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1Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
2National Cancer Control Institute, National Cancer Center, Goyang, Korea
©2022, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest to declare for this study.
FUNDING
This research was supported by a Grant-in-Aid for Cancer Research and Control from the National Cancer Center of Korea (#2210772).
AUTHOR CONTRIBUTIONS
Conceptualization: Choi KS, Trinh TTK, Suh M, Jun JK. Data curation: Lee YY. Formal analysis: Trinh TTK, Choi KS. Funding acquisition: Choi KS. Methodology: Trinh TTK, Choi KS. Project administration: Choi KS. Visualization: Trinh TTK. Writing –original draft: Trinh TTK, Choi KS. Writing – review & editing: Trinh TTK, Choi KS, Suh M, Jun JK, Lee YY.
Characteristics |
Survey year, % |
p-value | |
---|---|---|---|
2019 | 2020 | ||
Total no. of respondents (n) | 4,500 | 4,600 | |
Gender | 0.730 | ||
Men | 38.8 | 39.1 | |
Women | 61.2 | 60.9 | |
Age (yr) | 0.788 | ||
20-29 | 11.1 | 10.9 | |
30-39 | 10.2 | 9.8 | |
40-49 | 24.8 | 24.3 | |
50-59 | 25.5 | 25.2 | |
60-69 | 18.0 | 19.1 | |
70-74 | 10.4 | 10.7 | |
Education | 0.342 | ||
Lower secondary school | 13.0 | 11.8 | |
High school | 46.2 | 47.4 | |
University/College | 40.5 | 40.4 | |
Postgraduate | 0.4 | 0.4 | |
Monthly household income (US$)1 | 0.297 | ||
≤1,999 | 7.5 | 8.4 | |
2,000-3,999 | 34.6 | 34.4 | |
≥4,000 | 57.9 | 57.2 | |
Residential area | 0.004 | ||
Metropolitan | 44.5 | 47.4 | |
Non-metropolitan urban | 45.7 | 44.3 | |
Rural | 9.8 | 8.3 | |
Provinces | <0.001 | ||
Seoul | 19.4 | 18.9 | |
Busan | 6.9 | 6.7 | |
Daegu | 4.8 | 6.8 | |
Incheon | 5.7 | 5.6 | |
Gwangju | 2.7 | 2.7 | |
Daejeon | 2.8 | 2.7 | |
Ulsan | 2.2 | 2.2 | |
Gyeonggi | 24.8 | 24.7 | |
Gangwon | 3.0 | 3.0 | |
Chungbuk | 3.1 | 3.0 | |
Chungnam | 4.5 | 3.9 | |
Jeonbuk | 3.5 | 3.4 | |
Jeonam | 3.6 | 3.5 | |
Gyeongbuk | 5.2 | 5.0 | |
Gyeongnam | 6.4 | 6.3 | |
Jeju | 1.3 | 1.2 | |
Health insurance type | <0.001 | ||
National Health Insurance | 98.6 | 99.5 | |
Medical Aid Program | 1.4 | 0.5 |
Variables |
Survey year, % |
Change (%p) | p-value | |
---|---|---|---|---|
2019 | 2020 | |||
Lifetime screening rate1 | ||||
Stomach | 83.4 | 86.7 | 3.3 | <0.001 |
Colorectal | 77.2 | 83.2 | 6.0 | <0.001 |
Breast | 81.9 | 87.2 | 5.3 | <0.001 |
Cervical | 61.1 | 64.4 | 3.3 | 0.012 |
Screening rate according to recommendations2 | ||||
Stomach3 | 70.8 | 68.7 | -2.1 | 0.063 |
Upper endoscopy | 62.1 | 61.2 | -0.9 | 0.401 |
UGI series | 25.8 | 23.2 | -2.5 | 0.010 |
Colorectal4 | 62.6 | 64.3 | 1.7 | 0.201 |
FOBT | 19.1 | 15.3 | -3.8 | <0.001 |
Colonoscopy | 51.5 | 57.5 | 6.0 | <0.001 |
Breast5 | 62.3 | 63.5 | 1.2 | 0.458 |
Cervical6 | 51.0 | 50.6 | -0.4 | 0.751 |
Screening rate within 1 yr7 | ||||
Stomach8 | 32.7 | 27.6 | -5.1 | <0.001 |
Upper endoscopy | 27.0 | 24.2 | -2.8 | 0.006 |
UGI series | 10.0 | 7.8 | -2.2 | 0.001 |
Colorectal9 | 19.1 | 15.3 | -3.8 | <0.001 |
Breast10 | 26.3 | 23.8 | -2.5 | 0.083 |
Cervical11 | 22.2 | 20.7 | -1.5 | 0.173 |
KNCSS, Korean National Cancer Screening Survey; UGI, upper gastrointestinal; FOBT, fecal occult blood test.
1 The lifetime screening rate was defined as the proportion of target-aged respondents who had ever undergone the screening test(s).
2 The screening rate according to recommendations was defined as the proportion of respondents who had fulfilled the screening recommendation criteria among the respondents in the targeted age group for relevant cancer.
