Impacts of Household Income and Economic Recession on Participation in Colorectal Cancer Screening in Korea

To assess the impact of household income and economic recession on participation in CRC screening,we estimated annual participating proportions from 2007 to 2009 for different CRC screening modalitiesaccording to household income levels. A total of 8,042 subjects were derived from the fourth KoreanNational Health and Nutrition Examination Survey (KNHANES IV). Multivariate logistic regressionanalysis was used to estimate odds ratios and 95% confidence intervals for CRC screening with householdincome quartiles by gender in each year. People were less likely to attend a high-cost CRC screening suchas a sigmoidoscopy or colonoscopy independent of the income quartile during the economic recession.Income disparities for participating in opportunistic cancer screening appear to have existed among bothmales and females during the three years (2007-2009), but were most distinctive in 2009. An increase inmortality of CRC can therefore be expected due to late detection in periods of economic crisis. Accordingly,the government should expand the coverage of CRC screening to prevent excess deaths by reducing relateddirect and indirect costs during the economic recession.