Trends of Colorectal Cancer Screening Rates in Korea: Korean National Cancer Screening Survey 2005-2020

Abstract

Background/Aims: Screening for colorectal cancer (CRC) is important in reducing the morbidity and mortality of CRC. Thus, this study aimed to describe the trends of CRC screening in both organized and opportunistic settings in Korea from 2005 to 2020 according to sociodemographic characteristics. Methods: This study analyzed the data of adults aged 50 to 74 years from the Korean National Cancer Screening Survey. Trends for CRC screening rates (fecal immunochemical test [FIT] within the last year, double-contrast barium enema within the last 5 years, or colonoscopy within the last 10 years for 2005-2018 and FIT within the last year or colonoscopy within the last 10 years for 2019-2020) were analyzed using Joinpoint regression. The trends were also analyzed according to sociodemographic characteristics, including age, sex, monthly household income, education level, and residential area. Results: A total of 29,040 participants were included in the analysis. The CRC screening rate significantly increased from 25.0% to 60.1%, with an annual percent change (APC) of 9.2% between 2005 and 2014, followed by a nonsignificant increase to 64.4% between 2014 and 2020 (APC,1.7%). When the participants were stratified according to sociodemographic factors, the participants with higher household income and education levels generally had higher screening rates. Conclusions: There has been substantial improvement in CRC screening rates in the general Korean population. However, it is necessary to determine why the screening rate has stabilized since 2014 and identify barriers that cause disparities in CRC screening rates among populations with lower socioeconomic status.