Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021

• 영문명: Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021
• 발행기관: 한국역학회
• 저자명: Xuan Quy Luu Kyeongmin Lee Jae Kwan Jun Mina Suh Kui Son Choi
• 간행물 정보: 『Epidemiology and Health』45, 1~10쪽, 전체 10쪽
• 주제분류: 의약학 > 면역학
• 파일형태: PDF
• 발행일자: 2023.01.01

영문 초록

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.

목차

INTRODUCTION

MATERIALS AND METHODS

RESULTS

DISCUSSION

SUPPLEMENTARY MATERIALS

CONFLICT OF INTEREST

FUNDING

ACKNOWLEDGEMENTS

AUTHOR CONTRIBUTIONS

ORCID

REFERENCES

키워드

Colorectal cancer Mass screening Health inequities Healthcare disparity