Differences in breast cancer incidence between women with and without disabilities in South Korea

BACKGROUNDS: Breast Cancer (BRC) is a leading cause of morbidity and mortality in women. BRC incidence has steadily increased in South Korea. Women with disabilities encounter multiple challenges in accessing cancer prevention and diagnosis. This study aims to estimate the incidence of BRC among women with and without disabilities in South Korea. METHODS: We analyzed 2.87 million women aged ≥30 years in 2002 who participated in the National Health Screening Program in 2002-2003 retrieved from the National Health Insurance Database (NHID). Disabilities were identified by the disability registration data in the NHID from 2002-2019. BRC incidence was determined by the National Cancer Registry in 2003-2019; for women with disabilities, BRC diagnosed after registering disability were included. Age-standardized incidence rates (ASRs) and ratios (SIRs) compared to incidence in the general population were estimated for those with and without disabilities. RESULTS: During the follow-up period (2003-2019), incident cases were 2,605 (0.9%) and 46,267 (1.8%) among 296,689 women with- and 2,576,182 without disabilities, respectively. Women without disabilities had a 1.65 times higher risk of BRC than those with disabilities. The BRC risk in women with disabilities (SIR = 0.59, 95% CI 0.57-0.62; ASR = 58.2 per 100,000) was lower than the general population. However, women without disabilities (SIR = 0.98, 0.97-0.99; ASR = 96.0 per 100,000) were similar to the general population. Women with disabilities were less likely to undergo BRC screening (RR = 0.92, 0.92-0.92) and more likely to have advanced stages than women without disabilities. Even though the incidence was higher among women without disabilities, BRC mortality was similar between the two groups. CONCLUSIONS: Women with disabilities had a lower BRC incidence but a similar mortality rate to those without disabilities. Lesser accessibility to healthcare services in women with disabilities may partly explain the lower incidence rate. KEY MESSAGES: • Women with disabilities had a lower incidence but a similar mortality rate of BRC compared to women without disabilities. • Women with disabilities were less likely to undergo BRC screening and more likely to have advanced stages than those without disabilities.