* Based on 2022 Korea Disease Control and Prevention Agency's National Health and Nutrition Examination Survey
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Liver cancer is mainly caused by damage to the liver due to chronic hepatitis, which is why hepatitis prevention is essential to prevent liver cancer. Hepatitis can be broadly categorized into infectious and non-infectious hepatitis.
Infectious hepatitis, which has been linked to liver cancer, includes hepatitis B and hepatitis C. Hepatitis B is vaccinable, while hepatitis C is not.
Non-infectious hepatitis causes include alcoholic and non-alcoholic hepatitis. Moderate alcohol consumption and weight management are important for prevention.
If you already have hepatitis, you need to watch your drinking, smoking, and diet. You should discuss any dietary supplements or herbal remedies with your doctor because they can put a burden the liver.
Hepatitis C is treated with antiviral medications.
The main treatment for acute hepatitis B is supportive care to reduce symptoms. In chronic hepatitis B, where the inflammation caused by hepatitis lasts longer than six months, treatment options include taking antiviral medications.
Cigarette smoke contains a variety of harmful substances. Smoking increases your body's exposure to these harmful chemicals, which can cause various cancers. According to a report published by the Korea Centers for Disease Control and Prevention in 2022, 30% of cancers in Korea are caused by smoking. The most common cancers caused by direct exposure to tobacco smoke occur in the lung, larynx, esophagus, and oral cavity. Smoking is also known to increase the risk of colon, stomach, pancreas, and cervical cancer in Korea.
Unlike hepatitis B, there is no vaccine for hepatitis C. Because hepatitis C infection is primarily spread through contaminated blood, infection can occur through reuse of contaminated syringes or needles, piercing, or tattooing. Like hepatitis B, it is not commonly transmitted through sex, but it can still be spread through sex that results in bleeding.
Hepatitis B vaccination is offered to all newborns and infants through the National Immunization Program. However, some people do not develop antibodies even after immunization, so additional vaccination is recommended for people at high risk of exposure to the hepatitis B virus, such as
- Family members of people with chronic hepatitis B virus infection
- Patients who receive frequent blood transfusions
- Patients receiving dialysis- Healthcare workers
- People with diabetes and chronic liver disease
Hepatitis B is spread through blood or bodily fluids, so it can also be spread through sexual contact or a needle stick from a contaminated syringe.
Hepatitis B and C can be detected through a blood test. Hepatitis B is vaccinable, so if your blood test shows no hepatitis B antibodies, you can get vaccinated.
It is known that the longer you are exposed to female hormones, the greater the risk of developing breast cancer. Therefore, you should be cautious about taking female hormone replacement therapy after menopause, and it is contraindicated if you have breast cancer. There is no known link between oral contraceptives and breast cancer.
Cirrhosis is a disease in which chronic inflammation causes the liver tissue to break down and harden. It is often asymptomatic, so it is difficult to tell if you have cirrhosis based on symptoms alone. It can be diagnosed through biopsy or blood tests and imaging.
Human papillomavirus (HPV) is a disease that is spread through sexual contact. Vaccination is recommended before sexual experience. Female adolescents ages 12-17 and low-income women ages 18-26 can get HPV bivalent (Cervarix) or HPV quadrivalent (Gardasil) for free at health centers or designated health care providers.
If you are not eligible, you can get
HPV bivalent (Cervarix)
- First dose at age 9 to 14 years, followed by 2 doses 6 to 12 months apart
- 3 doses 0, 1, and 6 months apart for the first dose at age 15-25 years
HPV quadrivalent (Gardasil)
- First dose at age 9 to 14 years, followed by 2 doses 6 to 12 months apart
- 3 doses 0, 2, and 6 months apart at the first dose in persons 15 to 26 years of age and older
HPV 9-valent (Gardasil)
- First dose at age 9 to 14 years, followed by 2 doses 6 to 12 months apart
- 3 doses 0, 2, and 6 months apart for the first dose at 15-45 years of age.
Hereditary cancers are cancers that are caused by specific gene mutations. Hereditary cancers have the following characteristics: developing cancer at a young age, being diagnosed with more than one type of cancer, being a rare cancer, and having family members with these same cancer.
