On-schedule mammography rescreening in the National Cancer Screening Program for breast cancer in Korea

Abstract

Breast cancer is the most commonly diagnosed cancer among women in the Republic of Korea. However, many women are not aware of the importance of on-schedule mammography screening for breast cancer. The objectives of this study were to estimate the percentage of women that attended on-schedule mammography rescreening, and to examine the factors associated with rescreening, among the target screening population (women aged ≥ 40 years) in Korea. The study population was derived from the National Health Insurance (NHI) Corporation database for the National Cancer Screening Program (NCSP), and included 2,511,976 women from the target screening population who attended the NCSP for breast cancer in 2005-2006 (baseline). Study participants were followed-up to determine whether they attended mammography rescreening after 2 years as recommended. Among those who attended mammography screening in 2005-2006, 61.3% were rescreened on schedule 2 years later. The odds of being rescreened were the highest in study participants aged 60-69 years. NHI beneficiaries with a higher premium were significantly more likely to be rescreened than Medical Aid Program recipients. A false-positive screening result at baseline adversely affected subsequent screening behavior. Furthermore, those who had a history of mammography screening before baseline were more likely to return for rescreening. Therefore, assessment of a woman's screening history and socioeconomic status, in combination with interventions to reduce anxiety, such as involving primary care physicians or better informing women about breast cancer and mammography screening, are needed. Efforts to reduce false-positive results and improve the quality of mammography may also increase compliance with breast cancer screening recommendations