed to determine sociodemographic factors associated with the correct response, as defined in terms of medical context. RESULTS: Only 411 respondents (20.6%) chose "advanced," while most respondents (74.5%) chose "terminal stage" as the stage of the hypothetical patient, and a small proportion of respondents chose "early stage" (0.7%) or "don't know" (4.4%). Multinomial logistic regression analysis found no consistent or strong predictor. CONCLUSION: A large proportion of the general population could not differentiate advanced cancer from terminal cancer. Continuous effort is required in order to establish common and shared definitions of the different cancer stages and to increase understanding of cancer staging for the general population.

Public Perceptions on Cancer Incidence and Survival: A Nation-wide Survey in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to compare the public perceptions of the incidence rates and survival rates for common cancers with the actual rates from epidemiologic data. MATERIALS AND METHODS: We conducted a survey of Korean adults without history of cancer (n=2,000). The survey consisted of questions about their perceptions regarding lifetime incidence rates and 5-year survival rates for total cancer, as well as those of eight site-specific cancers. To investigate associated factors, we included questions about cancer worry (Lerman's Cancer Worry Scale) or cared for a family member or friend with cancer as a caregiver. RESULTS: Only 19% of Korean adults had an accurate perception of incidence rates compared with the epidemiologic data on total cancer. For specific cancers, most of the respondents overestimated the incidence rates and 10%-30% of men and 6%-18% of women had an accurate perception. A high score in "cancer worry" was associated with higher estimates of incidence rates in total and specific cancers. In cancers with high actual 5-year survival rates (e.g., breast and thyroid), the majority of respondents underestimated survival rates. However, about 50% of respondents overestimated survival rates in cancers with low actual survival rates (e.g., lung and liver). There was no factor consistently associated with perceived survival rates. CONCLUSION: Widespread discrepancies were observed between perceived probability and actual epidemiological data. In order to reduce cancer worry and to increase health literacy, communication and patient education on appropriate risk is needed.

What predicts the trust of online health information? / 한국역학회지

OBJECTIVES: Little attention has been paid to levels of trust in online sources of health information. The objective of this study was to investigate levels of trust in various sources of health information (interpersonal channels, traditional media, and Internet media), and to examine the predictors of trust in health information available on the Internet. METHODS: A questionnaire was administered to 1,300 people (20 years of age or older), evaluating levels of trust in various sources of health information. RESULTS: The highest level of trust was expressed regarding interpersonal channels, with hospital physicians regarded as the most trusted source of information age and income showed an association with trust in online information sources. Elderly people were not likely to trust Internet news sources, and high incomes were found to be strongly associated with trust in online sources of information overall. CONCLUSIONS: Public health organizations must consider the predictors for trust in various sources of information in order to employ appropriate media when targeting vulnerable individuals or developing messaging strategies for health professionals.

Perceptions of Cancer Risk and Cause of Cancer Risk in Korean Adults / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aims of the present study were to assess the prevalence of perceived risk for cancer; to explore associations between sociodemographics and family history of cancer and perceived cancer risk; to identify perceived cause of cancer risk; and to examine the associations between sociodemographics and family history of cancer and perceived cause of cancer risk. MATERIALS AND METHODS: This cross-sectional study was conducted among 1,009 participants aged 30-69 years, selected from a population-based database in October 2009 through multiple-stratified random sampling. Information was collected about the participants' perceived cancer risk and perceived cause of cancer risk. RESULTS: Overall, 59.5% of the respondents thought they had the chance of developing cancer. Female sex, younger age, lower income, and family history of cancer were positively associated with perceived cancer risk. The most important perceived cause of cancer risk was stress. There was a difference between sociodemographics and family history of cancer and perceived cause of cancer risk. CONCLUSION: Factors affecting perceptions of cancer risk and cause of cancer risk need to be addressed in risk communications. The results provide important directions for the development of educational strategies to promote awareness and self-appraisal of cancer risk and risk factors.

Suggestions for establishing a sustainable risk communication platform for carcinogenic factors / 한국역학회지

No abstract available.

Gender Differences in Relationship between Fat-Free Mass Index and Fat Mass Index among Korean Children Using Body Composition Chart

PURPOSE: This study aimed to investigate gender differences in the relationship between fat-free mass index (FFMI) and fat mass index (FMI) by applying body composition chart on Korean elementary students. MATERIALS AND METHODS: Data from 965 healthy Korean children of 8 to 12 years of age (501 boys, 464 girls) were obtained. FFMI and FMI were plotted on the body composition chart, and the differences in the relationships between FFMI and FMI were separately evaluated by gender or grade. RESULTS: Weight was heavier and BMI was higher in 3rd and 4th grade boys compare to girls. The value of FFM was higher in boys, but FM was not different. In subgroup analysis by grade, significant gender by FFMI interaction (p=0.015) was found, indicating that the slope of the lines for FMI vs. FFMI was different between boys and girls (Figure was not shown). In subgroup analysis by gender, grade by FFMI interaction was significant in boys, indicating that FMI vs. FFMI relationship differed according to grade only in boys. CONCLUSION: Boys are leaner than girls, despite having similar BMI. Gender difference in the direction of the change of the FFMI and FMI relationship is evident in children.

Risk Factors for Primary Multidrug Resistant Tuberculosis / 결핵및호흡기질환

BACKGROUND: Primary multidrug-resistant tuberculosis is defined as Mycobacterium tuberculosis isolates that are resistant to at least isoniazid and rifampin in never-been-treated tuberculosis patients, and this malady is caused by the transmission of a resistant strain from one patient, who is infected with a resistant Mycobacterium tuberculosis strain, to another patient. The prevalence of primary multidrug-resistant tuberculosis could be a good indicator of the performance of tuberculosis control programs in recent years. We conducted a case-control study to identify the risk factors for primary multidrug-resistant tuberculosis. METHODS: From January 1, 2001 to, June 30, 2003, by conducting prospective laboratory-based surveillance, we identified 29 hospitalized patients with P-MDRTB and these patients constituted a case group in this study. The controls were represented by all the patients with culture-confirmed drug susceptible tuberculosis who were admitted to National Masan Hospital during the same study period. The odds ratios for the patients with primary multidrug-resistant tuberculosis, as compared with those of the patients with drug susceptible tuberculosis, were calculated for each categorical variable with 95% confidence intervals. RESULTS: Multivariate logistic regression showed that the presence of diabetes mellitus (odds ratio 2.68; 95% confidence interval, 1.05-6.86) was independently associated with having primary multidrug-resistant tuberculosis. CONCLUSION: This study has shown that diabetes mellitus might be one of the risk factors for primary multidrug-resistant tuberculosis.

A Meta-analysis on the Association between Chronic Noise Exposure and Blood Pressure / 예방의학회지

OBJECTIVES: This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. METHODS: Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. RESULTS: All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studies were accomplished in a resting state, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. CONCLUSIONS: Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.