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Disparities in Liver Cancer Screening Among People with Disabilities: A National Database Study in Korea

43 Pages Posted: 5 Feb 2020

See all articles by Jae Youn Seo

Jae Youn Seo

Sungkyunkwan University - Department of Family Medicine/Supportive Care Center

Dong Wook Shin

Sungkyunkwan University - Department of Family Medicine/Supportive Care Center; Sungkyunkwan University - Department of Digital Health

Su Jong Yu

Seoul National University - Department of Internal Medicine

Jin-Hyung Jung

Catholic University of Korea - Department of Medical Statistics

Kyungdo Han

Catholic University of Korea - Department of Medical Statistics

In Young Cho

Sungkyunkwan University - Department of Family Medicine/Supportive Care Center

So Young Kim

Chungbuk National University - College of Medicine

Kui Son Choi

National Cancer Center, Korea

Jong-Heon Park

National Health Insurance Service; National Health Insurance Service - Department of Benefits Strategy

Jong Hyock Park

Chungbuk National University - College of Medicine

Ichiro Kawachi

Harvard University - Department of Society, Human Development, and Health

More...

Abstract

Background: Using the linked administrative database in Korea, we sought to investigate 1) whether there are disparities in liver cancer screening according to degree and type of disability and 2) temporal trends in liver cancer screening among people with disabilities.

Methods: We linked national disability registration data with national cancer screening data. We analyzed age-standardized participation rates for each year during the 2006-2015 period according to presence, type, and severity of disability. We also examined factors associated with liver cancer screening by multivariate logistic regression using the most current data (2014-2015).

Findings: The age- and sex-adjusted screening rate for liver cancer in people with disabilities increased from 25.7% in 2006 to 49.6% in 2015 (change: +23.9%); however, during the same period, screening rate among people without disabilities increased from 24.9 to 54.5% (change: +29.6%). As a result, disparities in liver cancer screening increased over time. The screening participation rate among people with disabilities was 12% lower than among people without disabilities (adjusted OR [aOR] 0.88, 95% confidence interval [CI], 0.87-0.89). Screening rates were markedly lower among people with severe disabilities (aOR 0.71, 95% CI 0.70-0.72) and people with renal disease (aOR 0.43, 95% CI 0.41-0.45), brain injuries (aOR 0.60, 95% CI 0.58-0.62), ostomy problems (aOR 0.60, 95% CI 0.53-0.68), and intellectual disabilities (aOR 0.69, 95% CI 0.66-0.73).

Interpretation: Despite the availability of a national liver cancer screening program, a marked disparity was found in liver cancer screening participation, especially among people with severe disabilities, renal disease, or brain-related or mental disabilities.

Funding Statement: This work was supported by the R&D grant (No. 2016007) on rehabilitation by Korea National Rehabilitation Center Research Institute, Ministry of Health & Welfare, and the National Research Foundation of Korea(NRF) grant funded by the Ministry of Education (No.2016R1D1A3B03931142) and by the Korea government(MSIT) (No. 2019R1H1A2080180, 2019R1A2C1087507) and by the Ministry of Science, ICT, & Future Planning (No. 2016R1A2B4011045).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: Our study was approved by the Institutional Review Board of Chungbuk National University (CBNU-201708-BM-501-01).

Keywords: liver neoplasms, hepatocellular carcinoma, early detection of cancer, disabled persons

Suggested Citation

Seo, Jae Youn and Shin, Dong Wook and Yu, Su Jong and Jung, Jin-Hyung and Han, Kyungdo and Cho, In Young and Kim, So Young and Choi, Kui Son and Park, Jong-Heon and Park, Jong Hyock and Kawachi, Ichiro, Disparities in Liver Cancer Screening Among People with Disabilities: A National Database Study in Korea (January 20, 2020). Available at SSRN: https://ssrn.com/abstract=3522579 or http://dx.doi.org/10.2139/ssrn.3522579

Jae Youn Seo

Sungkyunkwan University - Department of Family Medicine/Supportive Care Center

Seoul
Korea, Republic of (South Korea)

Dong Wook Shin (Contact Author)

Sungkyunkwan University - Department of Family Medicine/Supportive Care Center ( email )

Seoul
Korea, Republic of (South Korea)

Sungkyunkwan University - Department of Digital Health ( email )

Seoul
Korea, Republic of (South Korea)

Su Jong Yu

Seoul National University - Department of Internal Medicine

1 Gwanak-ro
Gwanak-gu
Seoul
Korea, Republic of (South Korea)

Jin-Hyung Jung

Catholic University of Korea - Department of Medical Statistics

Seoul, 06591
Korea, Republic of (South Korea)

Kyungdo Han

Catholic University of Korea - Department of Medical Statistics

Seoul, 06591
Korea, Republic of (South Korea)

In Young Cho

Sungkyunkwan University - Department of Family Medicine/Supportive Care Center

Seoul
Korea, Republic of (South Korea)

So Young Kim

Chungbuk National University - College of Medicine

Korea, Republic of (South Korea)

Kui Son Choi

National Cancer Center, Korea

Seoul, 100-715
Korea, Republic of (South Korea)

Jong-Heon Park

National Health Insurance Service

Wonju
Korea, Republic of (South Korea)

National Health Insurance Service - Department of Benefits Strategy

Wonju
Korea, Republic of (South Korea)

Jong Hyock Park

Chungbuk National University - College of Medicine

Korea, Republic of (South Korea)

Ichiro Kawachi

Harvard University - Department of Society, Human Development, and Health ( email )

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