You don't have to be a cancer patient to undergo genetic testing. However, given the cost and efficiency of testing, it is recommended that you only get tested if you suspect you have a hereditary cancer or have a family history of cancer. If you have a family member who has been diagnosed with cancer, they should be tested first, and if that's not possible, you can get tested after consulting a specialist. Depending on the test, you may pay a 5% or 50% co-payment if it's covered, or 100% co-payment if it's deemed necessary after a consultation even if you don't have cancer.
Family history of cancer means having at least 1 person diagnosed with cancer in the first, second, or third degree of family relationships. If you have a family history of cancer, you can also consult with a specialist for genetic testing.
First-degree family: parents, siblings, children
Second-degree relatives: grandparents, parents' siblings, grandchildren, nieces and nephews, and half-siblings.
Tertiary family relationships: great-grandparents, great-grandchildren, cousins.
If you are eligible for cancer screening in that year, you will receive a notice from the National Health Insurance Service. If you don't receive a notice, you can check it at the National Health Insurance Service (1577-1000).
According to the International Agency for Research on Cancer, a division of the World Health Organization (WHO), and the American Cancer Society, the causes of cancer include smoking, chronic infections, food, occupation, heredity, reproductive factors and hormones, alcohol, environmental pollution, and radiation.
In addition, the six most common causes of cancer, which account for two-thirds of cancer cases in Korea, are as follows
1. stomach cancer: diet (salty, fried, nitrates, etc.), Helicobacter pylori
2. lung cancer: smoking, occupational exposure (arsenic, asbestos, etc.), air pollution
3. liver cancer: hepatitis viruses (hepatitis B, C), cirrhosis, aflatoxins
4. colon cancer: genetic factors, high-fat diet, low fiber intake
5. breast cancer: genetic factors, high-fat diet, female hormones, obesity
6. cervical cancer: human papillomavirus (HPV), sexual intercourse.
You can find a cancer screening organization near you at your local public health center or the National Health Insurance Service (1577-1000).
Alternatively, you can use the Need app for more information, including a map and list of screenings.
Even if you are not eligible for cancer screening, you can receive a state-subsidized general health checkup at least once every two years (once a year for those who do not work in an office setting) if you are
- Comporate enrollee
- Local enrollee who are heads of households
- Local enrollee age 20 or older- Dependents age 20 or older
- Heads of household and household members aged 20 to 64 who receive medical benefits
Medical benefit recipients and health insurance enrollees who fall into the bottom 50% of the insurance premium threshold are eligible for free cancer screenings provided by the National Cancer Screening Program, with the cost of the screening covered by the government.
National health checkups are divided into general health checkups, life transition health checkups, cancer checkups, and infant and child checkups.
If you are not eligible for cancer screening, you may only receive a general health checkup.
The general health screening checks for obesity, dyslipidemia, hypertension, and diabetes. The cancer screening checks are organized to detect the six major cancers (stomach, colon, cervical, breast, liver, and lung) at an early stage.
Even if you are not eligible for cancer screening, you are eligible for a government-subsidized general health checkup at least once every two years (once a year for non-office workers) if you are:
- Comporate enrollee
- Local enrollee who are heads of households
- Local enrollee age 20 or older
- Dependents age 20 or older
- Heads of household and household members aged 20 to 64 who receive medical benefits
Within 15 days of your screening, you will receive a notification of your results.
You can also pull up your screening results in the Need app to collect your last 10 years of screening results.
The screening frequency and age for the six major cancers covered by the National Cancer Screening Program are as follows.
If you are scheduled for an ultrasound of your liver, you should fast for at least 8 hours. Eating makes it difficult for the test to be accurate due to bowel movements.
Alpha-fetoprotein (AFP) is a protein that is elevated when the liver is damaged and is rarely seen in normal adults, so if AFP levels are above a certain level, liver cancer can be suspected. Routine AFP testing is recommended for people with chronic liver disease, especially those with hepatitis B. AFP testing is done through a blood test.
An ultrasound works by using high-frequency sound waves to create images of the inside of the body. Take a deep breath and hold it for this test!
According to the National Cancer Center, people age 40 and older with hepatitis B or C virus, or those diagnosed with cirrhosis, should have a liver ultrasound and a blood test for serum alpha-fetoprotein (AFP) every 6 months. Conducting both tests improves the accuracy of screening.
