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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1507691
This article is part of the Research Topic The Impact of Primary Care on Cancer Screening Program Performance: Strategies to Increase Uptake and Effectiveness View all 7 articles
Regional population decline and health screening uptake in Korean adults: Nationwide study using multilevel regression analysis
Provisionally accepted- National Cancer Center, Goyang-si, Republic of Korea
Health screening is crucial for detecting medical needs and presenting effective alternatives. As Korea undergoes rapid demographic shifts and widening regional gaps, screening is increasingly important to identify these needs. This study explores how changes in regional population size related to health screening uptake among Korean adults. Data on 182,437 adults from the 2021 Korean Community Health Survey (KCHS) were used, with health screening divided into cancer and general medical screening. Regional population size, aging index and financial independence ratio from 2012-2022 KOSIS were linked to our data. Generalized linear mixed effects models were applied for hierarchical logistic regression analysis of the association between the regional population size and screening, controlling for regional- and individual-level variables. Decrease in regional population size were significantly associated with lower odds ratio (OR) of receiving health screening; OR 0.85 (95% CI 0.83—0.88), as well as cancer screening; OR 0.87 (95% CI 0.85—0.90). Similar results were observed in regions with stable in population size. Our study findings indicate the significant associations between regional population size decline and screening. Population-based policies should consider regional attributes to ensure equitable access to screening services.
Keywords: Regional population change, health screening, cancer screening, medical accessibility, Regional disparity
Received: 08 Oct 2024; Accepted: 01 Apr 2025.
Copyright: © 2025 Jeong, Kim and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Kyu-Tae Han, National Cancer Center, Goyang-si, Republic of Korea
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