3 Respondents who had last undergone upper endoscopy or UGI series screening within 2 years, among men and women aged ≥ 40 years.
4 Respondents who had last undergone screening with colonoscopy or FOBT within 10 years and 1 year, respectively, among men and women aged ≥ 50 years.
5 Respondents who had last undergone screening with mammography within 2 years, among women aged ≥ 40 years.
6 Respondents who had last undergone screening with conventional cytology within 2 years among women aged ≥ 20 years.
7 The screening rate within 1 year was defined as the proportion of respondents who underwent the latest screening test within 1 year among target-aged respondents for relevant cancer.
8 Respondents who had the latest upper endoscopy or UGI series screening within 1 year, among men and women aged ≥ 40 years.
9 Respondents who had the latest FOBT within 1 year, among men and women aged ≥ 50 years.
10 Respondents who had the latest mammography within 1 year, among women aged ≥ 40 years.
11 Respondents who had the latest conventional cytology within 1 year, among women aged ≥ 20 years.
Cancerrs | Metropolitan (n=4,180) | Non-metropolitan urban (n=4,096) | Rural (n=824) | |||
---|---|---|---|---|---|---|
Stomach | ||||||
2019 | 33.1 | 1.00 (reference) | 34.9 | 1.00 (reference) | 22.5 | 1.00 (reference) |
2020 | 24.5 | 0.66 (0.56, 0.76)*** | 30.3 | 0.81 (0.70, 0.94)** | 30.1 | 1.54 (1.10, 2.16)* |
Colorectal | ||||||
2019 | 20.1 | 1.00 (reference) | 19.4 | 1.00 (reference) | 15.0 | 1.00 (reference) |
2020 | 13.6 | 0.63 (0.50, 0.79)*** | 18.4 | 0.93 (0.75, 1.16) | 10.5 | 0.65 (0.40, 1.07) |
Breast | ||||||
2019 | 26.9 | 1.00 (reference) | 26.4 | 1.00 (reference) | 23.2 | 1.00 (reference) |
2020 | 21.6 | 0.75 (0.60, 0.94)* | 27.4 | 1.05 (0.84, 1.31) | 19.0 | 0.80 (0.48, 1.33) |
Cervical | ||||||
2019 | 21.6 | 1.00 (reference) | 24.2 | 1.00 (reference) | 14.9 | 1.00 (reference) |
2020 | 18.8 | 0.84 (0.69, 1.01) | 23.4 | 0.95 (0.79, 1.15) | 17.6 | 1.33 (0.80, 2.21) |
Characteristics | Survey year, % |
p-value | |
---|---|---|---|
2019 | 2020 | ||
Total no. of respondents (n) | 4,500 | 4,600 | |
Gender | 0.730 | ||
Men | 38.8 | 39.1 | |
Women | 61.2 | 60.9 | |
Age (yr) | 0.788 | ||
20-29 | 11.1 | 10.9 | |
30-39 | 10.2 | 9.8 | |
40-49 | 24.8 | 24.3 | |
50-59 | 25.5 | 25.2 | |
60-69 | 18.0 | 19.1 | |
70-74 | 10.4 | 10.7 | |
Education | 0.342 | ||
Lower secondary school | 13.0 | 11.8 | |
High school | 46.2 | 47.4 | |
University/College | 40.5 | 40.4 | |
Postgraduate | 0.4 | 0.4 | |
Monthly household income (US$) |
0.297 | ||
≤1,999 | 7.5 | 8.4 | |
2,000-3,999 | 34.6 | 34.4 | |
≥4,000 | 57.9 | 57.2 | |
Residential area | 0.004 | ||
Metropolitan | 44.5 | 47.4 | |
Non-metropolitan urban | 45.7 | 44.3 | |
Rural | 9.8 | 8.3 | |
Provinces | <0.001 | ||
Seoul | 19.4 | 18.9 | |
Busan | 6.9 | 6.7 | |
Daegu | 4.8 | 6.8 | |
Incheon | 5.7 | 5.6 | |
Gwangju | 2.7 | 2.7 | |
Daejeon | 2.8 | 2.7 | |
Ulsan | 2.2 | 2.2 | |
Gyeonggi | 24.8 | 24.7 | |
Gangwon | 3.0 | 3.0 | |
Chungbuk | 3.1 | 3.0 | |
Chungnam | 4.5 | 3.9 | |
Jeonbuk | 3.5 | 3.4 | |
Jeonam | 3.6 | 3.5 | |
Gyeongbuk | 5.2 | 5.0 | |
Gyeongnam | 6.4 | 6.3 | |
Jeju | 1.3 | 1.2 | |
Health insurance type | <0.001 | ||
National Health Insurance | 98.6 | 99.5 | |
Medical Aid Program | 1.4 | 0.5 |
Variables | Survey year, % |
Change (%p) | p-value | |
---|---|---|---|---|
2019 | 2020 | |||
Lifetime screening rate |
||||
Stomach | 83.4 | 86.7 | 3.3 | <0.001 |
Colorectal | 77.2 | 83.2 | 6.0 | <0.001 |
Breast | 81.9 | 87.2 | 5.3 | <0.001 |
Cervical | 61.1 | 64.4 | 3.3 | 0.012 |
Screening rate according to recommendations |
||||
Stomach |
70.8 | 68.7 | -2.1 | 0.063 |
Upper endoscopy | 62.1 | 61.2 | -0.9 | 0.401 |
UGI series | 25.8 | 23.2 | -2.5 | 0.010 |