Early symptoms of liver cancer include lethargy, fatigue, loss of appetite, and weight loss. However, because these are symptoms that many people experience on a daily basis, there are no clear-cut signs that liver cancer is present, so it's important to get regular screenings to increase the chances of early detection. A 2015 National Cancer Center report found that patients who were regularly screened for liver cancer had a higher chance of early detection, and those who had at least two screenings had a lower risk of death than those who did not.
The inflammation caused by hepatitis is often asymptomatic. Because the liver doesn't have nerves that feel pain, you can develop chronic hepatitis, cirrhosis, or liver cancer without symptoms. If you have hepatitis, it's important to follow up with regular checkups regardless of symptoms.
Hepatitis is an inflammatory disease of the liver. When this inflammation becomes chronic, it can cause liver cells to break down, making the liver more susceptible to cancerous changes. Hepatitis B and C viruses multiply in the liver and can lead to chronic hepatitis. If you develop chronic hepatitis, you may also develop cirrhosis, a condition in which the liver becomes scarred and smaller. Cirrhosis has the potential to develop into cancer. About 70% of liver cancers in Korea are caused by the hepatitis B virus and 10% by the hepatitis C virus.
People at high risk for liver cancer, including those over the age of 40 with cirrhosis or chronic liver disease caused by hepatitis B or C, should undergo screening every 6 months.
Two to three days before the test, you should stop drinking alcohol and eat a low-irritant diet. Fasting and smoking should be avoided for 8 hours before the endoscopy, and if the test is done under sedation, do not drive yourself after the test as your alertness and reflexes will be reduced.
If an gastroscopy is not possible, a upper gastrointestinal series may be performed. This involves drinking or injecting a substance called a contrast agent and then taking x-rays to indirectly see your esophagus, stomach, and duodenum.
A gastroscopy is used for stomach cancer screening and involves inserting an endoscope through the mouth to view the inside of the esophagus, stomach, and duodenum. This procedure provides an accurate assessment and helps determine if further examination or treatment is necessary. If a polyp is found during the exam, a biopsy may be performed.
Stomach cancer ranks among the top 5 most common cancers in South Korea each year. Adults over the age of 40 should be screened every two years, even if they don't have any symptoms.
Regular screening has a big impact on the outcome of stomach cancer treatment. Studies have shown that regular screening is associated with up to a 65% reduction in mortality and a cure rate of over 90%.
In the early stages of stomach cancer, you may have symptoms similar to gastritis, such as indigestion and upper abdominal discomfort, but often there are no obvious symptoms. As stomach cancer progresses, you may experience vomiting, early satiety, weight loss, fatigue, loss of appetite. In more advanced cases, you may be able to feel a lump in your abdomen. Black stools may also occur if the cancer has caused bleeding inside the stomach.
It is difficult to diagnose cancer based on mammogram results alone. If an abnormality is found on a mammogram, additional tests such as a localized mammogram or breast ultrasound are needed.
A mammogram doesn't require you to fast or take any medication like other cancer screenings. You'll usually change into a gown in a changing room prior to the exam.
If you're breastfeeding or have had breast augmentation surgery, tell your provider ahead of time. Also, to improve the accuracy of the test, it's recommended that you don't use body lotion on your breasts on the day of the exam, and it's best to have the exam 5-7 days after your period ends, when your breasts are tender.
Breast cancer screening is conducted using a mammogram, which utilizes X-rays to detect any abnormal changes in the breasts. The test typically takes about 10 minutes and may be uncomfortable due to the compression of the breasts. However, it is crucial to compress the breast as much as possible to allow the X-rays to more effectively detect any potential cancer.
The most common symptom of breast cancer is the presence of painless lumps in the breast. As the cancer progresses, additional symptoms may develop, including breast pain, lumps in the breasts or armpits, nipple discharge, and changes to nipple appearance.
Breast cancer is the leading cause of cancer-related deaths among women worldwide. It has a high recurrence rate and commonly spreads to other organs. However, if detected early, survival rates are high and advancements in medicine have made breast-preserving treatments available.
Stage 0-2 breast cancer has a 5-year survival rate of over 90% after surgery, whereas stage 4 has a survival rate of just 34%. Early detection through regular screening is crucial because symptoms are often not noticeable in the early stages.
