Cancer Control Plan & Cancer Registry in Korea

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1 Cancer Control Plan & Cancer Registry in Korea National Cancer Center Republic of Korea Hai-Rim Shin

2 Background Cancer Control planning Cancer Registration & Statistics National Cancer Screening Program & others

3 Trend of major causes of death in Korea % '84 '86 '88 '90 '92 '94 '96 '98 '00 '02 year HD DM Liver CVD Cancer Source: Cause of Death, NSO 2003

4 Plan to to establish the NCC formulated by MOHW (National Cancer Control Planning Board) 1 st 10-Year Strategy for Cancer Control Cancer Control Division, Health Promotion Bureau, Ministry of Health & Welfare (MOHW) National Cancer Center opening Plan to prepare 2 nd 10-Y strategy for Cancer Control

5 National Cancer Center, Korea Aims: to reduce the occurrence and mortality rate due to cancer improving the quality of the life of cancer patients. - Named National Cancer Center (NCC) based on the Korean National Cancer Center Act. - Focuses on cancer research, clinical oncology, and education. - Consists of the Cancer Research Institute and Hospital.

6 Division of Cancer Control & Epidemiology Statistical research on the cancer incidence, mortality and survival Development of the cancer prevention and early detection guidelines Epidemiological studies on the risk factors of cancer Development of system for improving the quality of life of cancer patients and their families

7 Background Cancer Control planning Cancer Registration & Statistics National Cancer Screening Program & others

8 Cancer Registries in Korea Korea Central Cancer Registry Headquarters: NCC start; 1980 Hospital based CR Cover; 90% of cancer cases KC CR CR for specific cancer Breast Cervix Liver Regional Cancer Registry 9 Regional CRs Seoul Busan Daegu.. Goyang Coverage: 50% of population

9 Regional Cancer Registries & Incidence Region Year Sex ASR Kwang hwa M F Seoul Busan Daegu M F M F M F CI5 Vol VIII Goyang Kwanghwa Seoul Incheon Daejon Daegu Gwangju Ulsan Busan Jejudo

10 Sources of data for cancer registration Training Hosp Regional CR Specific Ca Med Insurance Death Source As of hospitals 9 Breast, Cervix Liver, etc Claim data new cancer Cancer Death Data Base construction Dataware house IARC check & Modification Death PIN check DB construction Feed Back Each hospital & source Original registered data with updated information and death data Death DB with ID error

11 Legal aspects of cancer registration March Voluntarily participation of cancer registry from the training hospitals Cancer Act (May 2003) Stipulate mandatory cancer registration Cancer Act enforcement regulation - Prohibit against privacy protection - Need to amend the law (by MOHW)

12 Proportion (%) of 10 Major Cancers in 2002 Cancer Cases, 2002 Cancer Death, 2002 others 21.9% stomach 20.2% others 20.5% lung 20.0% cervix 1.6% bladder 2.2% pancreas 2.4% hemato 2.6% lung 11.9% brain 1.9% breast 2.2% leukemia 2.3% stomach 18.7% cervix 4.0% thyroid 4.9% breast 7.4% colon 11.2% liver 11.3% esophagus 2.4% pancreas 4.6% colon 8.1% liver 17.7% Korea Central Cacner Registry, 2002 (ICD-O2) Cause of Death, NSO, 2002 (ICD-10)

13 Comparison of Cancer Statistics World: Year 2000 Population: 6,070M Korea: Year 2000 Population: 46 M (0.76% of World Pop) Incidence: 10.1 million Mortality: 6 million Prevalence: 22 million Source: Global Action Against Cancer, WHO & UICC, 2003 Incidence: 100,000 Mortality: 63,000 Prevalence: 220,000

14 Background Cancer Control planning Cancer Registration & Statistics National Cancer Screening Program & others

15 National Cancer Screening Program Dept of Cancer Control, MOHW 1 Planning and funding the program The supporting and Evaluation Board of NCSP, NCC - Provides national guidance on screening - Training for health professional - Public education and promotion - Evaluation and monitoring of the program Medicaids Beneficiaries Public Health Centers 254 National Health Insurance Corporation Beneficiaries 2 Select the target population and send the invitation letter 5 Send the results and claim the bill 6 Pay for the bill Target population 3 Visit and take the screening 4 Send the results Screening Unit in hospital or clinic

16 National Cancer Screening Program Cancer Test or Frequency Target procedure Population Stomach Endoscopy every 2 year 40 & over or UGI* Breast Mammography & every 2 year 40 & over CBE (Women) Cervix Pap smear every 2 year 30 & over (Women) Liver Sonography & AFP every 6month high risk** Colon FOBT every 1 year 50 & over DCBE, Colonoscopy *: Upper Gastrointestinal series (Barium contrast study) ** : 40 & over with HBsAg positive or anti-hcv positive or liver cirrhosis

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18 Construction for Cancer Information Service First period (2004~ 2006) Collection of Ca information Construct DB Manual develop & Demonst project Second period (2007~ 2009) Standardization of CI Extend of CI DB Networking Application & Dissemination Third period (2010~ 2013) CI service Extend of research Area & Application Need for evidence-based CI Nation-wide Capacity building Apply for cancer research and Clinics

19 Strategy for Cancer Control Through Cancer Research & Control Program 1/3: Prevention Anti-smoking HBV Vaccine, 1/3: Early Detection and Tx Screening 1/3: Palliative Medicine Pain control etc

20 National Cancer Control Programs Fund for Cancer Research extramural & intramural Cancer Registration: Central, Regional, site-specific Public relations and education National Cancer screening program Support for Pain control of terminal Ca Patient (HC) Demonstration project for Hospice Support for BM transplantation capacity building Manual for Pain control of Cancer Patients (dissemination) Financial support for Childhood Leukemia patients through public health system

21 Primary Prevention Anti-smoking Banning in TV, News Paper

22 Thank you for your time and attention!