Factors associated with use of gastric cancer screening services in Korea

Table 1 Basic characteristics of the study population (n = 4593)

		n (%)
Socio-demographic factor
Age (yr)	40-49	1854 (40.37)
	50-59	1204 (26.21)
	60-69	924 (20.12)
	≥ 70	611 (13.3)
Sex	Male	2069 (45.05)
	Female	2524 (54.95)
Residence1	Metropolis	2058 (44.81)
	Town or country	2535 (55.22)
Household income2	Lowest tertile	1446 (31.88)
	Middle tertile	1550 (34.17)
	Highest tertile	1540 (33.95)
Education	Uneducated	497 (10.83)
	Elementary school	1117 (24.32)
	Middle-high school	2206 (48.03)
	University or higher	773 (16.83)
Marital status3	Without spouse	1053 (22.94)
	With spouse	3537 (77.06)
National health insurance (NHI) vs Medicaid4	NHI	4355 (95.17)
	Medicaid	221 (4.83)
General health status
Self-reported health status	Healthy	1522 (33.14)
	Middle	1682 (36.62)
	Unhealthy	1389 (30.24)
Limitation of general activity	Limited	671 (14.61)
	Unlimited	3922 (85.39)
Walking problem	Limited	881 (19.19)
	Unlimited	3711 (80.81)
Visual problem	Limited	1600 (34.84)
	Unlimited	2993 (65.16)
Hearing problem	Limited	635 (13.83)
	Unlimited	3958 (86.17)
Cancer risk factor
Smoking	Never	2536 (55.21)
	Ex-smoker	889 (19.36)
	Current smoker	1168 (25.43)
Alcohol consumption (number of binge drinking sessions per month)5	Non-binge drinker	2781 (60.55)
	Binge drinker	1413 (30.76)
	Frequent binge drinker	399 (8.69)
Psychological factors
Gastric cancer screening6	Participated	1457 (31.72)
	Did not participate	3136 (68.28)
Attitude to health check-up	Not effective7	1730 (15.46)
	Effective	2862 (84.54)
Stress severity	None	845 (18.4)
	Mild	2126 (46.29)
	Moderate	1311 (28.54)
	Severe	311 (6.77)
Depression (self-reported)	No	3788 (82.49)
	Yes	804 (17.51)

¹There are seven metropolitan areas in Korea, the other areas were defined as town or country;

²Defined as “household income/square root of number of persons in household”;

³State of “without spouse” includes never married, divorced, and separation by death;

⁴National health insurance includes regional health insurance and workplace health insurance;

⁵Binge drinking means alcohol consumption of more than 70 g of alcohol per episode for men or 50 g per episode for women in this study. One glass of Soju contains 10 g of alcohol;

⁶Experience or not of EGD (Esophago-Gastro-Duodenoscopy) or UGIS (Upper Gastrointestinal Series) within the previous 2 years;

⁷Includes people with negative thoughts about medical check-ups and those who have not previously undergone a medical check-up.

Table 2 Factors associated with gastric cancer screening¹ by univariate analysis (n = 4593)

		OR (crude)	95% CI
Socio-demographic factor
Age (yr)	40-49	1 (ref)
	50-59	1.07	0.89-1.29
	60-69	0.99	0.80-1.22
	≥ 70	0.61	0.47-0.79
Sex	Male	1 (ref)
	Female	0.95	0.84-1.07
Residence	Metropolis	1 (ref)
	Town or country	1.15	0.96-1.36
Household income	Lowest tertile (≤ 1.00 × 106 kW)	1 (ref)
	Middle tertile (1.00-2.42 × 106 kW)	1.25	1.03-1.53
	Highest tertile (≥ 2.45 × 106 kW)	1.80	1.47-2.20
Education	Uneducated	1 (ref)
	Elementary school	1.83	1.38-2.43
	Middle or high school	1.71	1.31-2.26
	University or higher	2.51	1.84-3.46
Marital status	Without spouse	1 (ref)
	With spouse	1.42	1.20-1.68
NHI vs Medicaid	NHI	1 (ref)
	Medicaid	0.98	0.66-1.45
General health status
Self-reported health status	Healthy	1 (ref)
	Middle	1.07	0.91-1.27
	Unhealthy	1.09	0.92-1.29
Limitation of general activity	Limited	1 (ref)
	Unlimited	1.20	1.00-1.45
Walking problem	Limited	1 (ref)
	Unlimited	1.15	0.96-1.39
Visual problem	Limited	1 (ref)
	Unlimited	1.15	1.00-1.32
Hearing problem	Limited	1 (ref)
	Unlimited	1.16	0.97-1.39
Cancer risk factor
Alcohol consumption	Non-binge drinker	1 (ref)
	Binge drinker	1.03	0.89-1.20
	Frequent binge drinker	0.76	0.59-0.98
Smoking	Never	1 (ref)
	Ex-smoker	1.05	0.88-1.24
	Current smoker	0.80	0.69-0.94
Psychological factor
Attitude to health check-up	No	1 (ref)
	Yes (cancer screening is effective)	5.61	4.66-6.75
Stress severity	None	1 (ref)
	Mild	1.18	0.99-1.41
	Moderate	1.23	1.01-1.49
	Severe	0.95	0.72-1.24
Depression (self-reported)	No	1 (ref)
	Yes	1.03	0.87-1.23

OR: Odds ratio; CI: Confidence interval.

¹Endoscope or Upper Gastrointestinal Series (UGIS) every 2 years.

Table 3 Factors associated with gastric cancer screening¹ by multivariate analysis (n = 4593)

		Multivariate OR	95% CI
Socio-demographic factor
Age (yr)	40-49	1 (ref)
	50-59	1.02	0.83-1.25
	60-69	0.95	0.74-1.23
	≥ 70	0.82	0.59-1.16
Household income	Lowest tertile (≤ 1.00 × 106 kW)	1 (ref)
	Middle tertile (1.00-2.42 × 106 kW)	1.08	0.86-1.36
	Highest tertile (≥ 2.45 × 106 kW)	1.36	1.06-1.73
Education	Uneducated	1 (ref)
	Elementary school	1.66	1.21-2.26
	Middle or high school	1.38	1.01-1.89
	University or higher	1.64	1.13-2.37
Marital status	Without spouse	1 (ref)
	With spouse	1.05	0.87-1.26
General health status
Limitation of general activity	Limited	1 (ref)
	Unlimited	0.95	0.76-1.19
Visual problem	Limited	1 (ref)
	Unlimited	1.03	0.88-1.21
Cancer risk factor
Alcohol consumption	Non-binge drinker	1 (ref)
	Binge drinker	0.93	0.77-1.13
	Frequent binge drinker	0.71	0.53-0.96
Currently smoking	Never	1 (ref)
	Ex-smoker	1.08	0.87-1.33
	Current smoker	0.86	0.70-1.06
Psychological factor
Attitude to health check-up	No	1 (ref)
	Yes (cancer screening is effective)	5.26	4.35-6.35
Stress severity	None	1 (ref)
	Mild	1.06	0.87-1.30
	Moderate	1.20	0.98-1.48
	Severe	1.06	0.80-1.41

¹Endoscope or UGIS every 2 years.