Cancer Screening Disparities Persist Despite Advances in Treatment

Despite significant improvements in cancer treatment and overall survival rates, access to crucial cancer screenings remains uneven, particularly for vulnerable populations. Whereas cancer incidence has risen sharply in recent decades, Korea boasts world-leading survival rates, highlighting the importance of early detection. However, disparities in screening participation threaten to undermine these gains.

Rising Cancer Incidence and Improved Survival Rates

According to the National Cancer Center, the number of new cancer cases in 2023 reached 288,613, a 2.8-fold increase compared to 1999 (101,854 cases). This increase is largely attributed to the country’s aging population, with those aged 65 or older now comprising 20.6% of the population in 2025, up from 6.6% in 1999. The lifetime probability of developing cancer is now 44.6% for men and 38.2% for women – roughly 1 in 2 and 1 in 3, respectively.

Fortunately, diagnostic and treatment capabilities have advanced considerably. The 5-year relative survival rate for all cancers in Korea is 69.9% (based on data from 2019-2023), meaning that 7 out of 10 cancer patients survive for more than 5 years. Specific cancer types have seen even greater improvements: stomach cancer (78.6%), colon cancer (75.6%), and breast cancer (94.7%). Early detection is critical, with a 5-year relative survival rate of 92.0% for cancers diagnosed in the localized stage.

Korea’s cancer treatment outcomes are internationally recognized. Based on 2022 data from the International Agency for Research on Cancer (IARC), Korea ranks first among 185 countries in the Mortality/Incidence (M/I) ratio for stomach, colon, and breast cancers, demonstrating lower death rates relative to incidence compared to other developed nations (0.21 for stomach cancer, 0.22 for colon cancer, and 0.08 for breast cancer).

Screening Rates Lag for Vulnerable Groups

Despite the overall success of Korea’s cancer control efforts, significant disparities exist in screening rates. While 59.8% of health insurance subscribers participate in national cancer screening programs, participation among individuals with disabilities is lower, at 46.1%. The rate is even lower for those receiving medical benefits (a vulnerable group), at only 28.9%, meaning that 7 out of 10 individuals in this group do not receive recommended screenings.

Kim Jun-hyeon, director of the Health Policy Participation Research Institute, notes that these disparities result in a gap of up to 30 percentage points in screening rates between different groups, and that those at higher risk and with greater health vulnerabilities have fewer opportunities for early diagnosis.

Government Initiatives to Improve Access

The Ministry of Health and Welfare has identified increasing screening rates among vulnerable groups as a key priority, outlined in the 5th Comprehensive Cancer Control Plan (2026-2030). Planned initiatives include strengthening publicity efforts, such as notifying medical benefit recipients about missed screenings, and improving accessibility for vulnerable populations, including individuals with disabilities.

System improvements are similarly underway, including lowering the age for colon cancer screening from 50 to 45 and transitioning from fecal occult blood testing to endoscopy. Expansion of lung cancer screening targets and the establishment of a post-screening follow-up management system are also planned.

Addressing Structural Barriers is Crucial

Experts emphasize that simply increasing publicity is insufficient to address the screening disparities. More comprehensive solutions are needed to overcome the complex barriers faced by vulnerable groups, including challenges related to mobility, financial burdens, and health literacy.

For example, women with disabilities experience a high incidence of breast cancer, but screening rates are low due to difficulties assuming imaging postures and the require to cover costs for additional ultrasound examinations. Lack of accessible transportation, the absence of disability-friendly hospital environments, and limited support for accompanying individuals also contribute to these disparities. Many individuals in vulnerable groups live in single-person households and may lack access to sign language interpreters or understanding from healthcare providers.

Kim Joon-hyeon emphasizes that many medical benefit recipients are elderly, live alone, and have low incomes, raising concerns about potential additional costs associated with screening or treatment. He also suggests that current promotional methods, often relying on text-based guidance, may not be effective for elderly or vulnerable populations.

Officials from the Ministry of Health and Welfare acknowledge the need for targeted promotional strategies for low-income individuals, recognizing that barriers often stem from individual circumstances rather than a lack of awareness about the screening system.

Cho Yun-hwa, head of the policy research team at the Korea Institute for the Development of Persons with Disabilities, stresses that simply strengthening publicity will not be enough. Meaningful improvements require disability-friendly hospital environments and practical accessibility enhancements, such as transportation and accompanying support.

Recent Legislative Efforts

In the U.S., legislation aimed at increasing access to breast and cervical cancer screening was recently introduced in the Senate. The Screening for Communities to Receive Early and Equitable Needed Services (SCREENS) for Cancer Act would reauthorize the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) through 2030. Senators Tammy Baldwin and Susan Collins reintroduced this bipartisan bill, highlighting the importance of providing screening and diagnostic services to low-income, uninsured, and underinsured women.