Published online Jul 21, 2020. doi: 10.3748/wjg.v26.i27.3963
Peer-review started: March 26, 2020
First decision: April 25, 2020
Revised: May 6, 2020
Accepted: July 4, 2020
Article in press: July 4, 2020
Published online: July 21, 2020
Processing time: 117 Days and 3.7 Hours
Colorectal cancer (CRC) is one of the most common types of cancer worldwide. Screening for CRC is recognized as an effective intervention through which to reduce the numbers of new cancer cases and cancer deaths. In South Korea, although the Korea National Cancer Center recommends CRC screening for adults aged 45 to 80 years, the Korea National Cancer Screening Program currently provides CRC screening for individuals aged 50 years and older with no upper age limit.
In general, people are likely to only pay attention to the benefits of cancer screening and to neglect its risks. Most consider the benefits of cancer screening as being far greater than the risks and are unaware that any potential benefits and harms can vary with age. Although several CRC screening guidelines recommend setting an upper age, there is a lack of information on perceptions and acceptance of an upper age limit for CRC screening.
In this study, we aimed to investigate acceptance of an upper age limit for CRC screening and factors associated therewith among cancer-free individuals targeted for screening in South Korea.
The present study analyzed data from the Korea National Cancer Screening Survey 2017, a nationally representative survey targeted for cancer screening. A total of 1922 participants were included in the final analysis. The baseline characteristics of the study population are presented as unweighted numbers and weighted proportions. Both univariate and multivariate logistic regression models were developed to examine factors related with acceptance of an upper age limit for CRC screening. Subgroup analysis was also applied.
About 80% of the respondents agreed that CRC screening should not be offered for individuals aged older than 80 years, especially respondents who had never been screened for CRC (91%). Overall, the factors significantly associated with acceptance of an upper limit age among the respondents were residential region, cancer screening history, family history of cancer, and physical activity. By subgroup analysis, we found gender, marital status, and lifetime smoking history among never-screened individuals and residential region, family history of cancer, and physical activity among never-screened individuals to be associated with acceptance of an upper age limit.
The majority of the participants in this study agreed with the recommendation of the National Cancer Center of Korea to stop CRC screening at the age of 80 years. CRC screening history was a strong factor associated with acceptance. In order to reduce unnecessary burden of cancer screening programs, it is recommended to provide balanced information on the benefits and risks of screening.
Our study results provide perspectives that should be considered, in addition to scientific evidence, when developing population-based cancer screening policies and programs. In the future, further research on attitudes and preferences toward cancer screening policies in the general population are required.