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World J Gastroenterol. Aug 7, 2009; 15(29): 3653-3659
Published online Aug 7, 2009. doi: 10.3748/wjg.15.3653
Factors associated with use of gastric cancer screening services in Korea
Young Min Kwon, Hyung Taek Lim, Kiheon Lee, Be Long Cho, Min Sun Park, Ki Young Son, Sang Min Park
Young Min Kwon, Be Long Cho, Min Sun Park, Ki Young Son, Sang Min Park, Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yunkeon-dong, Jongro-gu, Seoul 110-744, South Korea
Hyung Taek Lim, Department of Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
Kiheon Lee, Department of Family Medicine, Seoul National University Bundang Hospital and Department of the History of Medicine and Medical Humanities, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, South Korea
Author contributions: Kwon YM was the main author of this paper; Lim HT and Lee K contributed to study design and statistical analysis; Cho BL, Park MS and Son KY contributed to analysis and interpretation of data.
Correspondence to: Sang Min Park, MD, PhD, Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yunkeon-dong, Jongro-gu, Seoul 110-744, South Korea. smpark.snuh@gmail.com
Telephone: +82-2-20723331
Fax: +82-2-7663276
Received: May 20, 2009
Revised: July 3, 2009
Accepted: July 10, 2009
Published online: August 7, 2009
Abstract

AIM: To identify the factors associated with participation in gastric cancer screening programs.

METHODS: Using data from the Korea National Health and Nutrition Examination Survey 2005 (KNHANES III), a nationwide health-related survey in Korea, a cross-sectional study was performed to investigate the multiple factors associated with gastric cancer screening attendance among persons aged at least 40 years. The study population included 4593 individuals who completed a gastric cancer screening questionnaire and had no previous cancer history. Four groups of individual-level or environmental level covariates were considered as potential associated factors.

RESULTS: Using KNHANES III data, an estimated 31.71% of Korean individuals aged at least 40 years adhered to gastric cancer screening recommendations. Subjects who graduated from elementary school [adjusted odds ratio (aOR), 1.66; 95% CI: 1.21-2.26], middle/high school (aOR, 1.38; 95% CI: 1.01-1.89), and university or higher (aOR, 1.64; 95% CI: 1.13-2.37) were more likely to undergo gastric cancer screening than those who received no formal education at all. The population with the highest income tertile had more attendance at gastric screening compared to those with the lowest income tertile (aOR, 1.36; 95% CI: 1.06-1.73). Gastric screening was also negatively associated with excessive alcohol consumption (aOR, 0.71; 95% CI: 0.53-0.96). A positive attitude to preventive medical evaluation was significantly associated with better participation in gastric cancer screening programs (aOR, 5.26; 95% CI: 4.35-6.35).

CONCLUSION: Targeted interventions for vulnerable populations and public campaigns about preventive medical evaluation are needed to increase gastric cancer screening participation and reduce gastric cancer mortality.

Keywords: Socioeconomic factors, Health behavior, Health status disparity, Mental health, Early detection of cancer