Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, South Korea.
National Cancer Control Institute, National Cancer Center, Goyang-si 10408, South Korea.
World J Gastroenterol. 2020 Jul 21;26(27):3963-3974. doi: 10.3748/wjg.v26.i27.3963.
The Korea National Cancer Screening Program currently provides screening for colorectal cancer (CRC) for adults older than 50 years with no upper age limit. In general, people are likely to only pay attention to the benefits of cancer screening and to neglect its risks. Most consider the benefits of cancer screening as being far greater than the risks and are unaware that any potential benefits and harms can vary with age.
To report acceptance of an upper age limit for CRC screening and factors associated therewith among cancer-free individuals in Korea.
The present study analyzed data from the Korea National Cancer Screening Survey 2017, a nationally representative random sample of 4500 Korean individuals targeted for screening for the five most common types of cancer. A total of 1922 participants were included in the final analysis. The baseline characteristics of the study population are presented as unweighted numbers and weighted proportions. Both univariate and multivariate logistic regression models were developed to examine factors related with acceptance of an upper age limit for CRC screening; subgroup analysis was also applied.
About 80% (1554/1922) of the respondents agreed that CRC screening should not be offered for individuals older than 80 years. Specifically, those who had never been screened for CRC had the highest acceptance rate (91%). Overall, screening history for CRC [screened by both fecal occult blood test and colonoscopy, adjusted odds ratio (aOR) = 0.33, 95%CI: 0.22-0.50] and other cancers (aOR = 0.55, 95%CI: 0.34-0.87), as well as a family history of cancer (aOR = 0.66, 95%CI: 0.50-0.87), were negatively associated with acceptance of an upper age limit for CRC screening. In contrast, metropolitan residents (aOR = 1.86, 95%CI: 1.29-2.68) and people who exercised regularly (aOR = 1.42, 95%CI: 1.07-1.89) were more likely to accept an upper age limit. After subgrouping, we found gender, marital status, and lifetime smoking history among never-screened individuals and residential region, family history of cancer, and physical activity among never-screened individuals to be associated with acceptance of an upper age limit.
This study describes acceptance of an upper age limit for CRC screening and factors associated with it, and provides perspectives that should be considered, in addition to scientific evidence, when developing population-based cancer screening policies and programs.
韩国国家癌症筛查计划目前为 50 岁以上的成年人提供结直肠癌（CRC）筛查，没有年龄上限。一般来说，人们可能只关注癌症筛查的益处，而忽视其风险。大多数人认为癌症筛查的益处远远大于风险，并且不知道任何潜在的益处和危害可能因年龄而异。
报告韩国无癌症个体对 CRC 筛查的年龄上限的接受程度及其相关因素。
本研究分析了 2017 年韩国国家癌症筛查调查的数据，该调查是对全国 4500 名针对五种最常见癌症进行筛查的韩国人的代表性随机抽样。共有 1922 名参与者纳入最终分析。研究人群的基线特征以未加权数字和加权比例表示。使用单变量和多变量逻辑回归模型来检验与接受 CRC 筛查的年龄上限相关的因素；还进行了亚组分析。
约 80%（1554/1922）的受访者认为不应对 80 岁以上的个体进行 CRC 筛查。具体而言，从未接受过 CRC 筛查的人接受率最高（91%）。总体而言，CRC 筛查史[粪便潜血试验和结肠镜检查均进行，调整后的优势比（aOR）=0.33，95%CI：0.22-0.50]和其他癌症（aOR=0.55，95%CI：0.34-0.87），以及癌症家族史（aOR=0.66，95%CI：0.50-0.87）与接受 CRC 筛查的年龄上限呈负相关。相比之下，大都市居民（aOR=1.86，95%CI：1.29-2.68）和经常锻炼的人（aOR=1.42，95%CI：1.07-1.89）更有可能接受年龄上限。在亚组分析中，我们发现从未筛查过的人群中，性别、婚姻状况和终生吸烟史，以及从未筛查过的人群中，居住地、癌症家族史和身体活动与接受年龄上限相关。
本研究描述了对 CRC 筛查的年龄上限的接受程度及其相关因素，并提供了在制定基于人群的癌症筛查政策和计划时，除了科学证据之外，还应考虑的观点。
