Department of Healthcare Management, College of Medical Science, Soonchunhyang University, Shinchang-myun, Asan-si, Choongchungnam-do 336-745, Republic of Korea.
Cancer Epidemiol. 2011 Feb;35(1):90-6. doi: 10.1016/j.canep.2010.08.009. Epub 2010 Oct 13.
Although national-level organized cancer screening programs have reduced barriers to screening for people of low socioeconomic status, barriers to early screening remain. Our aim was to determine the diffusion pattern and identify the factors associated with early participation in stomach and breast cancer screening programs.
The study population was derived from the Korean National Cancer Screening Survey, conducted in 2007. A stratified random sample of people aged 40 years and older from a nationwide population-based database was gathered in Korea (n=1,517) in 2007. Time of participation in early screening was defined as the number of years that had elapsed between the participant's 30th birthday and the age at first screening.
Significant differences were observed in the probability of adopting stomach and breast cancer screening in relation to education, household income, and job level. Results from Cox's proportional hazard model indicated that higher household income was significantly associated with an increased probability of adopting stomach cancer screening earlier (p<0.05), and people with high household incomes were more likely to adopt breast cancer screening earlier than were those with incomes under US$1,500 per month (p<0.01). When considered at a significance level of 0.1, we found that the most highly educated women were more likely than the least educated to be screened early.
Despite organized governmental screening programs, there are still inequalities in the early adoption of cancer screening. The results of this study also suggest that inequalities in early adoption may affect participation in regular screening.
尽管国家级有组织的癌症筛查计划已经降低了经济社会地位较低人群的筛查障碍，但早期筛查仍然存在障碍。我们的目的是确定早期参与胃癌和乳腺癌筛查计划的扩散模式，并确定与早期参与相关的因素。
研究人群来自于 2007 年进行的韩国国家癌症筛查调查。从韩国全国人口基础数据库中抽取年龄在 40 岁及以上的分层随机样本（n=1517）。早期筛查的参与时间定义为参与者 30 岁生日与首次筛查年龄之间的年数。
在接受胃癌和乳腺癌筛查的概率方面，教育程度、家庭收入和工作水平存在显著差异。Cox 比例风险模型的结果表明，较高的家庭收入与更早地采用胃癌筛查的概率显著相关（p<0.05），家庭收入较高的人群比每月收入低于 1500 美元的人群更早地采用乳腺癌筛查（p<0.01）。在显著性水平为 0.1 时，我们发现受教育程度最高的女性比受教育程度最低的女性更有可能进行早期筛查。
尽管有组织的政府筛查计划，但在早期接受癌症筛查方面仍存在不平等现象。本研究的结果还表明，早期参与的不平等可能会影响定期筛查的参与。
