Determinants of Participation in the National Cancer Screening Program Among Older Korean Women: A Cross-Sectional...

Background: The incidence and mortality rates of cancer among females aged 65 years or older in the Republic of Korea are increasing; however, the national cancer screening rate (50.4%) remains low. Therefore, this study aimed to identify predictors of participation in the National Cancer Screening Program (NCSP) among women aged 65 years or older using data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019-2021). Methods: This cross-sectional study utilized data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019-2021). Study variables were selected based on Andersen's healthcare utilization model. Participation in the National Cancer Screening Program (NCSP) was defined as the dependent variable, and independent variables included predisposing, enabling, and need factors. Descriptive analyses were conducted to examine participants' characteristics. Chi-square tests were used to assess differences in NCSP participation according to participant characteristics. Multivariable logistic regression analysis was conducted to identify factors associated with participation, with all independent variables simultaneously included in the model to adjust for potential confounding. A p-value of <0.05 was considered statistically significant. Results: A total of 2105 women aged 65 years or older were included in the analysis. Of the 2105 women aged 65 years or older, 1429 (67.9%) reported participation in cancer screening within the past two years. NCSP participation was significantly associated with being married (OR = 1.540; 95% CI: 1.263-1.879), being a middle school (OR = 1.357; 95% CI: 1.022-1.801) or college graduate or higher (OR = 2.012; 95% CI: 1.199-3.378), having private insurance (OR = 1.930; 95% CI: 1.573-2.368), average subjective health (OR = 1.332; 95% CI: 1.004-1.766), dyslipidemia (OR = 1.347; 95% CI: 1.110-1.636), and physical activity participation (OR = 1.252; 95% CI: 1.029-1.524). In contrast, urban residence, income level, being employed, medical coverage type, hypertension, diabetes, monthly drinking status and current smoking status were not statistically significantly correlated with NCSP participation. Conclusions: These findings highlight the need for tailored outreach strategies and health education programs targeting women aged 65 years and older to enhance participation in the NCSP and ultimately improve public health outcomes.