Cancer Res Treat.  2023 Jul;55(3):910-917. 10.4143/crt.2022.1432.

Overview of the National Cancer Screening Program for Colorectal Cancer in Korea over 14 Years (2004-2017)

• Park B
• Her EY
• Lee K
• Nari F
• Jun JK
• Choi KS
• Suh M

• KMID: 2544171
• DOI: http://doi.org/10.4143/crt.2022.1432

Abstract

Purpose
This study aimed to evaluate the participation and follow-up test compliance rates and key performance indicators of the National Cancer Screening Program (NCSP) for colorectal cancer (CRC) from 2004 to 2017.
Materials and Methods
The overall outcomes of the NCSP for CRC were analyzed using the NCSP data collected from 2004 to 2017 and the Korean Central Cancer Registry for CRC from 2005 to 2017. We cross-sectionally analyzed the participation and follow-up test compliance rates and performance indicators for each year. The trend of participation rates as an annual percentage change was assessed, and other statistical analyses were performed.
Results
The screening participation rates increased from 7.3% in 2004 to 30.5% in 2017. Additionally, the screening rates were higher among individuals aged 60-69 years and National Health Insurance Service beneficiaries of low-income status. However, the adherence to the follow-up test decreased from 63% in 2004 to 32% in 2017. The follow-up tests using the double-contrast barium enema method decreased from 42.2% in 2004 to 0.3% in 2017. However, follow-up tests by colonoscopy increased from 21.0% in 2004 to 31.8% in 2017. Furthermore, the positivity, false-positive, and interval CRC rates decreased, whereas the specificity increased from 2004 to 2016, indicating improved performance of CRC.
Conclusion
The participation rates and performance of the NCSP for CRC have steadily improved, whereas adherence to follow-up tests has decreased. Additionally, there is a rapid growth in colonoscopy volume as a follow-up test. Continued efforts are required to improve the follow-up rates.

Keyword

Colorectal neoplasms; Early detection of cancer; Occult blood; Colonoscopy

Figure

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  Fig. 1 Trends of participation rates from 2004 to 2017 in the National Cancer Screening Program for colorectal cancer by sex: total (A), male (B), and female (C) annual percent change (APC). a)The slope is significantly different from zero at the alpha value of 0.05.

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  Fig. 2 Trends of participation rates from 2004 to 2017 in the National Cancer Screening Program for colorectal cancer by age group: 50–59 (A), 60–69 (B), 70–79 (C), and > 80 years (D) annual percent change (APC). a)The slope is significantly different from zero at the alpha value of 0.05.

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  Fig. 3 Trends of participation rates from 2004 to 2017 in the National Cancer Screening Program for colorectal cancer by type of insurance. National Health Insurance Service beneficiaries of high-income status (A), National Health Insurance Service beneficiaries of low-income status (B), and Medical Aid Program recipients (C) annual percent change (APC). a)The slope is significantly different from zero at the alpha value of 0.05.

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  Fig. 4 Trends of follow-up rates from 2004 to 2017 in the National Cancer Screening Program for colorectal cancer. (A) Total, (B) by sex, (C) by age group, and (D) by type of insurance. The follow-up rate was calculated as follows: number of colonoscopies or double-contrast barium enema test performed/number of positive fecal immunochemical test results. MAP, Medical Aid Program; NHIS, National Health Insurance Service.

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  Fig. 5 Trends of follow-up testing performed by either colonoscopy or double-contrast barium enema (DCBE) test from 2004 to 2017 in the National Cancer Screening Program for colorectal cancer.

Reference

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