YoungJee Kim1, Dong Wook Shin2,3, Hyoung Woo Kim4, Jin Hyung Jung5, Kyungdo Han5, In Young Cho1, So Young Kim6,7,8, Kui Son Choi9, Jong Heon Park10, Jong Hyock Park11,12, Ichiro Kawachi8. 1. Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea. 2. Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea. dwshin.md@gmail.com. 3. Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea. dwshin.md@gmail.com. 4. Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju, Korea. 5. Department of Medical Statistics, The Catholic University of Korea, Seoul, Korea. 6. College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, 28644, Korea. 7. Chungbuk National University Hospital, Chungbuk National University, Cheongju, Korea. 8. Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA. 9. Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea. 10. Big Data Steering Department, National Health Insurance Service, Wonju, Korea. 11. College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, 28644, Korea. jonghyock@gmail.com. 12. Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA. jonghyock@gmail.com.
Abstract
BACKGROUND AND AIM: Using the national disability registration linked to the cancer screening database in Korea, we examined (1) trends in the gastric cancer screening rate among people with disabilities over time, and (2) whether gastric cancer screening participation and modalities differed according to presence, severity, and type of disability. METHODS: We examined gastric cancer screening participation rates among individuals with registered disability, from 2006 to 2015. RESULTS: The age- and sex-adjusted rate for gastric cancer screening in people with disabilities increased from 25.9% in 2006 to 51.9% in 2015 (change: + 26.0%). During the same period, screening rates among people without disability improved from 24.7 to 56.5% (change: + 31.8%). Disability was associated with a screening rate [adjusted odds ratio (aOR) 0.89, 95% confidence interval (CI), 0.88-0.89]. Screening rates were markedly lower among people with severe disabilities (aOR 0.58, 95% CI 0.57-0.58) and people with autism (aOR 0.36, 95% CI 0.25-0.52), renal failure (aOR 0.39, 95% CI 0.38-0.39), brain injury (aOR 0.41, 95% CI 0.40-0.41), ostomy problems (aOR 0.53, 95% CI 0.51-0.55), intellectual disabilities (aOR 0.54, 95% CI 0.53-0.54), or mental disorders (aOR 0.55, 95% CI 0.54-0.56). The use of gastroscopy as the initial screening modality in people with disabilities was lower than in people without a disability. CONCLUSIONS: In spite of the availability of national gastric cancer screening program, we found significant disparities in gastric cancer screening participation, especially among people with severe disabilities and those with renal failure or brain-related/mental disabilities.
BACKGROUND AND AIM: Using the national disability registration linked to the cancer screening database in Korea, we examined (1) trends in the gastric cancer screening rate among people with disabilities over time, and (2) whether gastric cancer screening participation and modalities differed according to presence, severity, and type of disability. METHODS: We examined gastric cancer screening participation rates among individuals with registered disability, from 2006 to 2015. RESULTS: The age- and sex-adjusted rate for gastric cancer screening in people with disabilities increased from 25.9% in 2006 to 51.9% in 2015 (change: + 26.0%). During the same period, screening rates among people without disability improved from 24.7 to 56.5% (change: + 31.8%). Disability was associated with a screening rate [adjusted odds ratio (aOR) 0.89, 95% confidence interval (CI), 0.88-0.89]. Screening rates were markedly lower among people with severe disabilities (aOR 0.58, 95% CI 0.57-0.58) and people with autism (aOR 0.36, 95% CI 0.25-0.52), renal failure (aOR 0.39, 95% CI 0.38-0.39), brain injury (aOR 0.41, 95% CI 0.40-0.41), ostomy problems (aOR 0.53, 95% CI 0.51-0.55), intellectual disabilities (aOR 0.54, 95% CI 0.53-0.54), or mental disorders (aOR 0.55, 95% CI 0.54-0.56). The use of gastroscopy as the initial screening modality in people with disabilities was lower than in people without a disability. CONCLUSIONS: In spite of the availability of national gastric cancer screening program, we found significant disparities in gastric cancer screening participation, especially among people with severe disabilities and those with renal failure or brain-related/mental disabilities.
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