Disparities in gastric cancer screening among people with disabilities: a national registry-linkage study in South Korea

  • YoungJee Kim
  • Dong Wook ShinEmail author
  • Hyoung Woo Kim
  • Jin Hyung Jung
  • Kyungdo Han
  • In Young Cho
  • So Young Kim
  • Kui Son Choi
  • Jong Heon Park
  • Jong Hyock ParkEmail author
  • Ichiro Kawachi
Original Article


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.


Gastric cancer Screening Gastroscopy Disability 



National Cancer Screening Program


National Health Information Database


National Health Insurance Service


Upper gastrointestinal series


Author contributions

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.

Supplementary material

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019

Authors and Affiliations

  1. 1.Department of Family Medicine/Supportive Care Center, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Digital HealthSAIHST, Sungkyunkwan UniversitySeoulKorea
  3. 3.Department of Internal MedicineChungbuk National University Hospital, Chungbuk National UniversityCheongjuKorea
  4. 4.Department of Medical StatisticsThe Catholic University of KoreaSeoulKorea
  5. 5.College of Medicine/Graduate School of Health Science Business ConvergenceChungbuk National UniversityCheongjuKorea
  6. 6.Chungbuk National University HospitalChungbuk National UniversityCheongjuKorea
  7. 7.Harvard T.H. Chan School of Public HealthHarvard UniversityCambridgeUSA
  8. 8.Department of Cancer Control and Population Health, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangKorea
  9. 9.Big Data Steering DepartmentNational Health Insurance ServiceWonjuKorea

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