South Korea is poised to significantly alter its national cancer screening program, with plans to mandate colonoscopies for individuals aged 45 to 74 beginning in . This shift, announced by the Ministry of Health and Welfare, aims to improve early detection rates for colorectal cancer and ultimately boost survival rates, as cancer remains the leading cause of death in the nation.
Currently, colorectal cancer screening in South Korea targets those aged 50 and older. The existing process involves an annual fecal occult blood test, with a colonoscopy recommended only for individuals with positive results. The new policy will bypass the initial fecal test, offering a colonoscopy every ten years to all individuals between 45 and 74, regardless of initial test outcomes. While the exact out-of-pocket costs are still being finalized through the National Health Screening Committee and Health Insurance Policy Deliberation Committee, the government anticipates reducing the financial burden compared to the current system, particularly for those with lower incomes.
The decision to prioritize colonoscopy stems from the relatively low screening rate for colorectal cancer in South Korea, currently at 40.3% – the lowest among the six major cancers screened nationally (lung, cervical, stomach, breast, liver, and colorectal). This contrasts with screening rates of 74.6% for liver cancer, 63.5% for breast cancer, and 60.1% for cervical cancer. Colorectal cancer also carries a significant mortality rate, accounting for 16.1 deaths per 100,000 people in .
Lee Jung-gyu, public health policy director at the Ministry of Health and Welfare, explained that the change aims to make colonoscopies more accessible, particularly for those who might otherwise face higher costs to pursue the test after a positive fecal occult blood test. “It is difficult to feel the policy when receiving a colonoscopy as an in-house benefit at work, but low-income people and others currently only receive a fecal occult blood test and have to pay more as an option to receive a colonoscopy,” he stated.
Alongside the changes to colorectal cancer screening, the government is also planning to expand eligibility for lung cancer screening. The current program focuses on individuals aged 54 to 74 with a smoking history of at least 30 pack-years. The Ministry of Health and Welfare is considering lowering the starting age and relaxing the smoking history requirements, aligning with international best practices. The United States, for example, recently lowered its recommended screening age to 50 and reduced the minimum smoking history to 20 pack-years.
These initiatives are part of the Fifth Comprehensive Cancer Control Plan (–), a national strategy to combat cancer. The overarching goal of the plan is to increase the early diagnosis rate for the six major cancers to 60% by , up from 57.7% in . This focus on early detection is driven by the significant impact it has on survival rates. As of , 52.9% of the six major cancers were detected at the “localized” stage, meaning the cancer had not spread beyond the original organ. For these localized cancers, the five-year relative survival rate is an impressive 92.0%.
The need for expanded screening is underscored by the increasing number of cancer cases in South Korea. The number of new cancer patients has risen steadily from 147,000 in to 252,000 in , and further to 289,000 in . Notably, cancer incidence is increasing at a faster rate among younger adults (aged 20-39, with an annual increase of 4.7%) compared to older adults (aged 65 and older, with an average annual increase of 1.4%).
The Ministry of Health and Welfare emphasizes the importance of early cancer detection, highlighting that identifying cancer at an early, localized stage dramatically improves the chances of successful treatment and long-term survival. The implementation of these expanded screening programs represents a significant investment in public health and a commitment to reducing the burden of cancer in South Korea.
