Liver cancer screening in Korea: A report on the 2008 national cancer screening programme

Background: The Korean National Cancer Screening Programme (NCSP) for liver cancer was initiated in 2003. The objective of this study was to evaluate participation in the NCSP and provide essential evidence associated with the screening of Korean adults at high risk for liver cancer. Methods: Liver cancer screening was conducted in two stages. During the first, the fraction of the population at high risk for liver cancer was identified through detection of the hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibodies (anti-HCV Ab). During the second stage, this high-risk population was kept under surveillance to detect liver cancers as quickly as possible, and screening participation rates and recall rates were assessed. We estimated the 95% confidence intervals (CIs) for all outcome measures. Results: In the first stage, 2.57% (95% CI, 2.47-2.67) of Medical Aid Programme (MAP) recipients tested positive for HBsAg and 3.70% (95% CI, 3.25-4.15) tested positive for anti-HCV Ab. The total target population for liver cancer screening in 2008 included 433,822 adults over 40 years of age. Of them, 141,381 (32.6%) participated in the NCSP for liver cancer. Participation rates were 34.9% for National Health Insurance (NHI) recipients and 25.2% for MAP recipients. Among participants, 1,139 individuals exhibited a positive screening result (recall rate = 0.81%). Conclusions: Our findings demonstrate the current status of liver cancer screening in Korea. They provide evidence for implementing an organised liver cancer screening programme among high-risk groups.