Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Front Public Health. 2023 Oct 9;11:1256525. doi: 10.3389/fpubh.2023.1256525. eCollection 2023.
This study aimed to evaluate the socioeconomic inequality in gastric cancer (GC) screening in Korea. Socioeconomic inequality was assessed using both organized and opportunistic screening according to income and educational level.
GC screening data were obtained from the 2009-2022 Korean National Cancer Screening Survey. The final analysis included 47,163 cancer-free men and women. The weighted cancer screening rate was estimated using joinpoint regression. The inequality indices were measured in terms of both the absolute slope index of inequality (SII) and the relative index of inequality (RII) using the Poisson regression model.
The organized screening rate for GC increased from 38.2% in 2009 to 70.8% in 2022, whereas the opportunistic screening rate decreased from 18.8 to 4.5%. Regarding educational inequality, a negative SII value was observed [-3.5, 95% confidence interval (CI), -7.63-0.83%] in organized screening, while a positive SII (9.30%; 95% CI, 6.69-11.91%) and RII (1.98%; 95% CI, 1.59-2.46) were observed in opportunistic screening. Furthermore, income inequality was not found in organized GC screening; however, overall SII and RII for opportunistic screening were 7.72% (95% CI, 5.39-10.5) and 1.61 (95% CI, 1.42-1.81), respectively.
Organized screening rates have grown gradually over time and account for the majority of GC screenings in South Korea. While no socioeconomic inequalities were found in organized screening, significant socioeconomic inequalities were found in opportunistic screening.
本研究旨在评估韩国胃癌（GC）筛查中的社会经济不平等。根据收入和教育水平，采用有组织和机会性筛查来评估社会经济不平等。
GC 筛查数据来自 2009-2022 年韩国国家癌症筛查调查。最终分析包括 47163 名无癌症的男性和女性。使用 Joinpoint 回归估计加权癌症筛查率。使用泊松回归模型，以绝对不平等斜率指数（SII）和相对不平等指数（RII）衡量不平等指数。
GC 的有组织筛查率从 2009 年的 38.2%增加到 2022 年的 70.8%，而机会性筛查率从 18.8%下降到 4.5%。关于教育不平等，有组织筛查中观察到负 SII 值[-3.5，95%置信区间（CI），-7.63-0.83%]，而机会性筛查中观察到正 SII（9.30%；95%CI，6.69-11.91%）和 RII（1.98%；95%CI，1.59-2.46）。此外，在有组织的 GC 筛查中未发现收入不平等；然而，机会性筛查的总 SII 和 RII 分别为 7.72%（95%CI，5.39-10.5）和 1.61（95%CI，1.42-1.81）。
有组织的筛查率随着时间的推移逐渐增加，占韩国 GC 筛查的大部分。虽然在有组织的筛查中没有发现社会经济不平等，但在机会性筛查中发现了显著的社会经济不平等。
