Socioeconomic Inequalities in Stomach Cancer Screening in Korea, 2005–2015: After the Introduction of the National Cancer Screening Program
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Purpose: This study aimed to investigate socioeconomic inequalities in stomach cancer screening in Korea and trends thereinacross income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, a nationwide cross-sectional survey, were utilized. A total of 28913 men and women aged 40 to 74 years were included for analysis. Prior experience with stomach cancerscreening was defined as having undergone either an endoscopy or gastrointestinal series within the past two years. The slope indexof inequality (SII) and relative index of inequality (RII) were evaluated to check inequalities. Results: Stomach cancer screening rates increased from 40.0% in 2005 to 74.8% in 2015, with an annual percent change of 5.8%[95% confidence interval (CI) 4.2 to 7.5]. Increases in stomach cancer screening rates were observed for all age, education, andhousehold income groups. Inequalities in stomach cancer screening were noted among individuals of differing levels of education,with a pooled SII estimate of 6.14% (95% CI, 3.94 to 8.34) and RII of 1.26 (95% CI, 1.12 to 1.40). Also, income-related inequalitieswere observed with an SII of 6.93% (95% CI, 4.89 to 8.97) and RII of 1.30 (95% CI, 1.17 to 1.43). The magnitude of inequalitywas larger for income than for education. Conclusion: Both education and income-related inequalities were found in stomach cancer screening, despite a continuous increasein screening rate over the study period. Income-related inequality was greater than education-related inequality, and thiswas more apparent in women than in men.
Abstract
Purpose: This study aimed to investigate socioeconomic inequalities in stomach cancer screening in Korea and trends thereinacross income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, a nationwide cross-sectional survey, were utilized. A total of 28913 men and women aged 40 to 74 years were included for analysis. Prior experience with stomach cancerscreening was defined as having undergone either an endoscopy or gastrointestinal series within the past two years. The slope indexof inequality (SII) and relative index of inequality (RII) were evaluated to check inequalities. Results: Stomach cancer screening rates increased from 40.0% in 2005 to 74.8% in 2015, with an annual percent change of 5.8%[95% confidence interval (CI) 4.2 to 7.5]. Increases in stomach cancer screening rates were observed for all age, education, andhousehold income groups. Inequalities in stomach cancer screening were noted among individuals of differing levels of education,with a pooled SII estimate of 6.14% (95% CI, 3.94 to 8.34) and RII of 1.26 (95% CI, 1.12 to 1.40). Also, income-related inequalitieswere observed with an SII of 6.93% (95% CI, 4.89 to 8.97) and RII of 1.30 (95% CI, 1.17 to 1.43). The magnitude of inequalitywas larger for income than for education. Conclusion: Both education and income-related inequalities were found in stomach cancer screening, despite a continuous increasein screening rate over the study period. Income-related inequality was greater than education-related inequality, and thiswas more apparent in women than in men.
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