Disparities in Cancer-Related Avoidable Mortality by the Level of Area Deprivation in South Korea

Abstract

Background: This study investigated trends in cancer-related avoidable (preventable and treatable) mortality and its association with area deprivation in Korea. Methods: Cancer-related avoidable mortality rates per 100,000 population between 2015 and 2019 were measured using the Causes of Death Statistics. Area Deprivation Index (ADI) was measured from the Population and Housing Census and information on other independent variables from the Korea Community Health Survey. The gap in avoidable mortality between the more and less deprived groups was expressed as rate ratios (RR) and absolute differences (ADs) with a 95 percent confidence interval (95% CI). The association between avoidable mortality and ADI was investigated through Poisson regression modelling. Results: The more deprived areas had higher avoidable (RR 1.15, 95% CI 1.13–1.17; AD 6.58, 95% CI 5.59–7.57) and preventable (RR 1.19, 95% CI 1.17–1.21; AD 6.22, 95% CI 5.38–7.06) mortality. The overall cancer-related avoidable mortality decreased but the gap between the more and less deprived groups did not decline significantly during the study period. The association between avoidable and preventable mortality and area deprivation remained significant after adjusting for variables, including area levels of smokers and alcohol drinkers. Conclusions: The gap in avoidable mortality signifies the importance of addressing related disparities in cancer.

Avoidable Mortality between Metropolitan and Non-Metropolitan Areas in Korea from 1995 to 2019: A Descriptive Study of Implications for the National Healthcare Policy

“…In terms of disease groups, the mortality for cancer had a greater decrease than for other diseases. Cancer is the leading cause of death in Korea, and deaths due to cancer can be prevented or treated by primary prevention such as smoking cessation, secondary prevention such as cancer screening programs, and tertiary prevention such as appropriate treatment [ 11 ]. In Korea, the National Cancer Screening Program for the six major cancers (stomach, liver, colon, breast, cervix of the uterus, and lung) have been produced since 1990.…”

“…Avoidable death refers to death from preventable or treatable causes and has been used as an indicator to evaluate the effectiveness of health promotion policies, such as smoking cessation, alcohol consumption, and healthcare systems [ 9 , 10 ]. In addition, avoidable deaths can be used to identify areas with high healthcare needs and reflect differences in healthcare access in health inequality studies [ 11 , 12 , 13 , 14 ]. Causes of death included in avoidable deaths are continuously changing in consideration of the characteristics of each country and the development of medical technology.…”

“…Several studies have been conducted on the regional distribution or disparities in avoidable mortality in Korea [ 3 , 11 , 16 ]. Recently, Kim et al (2021) studied changes in specific avoidable causes of death, such as cancer [ 11 ].…”

“…Several studies have been conducted on the regional distribution or disparities in avoidable mortality in Korea [ 3 , 11 , 16 ]. Recently, Kim et al (2021) studied changes in specific avoidable causes of death, such as cancer [ 11 ]. Bahk and Jung-Choi (2020) established a study on the differences in life expectancy of avoidable deaths by age group [ 2 ].…”