Socioeconomic Inequalities in Colorectal Cancer Screening in Korea, 2005–2015: After the Introduction of the National Cancer Screening Program

• Published in: Yonsei medical journal Vol. 59; no. 9; pp. 1034 - 1040
• Main Authors: Mai, Tran Thi Xuan, Lee, Yoon Young, Suh, Mina, Choi, Eunji, Lee, Eun Young, Ki, Moran, Cho, Hyunsoon, Park, Boyoung, Jun, Jae Kwan, Kim, Yeol, Oh, Jin-Kyoung, Choi, Kui Son
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.11.2018; 연세대학교의과대학
• Subjects: Adult; Aged; Colonoscopy; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - prevention & control; Cross-Sectional Studies; Early Detection of Cancer - statistics & numerical data; Early Detection of Cancer - trends; Female; Health Status Disparities; Healthcare Disparities - statistics & numerical data; Healthcare Disparities - trends; Humans; Income; Male; Mass Screening - statistics & numerical data; Middle Aged; Occult Blood; Original; Registries; Republic of Korea; Social Class; Socioeconomic Factors; 의학일반; socioeconomic factors; inequalities; Colorectal neoplasms; early detection of cancer
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2018.59.9.1034

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. 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. 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. 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.