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韩国不同收入群体间癌症发病率和死亡率的不平等现象及政策影响

Inequalities in cancer incidence and mortality across income groups and policy implications in South Korea.

作者信息

Kim Chul-Woung, Lee Sang-Yi, Moon Ok-Ryun

机构信息

Department of Preventive Medicine, School of Medicine, Konyang University, Konyang, Korea.

出版信息

Public Health. 2008 Mar;122(3):229-36. doi: 10.1016/j.puhe.2007.07.003. Epub 2007 Nov 1.

Abstract

OBJECTIVE

To investigate inequalities in cancer incidence and mortality across income groups in South Korea.

STUDY DESIGN

After reviewing 2001 data from the Korean National Cancer Registry, and National Health Insurance and National Medical Aid data, 49,277 cancer cases were classified into six income groups. The incidence and 3-year mortality rates of major cancers were calculated separately and as a total.

METHODS

Two composite indices (slope index of inequality and relative index of inequality) were calculated to analyse the relative differences in cancer incidence. The 3-year mortality rate ratios for major cancers were calculated, with Class 1 as the reference, using a Cox regression model to adjust for age.

RESULTS

The relative risk of cancer incidence (total) in the lowest income group was 1.65 and 1.43 times higher than that in the highest income group for males and females, respectively. For cancer mortality, all other income groups showed significantly higher 3-year mortality rate ratios than the highest income group for males and females.

CONCLUSIONS

This study identified inequalities in cancer incidence and 3-year mortality across income groups in South Korea, most of which were unfavourable to lower income groups. It is suggested that lower income groups should receive financial assistance for cancer screening and inpatient medical services.

摘要

目的

调查韩国不同收入群体在癌症发病率和死亡率方面的不平等情况。

研究设计

在审查了韩国国家癌症登记处2001年的数据以及国民健康保险和国家医疗救助数据后,将49277例癌症病例分为六个收入组。分别计算并汇总了主要癌症的发病率和三年死亡率。

方法

计算了两个综合指数(不平等斜率指数和不平等相对指数)以分析癌症发病率的相对差异。以第1组为参照,使用Cox回归模型对年龄进行调整,计算主要癌症的三年死亡率比值。

结果

最低收入组男性和女性的癌症总发病率相对风险分别比最高收入组高1.65倍和1.43倍。对于癌症死亡率,所有其他收入组的男性和女性三年死亡率比值均显著高于最高收入组。

结论

本研究发现韩国不同收入群体在癌症发病率和三年死亡率方面存在不平等,其中大多数对低收入群体不利。建议低收入群体应获得癌症筛查和住院医疗服务的财政援助。

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