국가암조기검진 사업의 유방암 검진 수검과 유방암 발생의 관련성

Abstract

Aims : The incidence of breast cancer in Korea is rapidly increasing. The increased cancer incidences is typically interpreted as a rise in the true occurrence of disease but may also reflect changing pathological criteria or increased diagnostic activity. Randomized controlled trials have shown that the policy of mammographic screening contributes to a substantial and significant reduction in breast cancer mortality. We assessed the participation rate of the National Cancer Screening Program (NCSP), which was initiated in 1999 so as to decrease death rates from cancer by early detection and treatment, and analyzed data to find the effect of breast cancer screening on cancer incidence. Methods : We collected data from target population of NCSP in 2002-2005 and accessed participation in cancer screening. The women were classified into a screening group who participated in breast cancer screening or a nonscreening group without such experience. The outcome was expressed as the incidence rate of breast cancer. The incidence of breast cancer in follow-up period was identified using Korea Central Cancer Registry Database. The follow-up period was 1 year from their screening in the first group and the year when they had a screening invitation in the second group. Age standardized rate (ASR), standardized incidence ratio (SIR) and standardized rate ratio (SRR) were calculated for comparing the effect of breast screening on cancer incidence. Results : Yearly age standardized participation rates gradually increased (13.7%, 17.1%, 18.0% and 24.4% in 2002-2005) while the incidence rates of breast steadily increased from 2002 to 2005. The cancer incidence rates of breast were significantly high in our study population compared with those of Korea's total population. The rate ratio for incidence of breast cancer in the screening group was significantly high, compared to that of the nonscreening group in 2002-2005. Conclusions : The incidence rates of breast cancer were significantly high in screening group compared with nonscreening group. The increase of breast cancer incidence in Korea could be explained with the combination of screening effect and increased risk factors for breast cancer.