Purpose: We investigated retrospectively the detection rates of thyroid and breast cancers in women and prostate cancer in men by medical check-ups for screening purpose in asymptomatic volunteers. The cancer detection rates were compared with natural incidences of each cancer from National Cancer Registry (NCR) in Korea.

Materials and Methods: More than 50,000 apparently healthy adults take comprehensive medical check-ups in a year at Center for Health Promotion, Samsung Medical Center, with their own payments of 1,000 US dollars on average. A total of 283 thyroid cancers were detected among 29,498 thyroid ultrasounds in women for 2 years from 2008 to 2009. A total of 72 breast cancers were detected among 34,741 mammographies or breast ultrasounds in women during the same period. And a total of 77 prostate cancers were detected among 41,898 PSA (prostate-specific antigen) tests in men during the same period. The annual detection rate of each cancer was transformed to a cancer incidence per 100,000 persons through multiplying by 100,000. These cancer incidences from organ-specific and facility dependent tests were compared with crude incidences from 2007 National Cancer Registry according to age groups.

Results: Cancer detection rates of check-up programs for asymptomatic adults were much higher than natural incidences in general population for these three cancers. The average costs for thyroid ultrasound, mammography, breast ultrasound, and PSA in Korea are one third of those in US respectively.

Thyroid cancer by age (F) 20∼29 30∼39 40∼49 50∼59 60∼69 70∼

Incidence by check-up 892.9 807.6 1097.3 893.2 865.8 977.2

Natural incidence by NCR 28.8 80.9 144.3 159 108.7 37

Breast cancer by age (F) 20∼29 30∼39 40∼49 50∼59 60∼69 70∼

Incidence by check-up 0.0 165.1 246.8 188.9 242.3 0.0

Natural incidence by NCR 4.7 40.1 110.7 101.7 73.6 39.3

Prostate cancer by age 20∼29 30∼39 40∼49 50∼59 60∼69 70∼

Incidence by check-up 0.0 0.0 22.4 115.1 437.2 835.4

Natural incidence by NCR 0.0 0.1 1.4 18.3 110.7 262.4

Conclusions: Screening asymptomatic individuals is the effective strategy to detect early-stage disease. Specific imaging methods and blood-based test of reasonable prices showed high yields for prevalent cancers in this study. Well-designed check-up programs with considerations for costs and risks may contribute to national projects to detect cancers early. Further investigations are needed to evaluate issues on long-term mortality and possible disadvantages of screening for thyroid, breast or prostate cancers, especially in older people.

Citation Information: Cancer Prev Res 2011;4(10 Suppl):A18.