Investigating Factors Influencing the National Cancer Screening Program among Older Individuals in Republic of Korea-Data from the Korea National Health and Nutrition Examination Survey VIII

This study aims to determine the influencing factors of the participation of older individuals aged 65 years and above in South Korea's National Cancer Screening Program (NCSP) using data from the eighth wave (2019-2021) of the Korea National Health and Nutrition Examination Survey (KNHANES VIII), and discuss potential problems and coping strategies. Variables were selected based on Andersen's healthcare utilization model. "Participation in the NSCP" was considered the dependent variable, with independent variables including sociodemographic characteristics (sex, marital status, residence, education level, income level, economic activity, medical coverage type, and private insurance), health conditions (subjective health status, hypertension, and diabetes), and health behaviors (physical activity, monthly alcohol consumption, and current smoking status). The analysis revealed that higher participation rates correlated with being married, having an education level beyond elementary school, being employed, subscribing to private insurance, perceiving oneself as having average or poor health, engaging in physical activity, and not smoking. Sex, residence, income, medical coverage type, hypertension, diabetes, and monthly alcohol consumption were found to be insignificantly correlated. These findings underscore the importance of tailored promotion and health education for older individuals to boost NCSP participation rates, which could ultimately elevate public health standards.

Income Disparities in Cancer Screening: A Cross-Sectional Study of the Korean National Health and Nutrition Examination Survey, 2013–2019

Background

Cancer is one of the leading chronic diseases, which causes premature mortality in Korea. Early detection has been reported to be associated with reduced mortality and morbidity. Consistent evidence reports that lower screening rates are associated with socioeconomic-based disparities. This study aimed to examine income-related disparities in cancer screening services and to analyze the association between utilization of cancer screening and individual characteristics, including income levels.

Methods

This study utilized the data from the Korea National Health and Nutrition Examination Survey (KNHANES), a population-based survey from 2013 to 2019. The study population included individuals aged 40 years or over. The variables were socioeconomic characteristics and perceived health status. Household income was categorized into quartiles from Q1 (the lowest income group) to Q4 (the highest income group). Multivariate logistic regression analysis was performed to analyze the association between cancer screening and individual characteristics and household income levels.

Results

There were 20,347 individuals included in this study. Among these, 14,741 (72.4%) had undergone cancer screening. There existed a gap in the utilization of cancer screening between the lowest (Q1) and highest (Q4) income quintiles owing to evident income disparities; Q4 thus had a significantly higher likelihood of undergoing cancer screening than other quintiles. Female sex, university and over education, number of chronic diseases, and private insurance coverage were positively associated with cancer screening (p < 0.001).

Conclusion

Our findings suggest that policymakers should develop and design strategies to increase awareness and efforts to improve the education and promotion of cancer screening among lower-income target groups.

Effects of socioeconomic status, health behavior, and physical activity on the prevalence of metabolic syndrome

Routine medical checkups have been provided by both the government-led and private hospitals for the purposes of prevention and early detection of diseases. Various studies were conducted with clinical results obtained from both government and private hospital based results. However, results from two types of health checkups have not been conducted. The results should be compared for the prevalence of metabolic disease in the aspects of socioeconomic status and health care behaviors to observe the pros and cons of two types of health checkups. Routine health checkup results of the National Health and Nutrition Survey (1,593 men, 2,180 women) and a private hospital (12,823 men, 7,070 women) of the year 2012 were used for the study. Education level and monthly household income were used to assess the socioeconomic status. Alcohol consumption, smoking, and International Physical Activity Questionnaire were used to assess health behaviors. Logistic regression analysis was applied (P<0.05). Participants of the private hospital had significantly greater household income, education level, amount of physical activity and intensity, and number of nonsmokers. Women showed no differences in the amount of vigorous physical activity. The prevalence rates of metabolic syndrome showed similar results. Education level, physical activity, and alcohol consumption were significantly associated in men of the government group. Smoking showed significant influence in men of both groups. Education level, alcohol consumption, and smoking showed significant influence in women of the government group. Participants who conducted government-led health examinations showed stronger influence of socioeconomic level and health behaviors on metabolic syndrome especially in men.

Joint Symposium of Korean Cancer Association & UICC-ARO-Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia

On 16 June 2016, the Korean Cancer Association (KCA) and Union for International Cancer Control-Asia Regional Office (UICC-ARO) organized a joint symposium as part of the official program of the 42nd Annual Meeting of the Korean Cancer Association to discuss the topic 'Cross-boundary Cancer Studies: Cancer and Universal Health Coverage (UHC) in Asia.' Universal Health Coverage is included in the Sustainable Development Goals adopted by the United Nations as part of the 2030 Agenda for Sustainable Development. The objectives of UHC are to ensure that all people can receive high-quality medical services, are protected from public health risks, and are prevented from falling into poverty due to medical costs or loss of income arising from illness. The participants discussed the growing cost of cancer in the Asian region and the challenges that this poses to the establishment and deployment of UHC in the countries of Asia, all of which face budgetary and other systemic constraints in controlling cancer in the region. Representatives from Korea, Japan and Indonesia reported on the status of UHC in their countries and the challenges that are being faced, many of which are common to other countries in Asia. In addition to country-specific presentations about the progress of and challenges facing UHC, there were also presentations from WHO Kobe Centre concerning advancing UHC in non-communicable diseases and prospects for further collaboration and research on UHC. A presentation from the University of Tokyo also highlighted the need to focus on multidisciplinary studies in an age of globalization and digitization.

Assessment of trends in socioeconomic inequalities in cancer screening services in Korea, 1998-2012

BACKGROUND

This study aimed to examine how income-related inequalities in screening services for gastric and colorectal cancer in Korea have changed over the past decades, along with the implementation of the national cancer screening program, and also to quantify each contribution from various socio-demographic factors income-related inequalities with respect to these cancer screening services.

METHODS

Three cycles (1998, 2005, and 2010-2012) of Korea National Health and Nutrition Examination Survey (KNHANES) were utilized. To measure income-related inequalities in the use of gastric and colorectal cancer, individuals over the age of 40 and the age of 50 were included respectively, and the Concentration Index (CI) was calculated for each cycle. To identify and quantify contribution from each socio-demographic factor, decomposition of the CIs was conducted.

RESULTS

Throughout this study, CIs and horizontal inequity indices (HIs) steadily but consistently decreased, suggesting that inequalities and inequities in participation in gastric and colorectal cancer screening were weakened after the implementation of the national public cancer screening program. Decomposition analyses revealed that whereas decreases in inequalities mostly stemmed from income and educational levels; higher income and better education levels are still major contributors to the observed inequalities that influence participation in cancer screening services in Korea.

CONCLUSION

Our empirical findings suggest that, although the policy of reducing out-of-pocket payment for cancer screening may contribute to the observed decreases in inequality, it alone is not likely to completely eliminate inequality. Further research is required to identify barriers that prevent people with lower socioeconomic status from participation in cancer screening, which allows equal access for equal need.