All-cause mortality, cardiovascular mortality, and incidence of cardiovascular disease according to a screening program of cardiovascular risk in South Korea among young adults: a nationwide cohort study. (January 2021)

• Record Type: Journal Article
• Authors: Yun, J.M.; Choi, S.; Kim, K.; Kim, S.M.; Son, J.S.; Lee, G.; Jeong, S.-M.; Park, S.Y.; Kim, Y.-Y.; Park, S.M.
• Is Part Of: Public health. Volume 190(2021)
• Page Start: 23
• Page End: 29
• Publication Date: 2021-01
• Subjects: Young adults -- Health screening -- Cardiovascular disease -- Mortality; Public health -- Periodicals; Public health -- Periodicals; Electronic journals; 362.1
• DOI: 10.1016/j.puhe.2020.10.023
• Languages: English
• ISSNs: 0033-3506

Abstract

Abstract: Objectives: We aimed to determine whether there are any differences in all-cause and cause-specific mortality with cardiovascular disease (CVD) risk between health screening attenders and non-attenders among young adults. Study design: We performed a retrospective cohort study using claim data from the Korean National Health Insurance Service database. Methods: Individuals aged 20–39 years who had received health screening at least once between 2002 and 2005 were classified as attenders, and the others were classified as non-attenders. After propensity score matching according to attendance of health screening, 2, 060, 409 attenders and 2, 060, 409 non-attenders were included. We estimated adjusted hazard ratios (HRs) and 95% confidence interval (CI) for all-cause mortality, cause-specific mortality, and hospitalization of CVD from 2006 to 2015. Results: Survival from all-cause mortality was greater among attenders than among non-attenders (log rank P < 0.001). Similarly, death from CVD (log rank P = 0.007) and CVD events (log rank P < 0.001) were less likely among attenders. The risk for all-cause mortality in attenders was significantly lower than that in non-attenders (HR = 0.83, 95% CI = 0.81 to 0.84). The risk for CVD mortality (HR = 0.80, 95% CI = 0.73 to 0.87) and hospitalization of CVD (HR = 0.92, 95% CI = 0.91 to 0.94) were lower in attenders. In stratified analyses, the risk for all-cause and cause-specific mortalities was lower among attenders regardless of insurance type. Conclusions: Among young adults, the risk for all-cause mortality, CVD mortality, and hospitalization of CVD were lower for those who underwent health screenings. Future studies that evaluate the cost-effectiveness of health screening with additional consideration of psychosocial aspects are needed. Highlights: Young adults who underwent health screening examinations had lower mortality risk. Health screening was also associated with lower cardiovascular disease risk. This association was preserved regardless of insurance type of household income.