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1 "Healthcare disparity"
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Original Article
Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kui Son Choi
Epidemiol Health. 2023;45:e2023086.   Published online September 17, 2023
DOI: https://doi.org/10.4178/epih.e2023086
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate socioeconomic status (SES)-based inequality in colorectal cancer (CRC) screening in Korea. We assessed whether the rates of opportunistic and organized CRC screening differed according to income and education levels.
METHODS
We analyzed data from the Korean National Cancer Screening Survey of 27,654 cancer-free individuals, aged 50-74 years, from 2009 to 2021. The weighted cancer screening rates with trends were estimated with the average annual percentage change using joinpoint regression. Inequality was calculated in both relative and absolute terms, based on a Poisson regression model.
RESULTS
The organized screening rate increased significantly from 22.1% in 2009 to 53.1% in 2020 and 50.6% in 2021, with an average annual change of 8.6% (95% confidence interval [CI], 4.9 to 12.5). In contrast, no significant trend was observed for opportunistic screening. The SES inequality in opportunistic screening uptake was indicated by a slope index of inequality (SII) of 9.74% (95% CI, 6.36 to 13.12), relative index of inequality (RII) of 2.18 (95% CI, 1.75 to 2.70) in terms of education level; and an SII of 7.03% (95% CI, 4.09 to 9.98), RII of 1.81 (95% CI, 1.41 to 2.31) in terms of measured income. Although there was an increasing trend in income inequality, no significant SES inequalities were observed in the overall estimates for organized screening.
CONCLUSIONS
Organized CRC screening is effective in improving the participation rate, regardless of SES. However, significant inequalities were found in opportunistic screening, suggesting room for improvement in the overall equity of CRC screening.
Summary
Korean summary
이번 연구는 한국의 대장암 검진에서 사회경제적 수준에 따른 불평등이 있는지를 분석했다. 국가암검진사업 도입 이래로 2009-2021년 연구기간 동안 공공검진을 통한 대장암 수검률은 지속적으로 증가한 반면, 개인검진의 증가는 관찰되지 않았다. 특히 공공 검진의 경우 소득이나 교육수준에 따른 수검률에 차이는 없는 반면, 개인검진에서는 상당한불평등이 관찰되었다.
Key Message
"The study investigated socioeconomic status (SES)-based inequality in colorectal cancer (CRC) screening in Korea. We found that the introduction of the National Cancer Screening Program for CRC effectively increased the participation rate, regardless of the SES of the individuals throughout the study period. However, significant inequalities were observed in opportunistic screening related to education and income."

Citations

Citations to this article as recorded by  
  • Disparities in Cancer Incidence across Income Levels in South Korea
    Su-Min Jeong, Kyu-Won Jung, Juwon Park, Nayeon Kim, Dong Wook Shin, Mina Suh
    Cancers.2023; 15(24): 5898.     CrossRef

Epidemiol Health : Epidemiology and Health