Warning: fopen(/home/virtual/epih/journal/upload/ip_log/ip_log_2025-06.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 95 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 96 Socioeconomic inequality in organized and opportunistic screening for breast cancer: results from the Korean National Cancer Screening Survey, 2009-2021
Skip Navigation
Skip to contents

Epidemiol Health : Epidemiology and Health

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Epidemiol Health > Accepted Articles > Article
Original article Socioeconomic inequality in organized and opportunistic screening for breast cancer: results from the Korean National Cancer Screening Survey, 2009-2021
Yejin Ha1orcid , Xuan Quy Luu2,3orcid , Woorim Kim1orcid , Jae Kwan Jun1,3orcid , Mina Suh1,3orcid , Kui Son Choi1,3orcid
Epidemiol Health 2025;e2025031
DOI: https://doi.org/10.4178/epih.e2025031 [Accepted]
Published online: May 30, 2025
1National Cancer Control Institute, National Cancer Center, Goyang, Korea
2Department of Epidemiology, Faculty of Fundamental Science, Hanoi University of Public Health, Hanoi , Viet Nam
3Graduate School of Cancer Science and Policy, National Cancer Center , Gyeonggi-do , Korea
Corresponding author:  Kui Son Choi,
Email: kschoi@ncc.re.kr
Received: 18 January 2025   • Revised: 22 April 2025   • Accepted: 2 May 2025
  • 374 Views
  • 23 Download
  • 0 Crossref
  • 0 Scopus
Full Article

Download PDF Download PDF

Abstract

OBJECTIVES
Breast cancer screening rates have increased since the introduction of the National Cancer Screening Program (NCSP) in Korea. However, it remains unclear whether socioeconomic inequalities have improved, particularly according to screening type. This study investigated inequalities in organized (government-led) and opportunistic (individually initiated) screening, stratified by education and income levels.
METHODS
Data were obtained from the Korean National Cancer Screening Survey, conducted annually from 2009 to 2021, involving approximately 1,700 women each year except in 2009. Trends were analyzed using joinpoint regression to calculate average annual percent changes (AAPCs). Socioeconomic inequalities were assessed using the slope index of inequality (SII) and relative index of inequality (RII).
RESULTS
Organized screening rates increased from 42.0% in 2009 to 60.2% in 2021 (AAPC, 1.9; 95% confidence interval [CI], 0.7-3.4), whereas opportunistic screening rates declined from 13.3% to 11.2% (AAPC, -5.4; 95% CI, -8.7 to -2.3). For organized screening, individuals with lower education levels exhibited higher participation, resulting in negative inequality indices (SII, -5.37%; RII, 0.80). No significant income-based inequality was found (SII, 1.60; RII, 1.07). However, opportunistic screening demonstrated significant inequalities by both education (SII, 5.37%; RII, 1.92) and income (SII, 5.90%; RII, 1.96), with higher participation rates among more advantaged groups.
CONCLUSIONS
The NCSP has improved breast cancer screening rates and reduced income-related inequality in organized screening. However, educational and income-based inequalities persist in opportunistic screening. To reduce screening inequities, policy efforts are needed to further promote the NCSP, including improving program quality and providing financial support for follow-up examinations.

Related articles
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
TOP