Open Access Research article

Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

Beomseok Suh1, Dong Wook Shin12*, So Young Kim3, Jae-Hyun Park4, Weon Young Chang5, Seung Pyung Lim6, Chang-Yeol Yim7, Be-Long Cho12, Eun-Cheol Park8 and Jong-Hyock Park39*

Author Affiliations

1 Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Republic of Korea

2 Cancer Survivorship Clinic, Seoul National University Cancer Hospital, 101 Daehak-ro, Jongno-Gu, Seoul, 110-744, Republic of Korea

3 Division of Cancer Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea

4 Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea

5 Department of General Surgery, Cheju Regional Cancer Center, Cheju National University Hospital, Jeju, Republic of Korea

6 Department of Thoracic and Cardiovascular Surgery, Daejon Regional Cancer Center, Chungnam National University Hospital, Daejon, Republic of Korea

7 Division of Hematology-Oncology, Jeonbuk Regional Cancer Center, Chonbuk National University Hospital, Jeonju, Republic of Korea

8 Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea

9 Division of Cancer Policy and Management, National Cancer Control Research Institute, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea

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BMC Cancer 2012, 12:557  doi:10.1186/1471-2407-12-557

Published: 26 November 2012



While knowledge and risk perception have been associated with screening for second primary cancer (SPC), there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected) is associated with subsequent completion of all appropriate SPC screening in cancer survivors.


Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines.


Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33), after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis.


The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

Cancer survivor; Second primary cancer; Screening; Mode of detection; Screen-detected