Skip to main content

Advertisement

SpringerLink
Log in

Cervical Cancer Screening and Its Associated Factors Among North Korean Defectors Living in South Korea

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

North Korean defectors (NKD) have many health problems related to insufficient nutrition, trauma from escaping, and being exposed to infectious diseases, but little research exists on their cancer screening. A total of 638 NKD participated in this cross-sectional survey. South Korean natives (SKN) who participated in the Korean National Health and Nutrition Examination Survey V were selected using age matching to each NKD. Fisher’s exact tests and logistic regression were used for data analysis. The cervical cancer screening rate of NKD was significantly lower than for SKN (42 and 70 %, respectively; P < .001). The adjusted proportions of cervical cancer screening for NKD in all age groups under 60 years (P < .01) and having education beyond high school (P < .001) were significantly lower than that of SKN. NKD who had education under a high school level were more likely to have cervical cancer screening compared to NKD with education beyond a high school level (OR 1.81, 95 % CI 1.12–2.93). NKD were less likely to receive appropriate cervical cancer screening compared to SKN, especially those aged 30–39 years or married. Tailored interventions for NKD are needed to improve cervical cancer screening compliance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ministry of Unification. Number of North Korean defectors entered South Korea. http://www.unikorea.go.kr/content.do?cmsid=3099#a. Accessed 22 Oct 2015.

  2. Jeon W, Hong C, Lee C, et al. Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea. J Trauma Stress. 2005;18:147–54.

    Article  PubMed  Google Scholar 

  3. Lee Y, Lee MK, Chun KH, et al. Trauma experience of North Korean refugees in China. Am J Prev Med. 2001;20:225–9.

    Article  CAS  PubMed  Google Scholar 

  4. Lee YS, Ku HW, Han IY. Systematic reviews of North Korean refugees: women’s distinguishable experience. Korean J Unification Aff. 2011;23:147–93.

    Google Scholar 

  5. Burk RD, Hi GY, Beardsly L, et al. Sexual behavior and partner characteristics are the predominant risk factors for genital human papillomavirus infection in young women. J Infect Dis. 1996;174:679–89.

    Article  CAS  PubMed  Google Scholar 

  6. Ott JJ, Ullrich A, Mascarenhas M, et al. Global cancer incidence and mortality caused by behavior and infection. J Public Health (Oxf). 2011; 33: 223–33.

    Article  CAS  Google Scholar 

  7. Suh M, Choi KS, Lee YY, et al. Trends in cancer screening rates among Korean men and women: results from the Korean National Cancer Screening Survey, 2004–2012. Cancer Res Treat. 2013;45:86–94.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Lin SJ. Factors influencing the uptake of screening services for breast and cervical cancer in Taiwan. J R Soc Promot Health (London). 2008;128:327–34.

    Article  Google Scholar 

  9. McDonald JT, Kennedy S. Cervical cancer screening by immigrant and minority women in Canada. J Immigr Minor Health. 2007;9:323–34.

    Article  PubMed  Google Scholar 

  10. McDonald JT, Neily J. Race, immigrant status, and cancer among women in the United States. J Immigr Minor Health. 2011;13:27–35.

    Article  PubMed  Google Scholar 

  11. Yu TC, Chou CF, Johnson PJ, et al. Persistent disparities in pap test use: assessments and predictions for Asian women in the U.S., 1982–2010. J Immigr Minor Health. 2010;12:445–53.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jung KW, Won YJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat. 2015;47:127–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147–72.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Min KJ, Lee YJ: The Korean guideline for cervical cancer screening. J Gynecol Oncol. 2015; 26(3): 232–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. National Cancer Screening Program. https://ncc.re.kr/main.ncc?uri=english/sub04_ControlPrograms03. Accessed 5 July 2016.

  16. Ko KD, Lee KY, Cho B, et al. Disparities in health-risk behaviors, preventive health care utilizations, and chronic health conditions for people with disabilities: the Korean National Health and Nutrition Examination Survey. Arch Phys Med Rehabi. 2011;92:1230–7.

    Article  Google Scholar 

  17. Ko KD, Park SM, Lee K. Factors associated with the use of uterine cervical cancer screening services in Korean elderly women. Korean J Fam Med. 2012;33:174–81.

    Article  PubMed  PubMed Central  Google Scholar 

  18. IOC Information Centre on HPV and Cancer. 15 June 2016. http://www.hpvcentre.net/index.php. Accessed 28 June 2016.

  19. World Health Organization. WHO guidelines for screening and treatment of precancerous lesions for cervical Cancer prevention. http://apps.who.int/iris/bitstream/10665/94830/1/9789241548694_eng.pdf.

