Healthc Inform Res.  2017 Apr;23(2):119-125. 10.4258/hir.2017.23.2.119.

Care Pathway for Cancer Survivorship in Korea: Trend of Breast Cancer Pathway from 2003 to 2010

• Seo HJ
• Noh DY

• KMID: 2378520
• DOI: http://doi.org/10.4258/hir.2017.23.2.119

Abstract

OBJECTIVES
The survival rate of cancer patients has exceeded 60%. Although cancer survivors may die of other diseases except cancer, the health management system including chronic disease prevention-management for cancer survivors, has not been established in the diverse aspects. Therefore, services according to care pathway of cancer patients need to be provided through a support system based on a platform concept that can be used to meet patient needs in various ways.
METHODS
A sample cohort database (2002-2010) of approximately 1 million persons"”2% of the whole nation (50 million)"”was used to estimate cancer survivors through a principal care pathway for cancer management. The sample cohort database was built to estimate the number of breast cancer survivors in the five stage: "˜Diagnosis and treatment,'"˜Supportive care,'"˜Monitoring,'"˜Progress illness,' and "˜Hospice care'. In this way, the scale of breast cancer survivors was estimated.
RESULTS
There were 330 (9.8%) cases of the incidence of cancer in 2010 in the "˜Diagnosis and treatment.' Among the cases of the incidence of cancer in the previous year, the number of one-year survivors was 328 (9.7%); these were included in the category "˜Supportive care.' In the "˜Monitoring' category, 2,593 (76.9%) who maintained health lives were included. A total of 84 (2.5%) survivors were checked to identify an ongoing disease; these were included in the category "˜Progress illness.' In the category "˜Hospice care,' 36 (1.1%) end-stage cancer patients requiring hospice care were included.
CONCLUSIONS
We established a care pathway by survival stage in order to fulfill prevention and health management services post-treatment management steps.

Keyword

Breast Neoplasms; Survival Rate; Critical Pathways; Cohort Studies; Postoperative Care

MeSH Terms

Breast Neoplasms*
Breast*
Chronic Disease
Cohort Studies
Critical Pathways
Hospice Care
Humans
Incidence
Korea*
Postoperative Care
Survival Rate*
Survivors

Figure

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  Figure 1 Database (DB) architecture for cohort DB with breast cancer.

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  Figure 2 Care pathway based assumption results for breast cancer survivorship (cohort database of National Health Insurance Service, 2004–2010).

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  Figure 3 Age-specific survival patients of breast cancer from 2003 to 2010 in Korea. (A) Diagnosis and treatment and (B) Monitoring.

Reference

1. Mullan F. Seasons of survival: reflections of a physician with cancer. N Engl J Med. 1985; 313(4):270–273.

2. Min SY, Kim Z, Hur MH, Yoon CS, Park EH, Jung KW, et al. The basic facts of Korean Breast Cancer in 2013: results of a Nationwide Survey and Breast Cancer Registry Database. J Breast Cancer. 2016; 19(1):1–7.

3. Oh CM, Won YJ, Jung KW, Kong HJ, Cho H, Lee JK, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2013. Cancer Res Treat. 2016; 48(2):436–450.

4. Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M, et al. Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer. 2009; 101(3):541–547.

5. Yoon JR, Kim YN, Lee CS. Life after cancer [Internet]. Seoul, Korea: segye.com;c2016. cited at 2017 Apr 15. Available from: http://www.segye.com/content/html/2016/07/06/20160706003541.html?OutUrl=naver.

6. National Cancer Survivorship Initiative. Living with and beyond cancer: taking action to improve outcomes. London, UK: Department of Health;2013.

7. The Korea Central Cancer Registry. Annual report of cancer statistics in Korea in 2013 [Internet]. Goyang, Korea: National Cancer Center;c2016. cited at 2017 Apr 15. Available from: http://ncc.re.kr/cancerStatsView.ncc?bbsnum=358&searchKey=total&searchValue=&pageNum=1.

8. National Cancer Information Center. Cancer statistics [Internet]. Goyang, Korea: National Cancer Information Center;c2016. cited at 2017 Apr 15. Available from: http://www.cancer.go.kr/mbs/cancer/subview.jsp?id=cancer_040101000000.

9. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. 3rd ed. Philadelphia (PA): Lippincott Williams & Wilkins;2012.

10. Maher J, McConnell H. New pathways of care for cancer survivors: adding the numbers. Br J Cancer. 2011; 105:Suppl 1. S5–S10.

11. Ward SE, Viergutz G, Tormey D, deMuth J, Paulen A. Patients' reactions to completion of adjuvant breast cancer therapy. Nurs Res. 1992; 41(6):362–366.

12. Lee YS. Psychosocial experience in post-mastectomy women. Korean J Soc Welf. 2007; 59(3):99–124.

13. Korean Breast Cancer Society [Internet]. Seoul, Korea: Korean Breast Cancer Society;c2009. cited at 2017 Apr 15. Available from: http://www.kbcs.or.kr/main/main.html.

14. Burnham TR, Wilcox A. Effects of exercise on physiological and psychological variables in cancer survivors. Med Sci Sports Exerc. 2002; 34(12):1863–1867.

15. Kim HJ, So HS. A study on health promoting behavior in post-mastectomy patients. J Korean Acad Soc Adult Nurs. 2001; 13(1):82–95.

16. Harding M. Health-promotion behaviors and psychological distress in cancer survivors. Oncol Nurs Forum. 2012; 39(2):E132–E140.

17. Lee Y, Moon M. Utilization and content evaluation of mobile applications for pregnancy, birth, and child care. Healthc Inform Res. 2016; 22(2):73–80.