Journal of Preventive Medicine and Public Health

Special Articles

Current Status of the National Cancer Screening Program in Korea: History, Achievements, and Future Directions: Kyeongmin Lee, Mina Suh, Kui Son Choi; J Prev Med Public Health. 2025;58(4):337-347. Published online June 21, 2025; DOI: https://doi.org/10.3961/jpmph.25.268

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Abstract Summary PDF Supplementary Material

Cancer is the leading cause of morbidity and mortality worldwide. To reduce this burden, the Korean government established the National Cancer Screening Program (NCSP) in 1999, initially offering stomach, breast, and cervical cancer screening to Medical Aid Program (MAP) beneficiaries. By 2019, the NCSP had broadened both its eligible population and the range of cancers screened—stomach, liver, cervical, breast, colorectal, and lung—for both MAP recipients and health insurance beneficiaries. Since its inception, participation and adherence to recommended screening have risen steadily, driven by nationwide policy initiatives and expanded access. Over the past 2 decades, the NCSP has played a key role in reducing the incidence of stomach, liver, colorectal, and cervical cancers while increasing detection at precancerous stages, especially for cervical and colorectal cancers. Five-year relative survival rates for major cancers—most notably stomach, colorectal, and breast—have also improved substantially. Accumulated evidence, including cancer detection rates, stage distribution at diagnosis, and mortality reduction, underscores the program’s effectiveness in facilitating early detection and reducing cancer-specific deaths. Notably, Korea’s mortality-to-incidence ratio for major cancers remains well below the Organization for Economic Cooperation and Development average, illustrating the impact of the nation’s comprehensive cancer control strategies. Continued research, surveillance, and refinement of evidence-based screening guidelines will be critical to further enhancing the efficiency and effectiveness of the NCSP.

Summary

Korean summary
한국의 국가암검진 사업은 도입 이후 지난 20여 년간 암 발생률과 사망률 감소에 크게 기여해왔다. 본 연구에서는 한국의 국가암검진 프로그램의 도입 이후 발전과정을 살펴보고, 암 질병부담 감소에 기여한 주요성과들을 고찰하였다. 또한, 국가암검진의 효과성을 높이기 위해 근거에 기반한 암검진 권고안 개정의 필요성을 논의하고, 향후 국가암검진 사업의 지속적인 성과 향상을 위한 발전방안을 제시하였다.

Key Message
Since its inception, Korea’s National Cancer Screening Program (NCSP) has played a critical role in reducing cancer incidence and mortality over the past two decades. This study presents a comprehensive review of the NCSP’s development and its key contributions to alleviating the national cancer burden. In addition, it emphasizes the necessity of updating cancer screening guidelines in accordance with the latest scientific evidence and outlines strategic directions to further strengthen the program’s effectiveness and long-term outcomes.

Citations

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Inequalities in breast cancer incidence and mortality in women with and without disabilities in South Korea: A population-based cohort study
Hee-Yeon Kang, Eunjung Park, Thi Tra Bui, Byungmi Kim, Jin-Kyoung Oh
Preventive Medicine Reports.2025; 59: 103242. CrossRef
Enhancing cancer risk awareness and screening management through artificial intelligence: a narrative review
Jiaxuan Wu, Xiaolong Tang, Qian Zheng, Xinhang Gu, Li Ma, Jinghong Xian, Hui Mao, Jiadi Gan, Guiyi Ji
Frontiers in Oncology.2025;[Epub] CrossRef
Practice of Cytopathology in Korea: A 40‐Year Evolution Through Standardization, Digital Transformation, and Global Partnership
Yosep Chong, Ran Hong, Hyeong Ju Kwon, Haeryoung Kim, Lucia Kim, Soon Jae Kim, Yoon Jung Choi
Diagnostic Cytopathology.2025;[Epub] CrossRef
Temporal trends and future projections of six major cancers among women of childbearing age in northeast Asia: analysis of data from the global burden of disease study 2021
Jingqian Liang, Baogeng Huai, Zeping Yang, Shan Zhang, Haoliang Cui, Jianyi Zhang, Deshan Liu
Frontiers in Oncology.2025;[Epub] CrossRef

Primary Care Physicians’ Action Plans for Responding to Results of Screening Tests Based on the Concept of Quaternary Prevention: Jong-Myon Bae, Marc Jamoulle; J Prev Med Public Health. 2016;49(6):343-348. Published online October 13, 2016; DOI: https://doi.org/10.3961/jpmph.16.059

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Abstract PDF

Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.

Summary

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Awareness of quaternary prevention and defensive attitudes among family physicians
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Quaternary prevention: reviewing the concept
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European Journal of General Practice.2018; 24(1): 106. CrossRef
Ethical, pedagogical, socio-political and anthropological implications of quaternary prevention
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Original Articles

Rates of Change to a Positive Result in Subsequent Screening Mammography in Korean Women: A Retrospective Observational Study: Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nam Kim, Chung Mo Nam; J Prev Med Public Health. 2015;48(1):48-52. Published online December 26, 2014; DOI: https://doi.org/10.3961/jpmph.14.042

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Abstract PDF: Objectives
This retrospective cohort study aimed at calculating some parameters of changes in the findings of the subsequent screening mammography (SSM) in female Korean volunteers.
Methods
The study included screenees aged 30 to 79 years who underwent SSM voluntarily after testing negative in the baseline screenings performed between January 2007 and December 2011. A change to a positive result was defined as category 4 or 5 by using the American College of Radiology Breast Imaging Reporting and Data System. The proportion of results that had changed to positive (CP, %) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of study participants. The rate of results that had changed to positive (CR, cases per 100 000 screenee-months) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of months of the follow-up period.
Results
The overall CP and CR in all age groups (n=77 908) were 2.26% and 93.94 cases per 100 000 screenee-months, respectively. The median CP interval in the subjects who had positive SSM results was 30 to 36 months, while that in the age group of 30 to 39 years was shorter.
Conclusions
Different screening intervals should be considered among women aged between 30 and 59 years. In addition, a strategy for a screening program should be developed for the age group of 30 to 39 years, in particular.; Summary

Mean Sojourn Time of Preclinical Gastric Cancer in Korean Men: A Retrospective Observational Study: Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim; J Prev Med Public Health. 2014;47(4):201-205. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.201

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105 Download
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Abstract PDF

Objectives
This retrospective cohort study aimed to estimate the mean sojourn time (MST) of preclinical gastric cancer in Korean men.
Methods
The subjects consisted of voluntary male screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative at a baseline screening performed between January 2007 and December 2011. A new case was defined if gastric cancer cells were present in the biopsy specimens obtained from gastroscopy. The follow-up period was calculated as the number of person-years between the date of baseline screening gastroscopy and positive findings at a subsequent screening. The MST was calculated using transition rates of gastric cancer to determine the best screening interval.
Results
Of the 171 979 voluntary male screenees, 61 688 (36%) underwent subsequent screening gastroscopies between January 2007 and December 2011. A total of 91 incident cases were found during 19 598 598 person-years of follow-up. The MST of gastric cancer was 2.37 years (95% confidence intervals, 1.92 to 2.96), and those aged 40 to 49 years had a shorter MST than those 50 to 69 years did.
Conclusions
These findings support the 2-year interval of screening recommended by the nationwide gastric cancer screening program in Korea. Further studies for the age-specific MST among women are needed.

Summary

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