[Trend of socioeconomic inequality in participation in cervical cancer screening among Korean women].
OBJECTIVE
While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001.


METHODS
Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, and the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age.


RESULTS
Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found.


CONCLUSIONS
Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.
Institute of Health and Environment, Seoul National University.
Soong-Nang
SN
Jang
Sung-Il
SI
Cho
Seung-Sik
SS
Hwang
Kyunghee
K
Jung-Choi
So-Young
SY
Im
Ji-Ae
JA
Lee
Minah Kang
MK
Kim
D000328:Adult; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities; D006801:Humans; D007723:Korea; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D016387:Women's Health