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Original Article
- The delayed cancer treatment and economic inequality in Korea: results of common cancers by the time-to-surgery
- Noorhee Son, Woo-Ri Lee, Dong-Woo Choi, Kyu-Tae Han
- Epidemiol Health. 2025;47:e2025056. Published online September 27, 2025
- DOI: https://doi.org/10.4178/epih.e2025056
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AbstractOBJECTIVES
Growing concerns regarding the concentration of cancer treatment in the capital city in Korea have raised questions about equitable access to timely and optimal patient care. In this study, we evaluated the impact of time-to-surgery (TTS) on healthcare utilization and outcomes, with the goal of providing policy recommendations for effective quality assessment of cancer care.METHODSThis retrospective cohort study analyzed data from 2011 to 2021 obtained from National Health Insurance Service claims. A generalized estimating equation and a Cox proportional hazards model were applied to assess the effects of TTS on length of stay (LOS), medical costs, and 5-year mortality among patients diagnosed with lung, liver, and colorectal cancers. Subgroup analyses were conducted based on patients’ baseline economic status.RESULTSAmong patients who underwent surgical treatment for lung, liver, or colorectal cancer, 20.4%, 11.4%, and 11.4% experienced treatment delays, respectively. Regardless of cancer type, longer TTS was associated with prolonged LOS and higher medical costs. Moreover, patients with extended TTS demonstrated an increased risk of 5-year mortality. Disparities by income level were evident, with greater differences observed in the lower-income group.CONCLUSIONSThis study highlights the importance of timely surgical treatment for patients with cancer, particularly in relation to income-based disparities. These findings emphasize the need to improve Korea’s concentrated cancer care delivery system to enhance healthcare efficiency and address health literacy gaps affecting treatment by income level. -
SummaryKorean summary
- 수술 환자의 약 10%~20%에서 치료 지연이 발생했다. - 수술까지 대기시간이 길수록 재원일수가 늘고, 의료비용이 증가하며, 5년 사망위험이 높았다. - 소득수준에 따른 격차가 확인되었고, 저소득층에서 불리한 영향이 더 크게 나타났다.Key Message
- Among surgical patients, approximately 10–20% experienced treatment delays. - Longer time-to-surgery (TTS) was linked to prolonged length of stay (LOS), higher medical costs, and an increased 5-year mortality risk. - Income-level disparities were evident, with more pronounced adverse differences in lower-income groups.
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