Unlike a conventional chest CT, a low-dose chest CT scan does not require fasting, as no contrast is used. Therefore, there is no preparation needed.
A low-dose chest CT scan is used to screen for lung cancer. The CT scan takes around five minutes. Please follow the CT technologist's instructions such as "Breath in" and "Hold your breath" during the exam.
Symptoms of lung cancer can include incessant coughing, coughing up blood, difficulty breathing, and voice changes. However, in the early stages, these symptoms may not appear, which is why it's important to get screened regularly for lung cancer. A low-dose chest CT performed during a lung cancer screening can effectively detect even the smallest cancer nodules.
Adults aged 54 to 74 years old who are at high risk for lung cancer should receive a lung cancer screening every two years. Those who are at high risk are smokers whose smoking history is 30 pack years or more. Pack year is calculated through multiplying the [average daily cigarette consumption (packs)] by [years of smoking].
You should avoid aspirin and other anti-inflammatory pain relievers for 1 week before taking the Fecal Occult Blood Test (FOBT). If you have any symptoms such as hematuria (bloody urine) or diarrhea, postpone the test until these symptoms have resolved. Additionally, the FOBT should not be performed three days before or after your menstrual period. Be sure to follow the specific instructions provided by the hospital where you have scheduled your appointment to ensure the test is conducted properly.
For a colonoscopy procedure, hospitals use different bowel preparation methods, so adhere to the instructions given by the hospital.
A colonoscopy is only performed when the Fecal Occult Blood Test (FOBT) is positive. A colonoscopy can help detect any polyps or cancer masses in the colon and rectum.
The screening process starts with the Fecal Occult Blood Test (FOBT). For FOBT, you will have collect a small sample of your stool prior to appointment date. A container and scoop for the sampling will be provided. It is best to collect the sample on the same day as your appointment so that the stool doesn't dry out.
If the FOBT is positive, meaning that blood was found in the stool, a follow up colonoscopy will be performed.
Colorectal cancer is the third most common cancer for both men and women in South Korea. Survival rate is about 90% for early colorectal cancer, but the survival rate drops to approximately 50% for more advanced stages. Since patients with early colorectal cancer typically experience few symptoms and the cancer grows slowly over time, regular screening is crucial. The South Korean government recommends that all adults over the age of 50 undergo annual screening for colorectal cancer.
A colon polyp is a protrusion of the mucous membrane lining the colon. Not all polyps develop into cancer, but larger ones have a 48% chance of becoming cancerous. Polyps need to be confirmed through biopsy and can be removed through colonoscopy, preventing any cancerous development.
If colorectal cancer is advanced, you might experience changes in bowel habits, such as constipation and diarrhea, as well as bloody stools, indigestion, and weight loss. In the early stages, symptoms are often not noticeable, but you might feel a new lump in your stomach. This is why early detection through regular screening is crucial.
An "abnormal" (or positive) Pap test result indicates that the cells and tissues of the cervix have undergone changes that require further evaluation. These changes can potentially develop into cancer over time, making it crucial to detect them early through regular screenings.
The Human Papillomavirus (HPV) is an important cause of cervical cancer. While vaccination greatly reduces your chance of contracting HPV, it is not a 100% guarantee, which is why regular screenings are important.
It is recommended that you receive a Pap test (Pap smear) between 10-20 days after the start of your period. You should avoid sex and douching for 2-3 days before your appointment. Vaginal suppositories should also be avoided. The test may cause some discomfort as a speculum will be inserted into the vaginal canal. Please pay close attention to the instructions provided by your doctor's office.
Cervical cancer screening is also known as a Pap test (Pap smear). It is done by inserting a speculum into the vagina to collect cells on the cervix. The collected cells can be looked at under a microscope to see if there is 'cancer' or 'abnormal cells that may lead to cancer'.
Symptoms of cervical cancer include increased vaginal discharge, vaginal bleeding, pelvic pain, back pain, and weight loss. However, in the early stages, it's hard to notice any symptoms. It is important to get screened regularly to increase the chances of an early diagnosis.
When detected early, cervical cancer has a high survival rate of around 94%. Once the cancer spreads to other parts of the body, the survival rate drops to a low 27%. The government recommends that all women over the age of 20 be screened for cervical cancer every 2 years.