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Objective: This study aimed to analyze the trends in cervical cancer screening rates, including organized and opportunistic cancer screening rates, with the Papanicolaou test among Korean women. Methods: Data were collected from a nationwide, cross-sectional, Korean National Cancer Screening Survey. To evaluate the cervical cancer screening rates, we used the screening approach of " cervical cancer screening rate with recommendation," defined as the proportion of women who underwent the Papanicolaou test during the previous 2 years according to the Protocol of National Cancer Screening Program for Cervical Cancer in Korea. The joinpoint regression analysis, which describes the annual percent change (APC), was performed to detect significant changes in cervical cancer screening rates in women aged 30-74 years during 2005-2020. Results: The cervical cancer screening rate was 56.0% in 2020. From 2005 to 2013, there was a rising trend in cervical cancer screening rates (APC=2.70%, 95% confidence interval [CI]:1.05 to 4.38), followed by a falling trend (APC=-2.67%, 95% CI:-4.3 to -1.01). The falling trend was significantly associated with age (≥40 years), education level (below the 15 th grade), household income (below the middle-income level), and residence (all residential areas). Conclusion: The recent falling trend was more common in women with a low socioeconomic status, which suggests that there is a socioeconomic gap in cervical cancer screening. Moreover, young women in their thirties had a low screening rate. Therefore, an active participation strategy for women vulnerable to cervical cancer is required. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine the differences in stage at diagnosis of cervical cancer among Korean women according to screening history. Methods: Using linkage data from the Korean Central Cancer Registry and Korean National Cancer Screening Program (KNCSP), we included 18,388 women older than 30 years who were newly diagnosed with cervical cancer between 2013 and 2014 and examined their screening history. Between individuals, age group and socioeconomic status were matched to control for potential confounders. Results: Significantly more cases of carcinoma in situ (CIS) were diagnosed in the everscreened (71.77%) group than in the never-screened group (54.78%), while localized, regional, distant, and unknown stage were more frequent in the never-screened group. Women in the ever-screened group were most likely to be diagnosed with CIS than with invasive cervical cancer (adjusted odds ratio [aOR]=2.40; 95% confidence interval [CI]=2.18-2.65). The aOR for being diagnosed with CIS was highest among women who were screened 3 times or more (aOR=5.10; 95% CI=4.03-6.45). The ORs were highest for women screened within 24 months of diagnosis and tended to decrease with an increasing time since last screening (p-trend <0.01). Conclusion: The KNCSP for cervical cancer was found to be positively associated with diagnosis of cervical cancers at earlier stages among women aged 30 years or older. The benefit of screening according to time was highest for women screened within 24 months of diagnosis. [ABSTRACT FROM AUTHOR]

Objective: This study sought to examine changes in trends for quality indicators of the population-based Korean National Cancer Screening Program (KNCSP) for cervical cancer from years 2005 to 2013. Methods: Our study data were derived from the KNCSP database. Cervical cancer diagnosis information was ascertained through linkage with the Korean National Cancer Registry and the KNCSP database. Performance measures for cervical cancer screening were estimated, including participation rate, positive rate, crude detection rate (CDR), interval cancer rate (ICR), positive predictive value (PPV), sensitivity, and specificity. Joinpoint analysis was applied to calculate annual percentage changes (APCs) in all indicators according to sociodemographic factors. Results: A significant increasing trend was noted in participation rates (APC=13.4%; 95% confidence interval [CI]=10.5, 16.4). PPV and specificity increased from years 2005 to 2009 and remained stable till 2013. An increasing trend was discovered in CDRs for cervical cancer in situ (APC=3.9%; 95% CI=1.0, 6.9), whereas a decreasing trend was observed in ICRs for invasive cervical cancer (APC=-2.5%; 95% CI=-4.5, -0.5). Medical Aid recipients and women older than 70 years showed the lowest participation rates, but higher CDRs and ICRs, compared to other groups. In general, most of the quality indicators for cervical cancer screening improved from 2005 to 2009 and remained stable to 2013. Conclusion: The KNCSP for cervical cancer in Korea has improved in terms of participation rate and accuracy of the screening test. These results may be attributed to the National Quality Improvement Program for KNCSP. [ABSTRACT FROM AUTHOR]

The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass-screening program. Furthermore, a new method has been introduced in cervical cancer screening. Therefore, the committee for cervical cancer screening in Korea updated the recommendation statement established in 2002. The new version of the guideline was developed by the committee using evidence-based methods. The committee reviewed the evidence for the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing, and reached conclusions after deliberation. The committee recommends screening for cervical cancer with cytology (Papanicolaou test or liquid-based cytology) every three years in women older than 20 years of age (recommendation A). The cervical cytology combined with HPV test is optionally recommended after taking into consideration individual risk or preference (recommendation C). The current evidence for primary HPV screening is insufficient to assess the benefits and harms of cervical cancer screening (recommendation I). Cervical cancer screening can be terminated at the age of 74 years if more than three consecutive negative cytology reports have been confirmed within 10 years (recommendation D). [ABSTRACT FROM AUTHOR]