Myong Jun-Pyo, Kim Hyoung-Ryoul
Department of Preventive Medicine and Catholic Industrial Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Asian Pac J Cancer Prev. 2012;13(5):1857-62. doi: 10.7314/apjcp.2012.13.5.1857.
To assess the impact of household income and economic recession on participation in CRC screening, we estimated annual participating proportions from 2007 to 2009 for different CRC screening modalities according to household income levels. A total of 8,042 subjects were derived from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Multivariate logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for CRC screening with household income quartiles by gender in each year. People were less likely to attend a high-cost CRC screening such as a sigmoidoscopy or colonoscopy independent of the income quartile during the economic recession. Income disparities for participating in opportunistic cancer screening appear to have existed among both males and females during the three years (2007-2009), but were most distinctive in 2009. An increase in mortality of CRC can therefore be expected due to late detection in periods of economic crisis. Accordingly, the government should expand the coverage of CRC screening to prevent excess deaths by reducing related direct and indirect costs during the economic recession.
为评估家庭收入和经济衰退对参与结直肠癌筛查的影响，我们根据家庭收入水平估算了2007年至2009年不同结直肠癌筛查方式的年度参与比例。共有8042名受试者来自第四次韩国国家健康与营养检查调查（KNHANES IV）。采用多因素逻辑回归分析来估计每年按性别划分的家庭收入四分位数进行结直肠癌筛查的优势比和95%置信区间。在经济衰退期间，无论收入四分位数如何，人们参加乙状结肠镜检查或结肠镜检查等高成本结直肠癌筛查的可能性较小。在这三年（2007 - 2009年）中，男性和女性参与机会性癌症筛查的收入差距似乎都存在，但在2009年最为明显。因此，预计在经济危机期间，由于检测延迟，结直肠癌死亡率会上升。相应地，政府应扩大结直肠癌筛查的覆盖范围，通过在经济衰退期间降低相关直接和间接成本来防止过多死亡。
