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Socioeconomic Inequalities in Colorectal 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 inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein usingthe 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-sectionalsurvey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience withCRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screeningrates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRCscreening 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 CRCscreening 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 estimatesdid not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. Noapparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economicinequalities in CRC screening.

Abstract

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein usingthe 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-sectionalsurvey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience withCRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screeningrates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRCscreening 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 CRCscreening 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 estimatesdid not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. Noapparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economicinequalities in CRC screening.

참고문헌 (36)

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