Disparities in gastric cancer screening among people with disabilities: a national registry-linkage study in South Korea
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.
We examined gastric cancer screening participation rates among individuals with registered disability, from 2006 to 2015.
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.
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.
KeywordsGastric cancer Screening Gastroscopy Disability
National Cancer Screening Program
National Health Information Database
National Health Insurance Service
Upper gastrointestinal series
Study concept and design: DWS, YK, SYK, and JHP. Acquisition of data: JHP, KH, JHP, and SYK. Analysis and interpretation of data: JHJ, KH, DWS, YK, HWK, SYK, KSC, JHP, JHP, and IK. Drafting of the manuscript: YK and DWS. Statistical analysis: JHJ and KH. Obtained funding: JHP. Administrative, technical or material support: JHP, JHP, and SYK.
This work was supported by the R&D grant (no. 2016007) on rehabilitation by Korea National Rehabilitation Center Research Institute, Ministry of Health & Welfare, and the National Research Foundation of Korea (NRF) grant funded by the Ministry of Education (no. 2016R1D1A3B03931142) and by the Korea government (MSIT) (nos. 2019R1H1A2080180, 2019R1A2C1087507).
Compliance with ethical standards
Conflict of interest
No author has potential conflict of interest, including financial interests or relationships.
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