Cervical cancer is the fourth most common malignant disease of women worldwide and the most common female genital malignancy in Korean women [1,2]. Because pre-invasive lesions caused by human papillomavirus infection progress into invasive cancers, cervical cancer could be screened and cured in early lesions by regular cervical cytology. Whereas the incidence of cervical cancer has decreased in many advanced countries with widespread use of routine cervical cytology for pre-invasive lesions, it is still reported in high incidence in many underdeveloped countries like Africa, Latin America, and southeastern Asia [3]. In Korea, national cancer screening program for 5 common cancers (stomach, colon, liver, breast and cervix) has been launched in 1999. Of them, cervical cancer is screened with cervical cytology every 2 years.

Thus, this work aimed to evaluate the effect of screening rates on the incidence of cervical cancer in Korean women. In addition, the difference of screening rates was evaluated according to geographic areas and age group.

The Korea Central Cancer Registry (KCCR) was set up in 1980 and has collected data for cancer incidence and mortality rate, etc. And the national health insurance service (NHIS) has reported data associated with screening for 5 common cancers [4]. The statistical portal system via the Statistics Korea and NHIS website is open to public research and available for cancer statistics [5,6]. The data for cancer incidence and screening rates were available from 1999 and 2010, respectively.

Thus, this work reports the change of screening rates, the difference of screening rates based on geographic area and age group, and the change of cervical cancer incidence from 2010 to 2015 annually.

The annual number of target population for cervical cancer screening has been steadily increasing from 6,422,573 in 2010 to 7,570,934 in 2015. And screening rate also showed similar trend from 40.3% in 2010 to 54.2% in 2015 (Table 1). During this period, the annual number of cervical cancer cases has been steadily declining from 3,977 in 2010 to 3,500 in 2015 (Figure 1).

Table 1: Annual screening rate from 2010 to 2015.

Figure 1: Total cases of cervical cancer from 2010 to 2014.

And age-standardized incidence rate (ASR) also decreased from 12.6 per 100,000 women in 2010 to 10.7 per 100,000 women in 2015 (Figure 2). The screening rate increased in all age groups from 2010 to 2015. In 2015, the screening rate was relatively higher ranged from 59% to 63% in 40~69 years groups, but it was lower in 30~39 (49%) and 70~79 (43%) years groups, especially 12% in ≥ 80 years group (Table 2). And the screening rate in Seoul metropolitan area was higher than that in provincial areas (Table 3).

Table 2: Annual screening rate according to age groups from 2010 to 2015.

Table 3: Annual screening rate according to geographic areas from 2010 to 2015.

Figure 2: Age-standardized incidence rate of cervical cancer from 2010 to 2014.

The screening rate for cervical cancer has been steadily increasing from 2010 to 2015. During this period, the ASR as well as annual number of cervical cancer cases has been decreasing steadily. Thus, improved participation rate in national cancer screening program could contribute to the decrease of cervical cancer incidence. However, it is worthy of notice that screening rate in Korean women was significantly lower than that of more than 70% in UK and USA [7,8]. Thus, continuous efforts to improve the screening rate would be an important issue in controlling cervical cancer incidence in Korean women. Another important issue is whether the screening rate would be different according to age groups and geographic areas that reflect health care accessibility and socio-economic status. The screening rate in relatively young (≤ 39 years) and old (≥ 70 years) aged women was lower than that of middle (40~69 years) aged group.

And the screening rate in Seoul metropolitan area was higher than that in provincial areas. These results support previous reports that social infrastructures like health care accessibility, socioeconomic status and education levels could affect the attitude and participation for cancer screening and be important factors in cancer-related health unfairness [9,10]. In summary, the incidence of cervical cancer has been decreasing steadily with the increased screening rate for cervical cancer leading to early detection and proper management of preinvasive lesions of the cervix. However, the screening rate for cervical cancer still varies by geographic area and age group reflecting the importance of social and personal factors including health care accessibility, socioeconomic status and education levels. Thus, improved delivery system for cancer screening should be developed under the control of national cancer screening program.