Nationwide cervical cancer screening in Korea: data from the National Health Insurance Service Cancer Screening Program and National Cancer Screening Program, 2009-2014

J Gynecol Oncol. 2017 Sep;28(5):e63. doi: 10.3802/jgo.2017.28.e63. Epub 2017 May 26.

Abstract

Objective: The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined.

Methods: The database of the National Health Insurance Service (NHIS) was used during the study period (2009-2014).

Results: The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253-6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%-31.9%) and those 30-39 years of age the second-lowest (27.7%-44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%-52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%-33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30-39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30-39 years to 60-69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014.

Conclusion: Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30-39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently.

Keywords: Early Detection of Cancer; Mass Screening; National Health Programs; Papanicolaou Test; Uterine Cervical Neoplasms.

MeSH terms

  • Adult
  • Aged
  • Atypical Squamous Cells of the Cervix / pathology
  • Early Detection of Cancer
  • Female
  • Humans
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • National Health Programs / statistics & numerical data*
  • Papanicolaou Test / statistics & numerical data
  • Republic of Korea / epidemiology
  • Squamous Intraepithelial Lesions of the Cervix / diagnosis
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / pathology
  • Vaginal Smears / statistics & numerical data