Factors associated with use of breast cancer screening services by women aged ≥ 40 years in Korea: The Third Korea National Health and Nutrition Examination Survey 2005 (KNHANES III)

Abstract

BackgroundDespite evidence that breast cancer screening reduces morbidity and mortality, until recently most women have not undergone regular mammogram examinations in Korea. We aimed to identify factors associated with use of breast cancer screening services.MethodsThe Health Promotion Knowledge, Attitude and Practice survey (HP-KAP survey) is part of the Third Korea National Health and Nutrition Examination Survey 2005 (KNHANES III), a nationwide health survey in Korea. Of 7,802 individuals who participated in the HP-KAP survey, 4,292 were female. Of these, 2,583 were women aged at least 40 years and without a history of breast cancer; these women were included in this study. Information about breast cancer screening participation was obtained from the responses to questionnaires. The overall rate of regular breast cancer screening was measured. Factors that affect participation in a breast cancer screening program were identified using multiple logistic regression analysis.ResultsAmong women aged at least 40 years, 30.4% complied with breast screening recommendations. Age of at least 65 years (adjusted odds ratio, aOR 0.61, 95% CI: 0.42-0.88), education level (no [ref], elementary school [aOR 1.51, 95% CI: 1.06-1.47], middle/high school [aOR 1.99, 95% CI: 1.36-2.92], university/higher [aOR 2.73, 95% CI: 1.71-4.35]), private health insurance (aOR 1.42, 95% CI: 1.71-4.35), attitude towards screening tests (aOR 0.18, 95% CI: 0.14-0.23), self-reported health status of 'fair' (aOR 1.26 95% CI: 1.00-1.58), and smoking (aOR 0.52, 95% CI: 0.35-0.79) were associated with the rate of regular breast cancer screeningConclusionsTo increase the nationwide breast cancer screening rate, more attention should be given to underrepresented groups, particularly the elderly, those with a low education level, smokers, and those with a negative attitude towards screening tests. These issues highlight the need for a new emphasis in health education, promotional campaigns and public health policy aimed at these underrepresented groups.

Factors Associated with the Use of Gastric Cancer Screening Services in Korea: The Fourth Korea National Health and Nutrition Examination Survey 2008 (KNHANES IV)

“…Consistent with previous studies of cancer screening (Kwon et al, 2009;Lee et al, 2010;Park et al, 2010), our results indicate that education level is significantly associated with the gastric cancer screening rate. By contrast, monthly household income did not reach statistical significance in the multivariate analysis.…”

“…Education level not only determines the social and physical environments, but is an important factor that could cause a difference in understanding the health beliefs and expected gains (Jang et al, 2007). Lee et al reported a large disparity in cancer screening rates among subjects with different education levels, whereas the disparity in the cancer screening rates according to income level had decreased (Lee et al, 2010). Our finding that a lower education level was significantly associated with less participation in gastric cancer screening, while the income level did not show significance, can be explained in this context.…”

Knowledge, attitudes, risk perception, and cancer screening behaviors among cancer survivors

“…9,16 The survey asked about sociodemographic factors known to be associated with screening practices, including age, 20,21 sex, 22 marital status, 18,20 education, 20,21,23 monthly household income, 18,24,25 employment status, 24 smoking status, 21 alcohol consumption, 25 and perceived health status. [20][21][22] Information regarding the presence of comorbidities was also collected because the frequent medical encounters because of such conditions are associated with cancer screening practices 23,26 and included hypertension; dyslipidemia; diabetes; osteoarthritis; rheumatoid arthritis; and cerebrovascular, cardiovascular, chronic liver, lung, kidney, or gastrointestinal disease. Clinical variables, including the date of the primary cancer diagnosis, stage of disease at the time of diagnosis, and types of cancer treatment patients had received, were collected through the review of medical records.…”

Need to Pay More Attention to Attendance at Follow-Up Consultation after Cancer Screening in Smokers and Drinkers

“…In terms of education level, disparities in attendance were observed for the opportunistic screening program. In another study, Lee et al conducted a study regarding factors associated with the use of breast cancer screening services by females in Korea (Lee et al, 2010). They concluded more attention should be given to under-represented groups, particularly the elderly, those with a low education level, smokers and those with a negative attitude towards screening tests.…”