  20. Tran NT, CHoe SI, Taylor R, et al. Knowledge, attitude and practice (KAP) concerning cervical cancer and screening among rural and urban women in six provinces of the Democratic People’s Republic of Korea. Asian Pac J Cancer Prev. 2011;12(11):3029–33.

    PubMed  Google Scholar 

  21. Lee M, Chang HS, Park EC, et al. Factors associated with participation of Korean women in cervical cancer screening examination by age group. Asian Pac J Cancer Prev. 2011;12(6):1457–62.

    PubMed  Google Scholar 

  22. Jang SN, Cho SI, Hwang SS, et al. Trend of socioeconomic inequality in participation in cervical cancer screening among Korean women. J Prev Med. Public Health. 2007;40(6):505–11.

    Google Scholar 

  23. Wang BR, Kwon YD, Jeon W, et al. Factors associated with the frequency of physician visits among North Korean defectors residing in South Korea: a cross-sectional study. BMC Health Serv Res. 2015;15:90.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ministry of Unification Statistics. http://www.unikorea.go.kr/content.do?cmsid=3099. Accessed 28 June 2016.

  25. Chen Y. Rate of cervical cancer screening associated with immigration status and number of years since immigration in Ontario, Canada. J Immigr Minor Health. 2013;15:244–8.

    PubMed  Google Scholar 

  26. Leung GM, Woo PP, Cowling BJ et al: Who receives, benefits from and is harmed by cervical and breast cancer screening among Hong Kong Chinese? J Public Health (Oxf). 2008;30:282–92.

    Article  Google Scholar 

  27. Kim Y, Jun JK, Choi KS, et al. Overview of the National Cancer screening programme and the cancer screening status in Korea. Asian Pac J Cancer Prev. 2011;12:725–30.

    PubMed  Google Scholar 

  28. Park MJ, Park EC, Choi KS, et al. Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS) 2005–2009. BMC Cancer. 2011;11:257.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lancuck L, Patnick J, Vessey M. A cohort effect in cervical screening coverage? J Med Screen. 2008;15:27–9.

    Article  CAS  PubMed  Google Scholar 

  30. Park YS, Cheung EK, Choi JS, et al. Cancer screening rates and its related factors in a rural and urban communities. J Korean Acadia Fam Med. 2006;27:21–32.

    Google Scholar 

  31. Adegboyega A, Hatcher J. Factors influencing pap screening use among African immigrant women. J Transcult Nurs 2016.

  32. Cadman L, Waller J, Ashdown-Barr L, Szarewski A. Barriers to cervical screening in women who have experienced sexual abuse: an exploratory study. J Fam Plann Reprod Health Care. 2012;38:214–20.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Gesink D, Mihic A, Antal J, et al. Who are the under- and never-screened for cancer in Ontario: a qualitative investigation. BMC Public Health. 2014;14:495.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Oscarsson MG, Wijma BE, Benzein EG. ‘I do not need to… I do not want to… I do not give it priority…’–why women choose not to attend cervical cancer screening. Health Expect. 2008;11:26–34.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Choe MA, Yi M, Choi JA, et al. Health knowledge, health promoting behavior and factors influencing health promoting behavior of north korean defectors in South Korea. J Korean Acad Nurs. 2012;42:622–31.

    Article  PubMed  Google Scholar 

  36. Islam N, Kwon SC, Senie R, et al. Breast and cervical cancer screening among South Asian women in New York City. J Immigr Minor Health. 2006;8:211–21.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by funds from the Institute for Peace and Unification Studies and North Korean Refugees Foundation.

Author information

Authors and Affiliations

  1. College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea

    Jeongok Park

  2. Department of Nursing, Dongnam Health University, Suwon-si, Gyeonggi-do, South Korea

    HeesSook Kim

  3. University of North Carolina at Chapel Hill, Doctoral Student, Biostatistics, Gillings School of Global Public Health, Chapel Hill, NC, USA

    Wonhee Yang

  4. Institute for Health and Unification Studies, School of Medicine, Seoul National University, Seoul, South Korea

    HaeWon Lee

  5. Department of Biomedical Sciences and Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Sang Min Park

Authors
  1. Jeongok Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. HeesSook Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wonhee Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. HaeWon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sang Min Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sang Min Park.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

The institutional review board of the Seoul National University Hospital exempted a review of this data as it was a secondary analysis of de-identified data. All procedures performed in the original study were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

Informed Consent

Informed consent was obtained from all individual participants included in the original study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, J., Kim, H., Yang, W. et al. Cervical Cancer Screening and Its Associated Factors Among North Korean Defectors Living in South Korea. J Immigrant Minority Health 20, 66–72 (2018). https://doi.org/10.1007/s10903-016-0510-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-016-0510-3

Keywords

Search

Navigation