Colorectal |
62.6 | 64.3 | 1.7 | 0.201 |
FOBT | 19.1 | 15.3 | -3.8 | <0.001 |
Colonoscopy | 51.5 | 57.5 | 6.0 | <0.001 |
Breast |
62.3 | 63.5 | 1.2 | 0.458 |
Cervical |
51.0 | 50.6 | -0.4 | 0.751 |
Screening rate within 1 yr |
||||
Stomach |
32.7 | 27.6 | -5.1 | <0.001 |
Upper endoscopy | 27.0 | 24.2 | -2.8 | 0.006 |
UGI series | 10.0 | 7.8 | -2.2 | 0.001 |
Colorectal |
19.1 | 15.3 | -3.8 | <0.001 |
Breast |
26.3 | 23.8 | -2.5 | 0.083 |
Cervical |
22.2 | 20.7 | -1.5 | 0.173 |
Cancerrs | Metropolitan (n=4,180) | Non-metropolitan urban (n=4,096) | Rural (n=824) | |||
---|---|---|---|---|---|---|
Stomach | ||||||
2019 | 33.1 | 1.00 (reference) | 34.9 | 1.00 (reference) | 22.5 | 1.00 (reference) |
2020 | 24.5 | 0.66 (0.56, 0.76) |
30.3 | 0.81 (0.70, 0.94) |
30.1 | 1.54 (1.10, 2.16) |
Colorectal | ||||||
2019 | 20.1 | 1.00 (reference) | 19.4 | 1.00 (reference) | 15.0 | 1.00 (reference) |
2020 | 13.6 | 0.63 (0.50, 0.79) |
18.4 | 0.93 (0.75, 1.16) | 10.5 | 0.65 (0.40, 1.07) |
Breast | ||||||
2019 | 26.9 | 1.00 (reference) | 26.4 | 1.00 (reference) | 23.2 | 1.00 (reference) |
2020 | 21.6 | 0.75 (0.60, 0.94) |
27.4 | 1.05 (0.84, 1.31) | 19.0 | 0.80 (0.48, 1.33) |
Cervical | ||||||
2019 | 21.6 | 1.00 (reference) | 24.2 | 1.00 (reference) | 14.9 | 1.00 (reference) |
2020 | 18.8 | 0.84 (0.69, 1.01) | 23.4 | 0.95 (0.79, 1.15) | 17.6 | 1.33 (0.80, 2.21) |
Variables | Metropolitan (n=1,507) | Non-metropolitan urban (n=1,406) | Rural (n=288) |
---|---|---|---|
Because I have no symptoms, I will have screening after the COVID-19 pandemic | 574 (38.1) | 610 (43.4) | 141 (49.0) |
I am worried about becoming infected with COVID-19 | 540 (35.9) | 452 (32.2) | 69 (23.9) |
I did not receive any invitation | 227 (15.1) | 227 (16.1) | 41 (14.2) |
No one recommended me to get screened | 121 (8.0) | 86 (6.1) | 16 (5.6) |
Costs | 20 (1.3) | 8 (0.6) | 0 (0.0) |
I have a fever or respiratory symptoms | 8 (0.5) | 9 (0.6) | 0 (0.0) |
Others | 17 (1.1) | 14 (1.0) | 21 (7.3) |
1 US$=1,000 Korean won.
KNCSS, Korean National Cancer Screening Survey; UGI, upper gastrointestinal; FOBT, fecal occult blood test. The lifetime screening rate was defined as the proportion of target-aged respondents who had ever undergone the screening test(s). The screening rate according to recommendations was defined as the proportion of respondents who had fulfilled the screening recommendation criteria among the respondents in the targeted age group for relevant cancer. Respondents who had last undergone upper endoscopy or UGI series screening within 2 years, among men and women aged ≥ 40 years. Respondents who had last undergone screening with colonoscopy or FOBT within 10 years and 1 year, respectively, among men and women aged ≥ 50 years. Respondents who had last undergone screening with mammography within 2 years, among women aged ≥ 40 years. Respondents who had last undergone screening with conventional cytology within 2 years among women aged ≥ 20 years. The screening rate within 1 year was defined as the proportion of respondents who underwent the latest screening test within 1 year among target-aged respondents for relevant cancer. Respondents who had the latest upper endoscopy or UGI series screening within 1 year, among men and women aged ≥ 40 years. Respondents who had the latest FOBT within 1 year, among men and women aged ≥ 50 years. Respondents who had the latest mammography within 1 year, among women aged ≥ 40 years. Respondents who had the latest conventional cytology within 1 year, among women aged ≥ 20 years.
Values are presented as percentage or adjusted odds ratio (95% confidence interval). COVID-19, coronavirus disease 2019. Adjusted by age and gender. p<0.05, p<0.01, p<0.001.
Values are presented as number (%).