J Gynecol Oncol.  2017 Sep;28(5):e63. 10.3802/jgo.2017.28.e63.

Nationwide cervical cancer screening in Korea: data from the National Health Insurance Service Cancer Screening Program and National Cancer Screening Program, 2009–2014

• Shim SH
• Kim H
• Sohn IS
• Hwang HS
• Kwon HS
• Lee SJ
• Lee JY
• Kim SN
• Lee K
• Chang S

• KMID: 2413223
• DOI: http://doi.org/10.3802/jgo.2017.28.e63

Abstract

OBJECTIVE
The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined.
METHODS
The database of the National Health Insurance Service (NHIS) was used during the study period (2009-2014).
RESULTS
The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253-6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%-31.9%) and those 30-39 years of age the second-lowest (27.7%-44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%-52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%-33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30-39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30-39 years to 60-69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014.
CONCLUSION
Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30-39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently.

Keyword

Uterine Cervical Neoplasms; Papanicolaou Test; Mass Screening; Early Detection of Cancer; National Health Programs

MeSH Terms

Adult
Aged
Atypical Squamous Cells of the Cervix/pathology
Early Detection of Cancer
Female
Humans
Mass Screening/*statistics & numerical data
Middle Aged
National Health Programs/*statistics & numerical data
Papanicolaou Test/statistics & numerical data
Republic of Korea/epidemiology
Squamous Intraepithelial Lesions of the Cervix/diagnosis
Uterine Cervical Neoplasms/*diagnosis/epidemiology/pathology
Vaginal Smears/statistics & numerical data