Socioeconomic Inequalities in Cervical and Breast Cancer Screening among Women in Korea, 2005–2015
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Purpose: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprivedwomen. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalitiesamong Korean women from 2005 to 2015. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey,were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income statuswere estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percentchanges (APCs), to show trends in cancer screening rates. Results: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of householdincome and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooledSII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening wereshown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educationalinequalities appeared to diminish over the study period for both cervical and breast cancer screening. Conclusion: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancerscreening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these wereconstant from 2005 to 2015 for both cervical and breast cancer screening.
Abstract
Purpose: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprivedwomen. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalitiesamong Korean women from 2005 to 2015. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey,were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income statuswere estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percentchanges (APCs), to show trends in cancer screening rates. Results: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of householdincome and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooledSII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening wereshown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educationalinequalities appeared to diminish over the study period for both cervical and breast cancer screening. Conclusion: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancerscreening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these wereconstant from 2005 to 2015 for both cervical and breast cancer screening.
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