Disparities in gastric cancer screening among people with disabilities: a national registry-linkage study in South Korea
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ORIGINAL ARTICLE
Disparities in gastric cancer screening among people with disabilities: a national registry‑linkage study in South Korea YoungJee Kim1 · Dong Wook Shin1,2 · Hyoung Woo Kim3 · Jin Hyung Jung4 · Kyungdo Han4 · In Young Cho1 · So Young Kim5,6,7 · Kui Son Choi8 · Jong Heon Park9 · Jong Hyock Park5,7 · Ichiro Kawachi7 Received: 25 July 2019 / Accepted: 15 October 2019 © The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019
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 brainrelated/mental disabilities. Keywords Gastric cancer · Screening · Gastroscopy · Disability Abbreviations NCSP National Cancer Screening Program NHID National Health Information Database NHIS National Health Insurance Service UGIS Upper gastrointestinal series
Dong Wook Shin and Jong Hyock Park have contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10120-019-01017-8) contains supplementary material, which is available to authorized users. * Dong Wook Shin [email protected] * Jong Hyock Park [email protected]; [email protected] Extended author information available on the last page of the article
Introduction Despite improvements in early detection and treatment, the incidence and mortality rates from gastric cancer remain high both worldwide and in Korea. Gastric cancer is the third leading cause of deat
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