Yonsei Medical Journal

Yonsei Univ College Medicine (연세대학교의과대학)
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Socioeconomic Inequalities in Colorectal Cancer Screening in Korea, 2005-2015: After the Introduction of the National Cancer Screening Program

  • Mai, Tran Thi Xuan (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Lee, Yoon Young (National Cancer Control Institute, National Cancer Center) ;
  • Suh, Mina (National Cancer Control Institute, National Cancer Center) ;
  • Choi, Eunji (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Lee, Eun Young (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Ki, Moran (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Cho, Hyunsoon (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Park, Boyoung (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Jun, Jae Kwan (National Cancer Control Institute, National Cancer Center) ;
  • Kim, Yeol (National Cancer Control Institute, National Cancer Center) ;
  • Oh, Jin-Kyoung (Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Choi, Kui Son (Graduate School of Cancer Science and Policy, National Cancer Center)
  • Received : 2018.02.08
  • Accepted : 2018.09.03
  • Published : 2018.11.01
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Abstract

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

Keywords

Acknowledgement

Supported by : National Cancer Center of Korea

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