Socioeconomic latent classes and cancer screening participation in Koreans aged 40 years and older: A latent class analysis based on the 2025 Community Health Survey

Objectives: To identify multidimensional socioeconomic latent classes and their associations with cancer screening participation among Korean adults. Methods: Data from 181,457 adults aged ≥ 40 years were extracted from the 2025 Community Health Survey. Using income, education, occupation, and residential area, a latent class analysis reflecting the survey design’s complexity was conducted. Hierarchical logistic regression was performed, calculating estimated adjusted odds ratios (aOR) and 95% confidence interval (CI) for screening across classes. The primary estimate was adjusted for predisposing factors (age, sex, and residential status with spouse). Results: Six classes were identified, as follows: socially advantaged, economically vulnerable, manual/sales-service labor, highly educated and economically inactive, agricultural, and rural vulnerable. The five non-advantaged classes (vs. socially advantaged) showed lower odds for screening. The economically vulnerable (aOR 0.42, 95% CI 0.39–0.44) and rural vulnerable (aOR 0.49, 95% CI 0.46–0.52) classes showed the lowest likelihood. Despite sharing rural residence with the rural vulnerable class, the agricultural class (aOR 0.65, 95% CI 0.61–0.69) resembled the intermediate classes. A linear gradient was not observed for the disparity, varying by how disadvantages combined. Conclusion: The economically vulnerable and rural vulnerable classes showed the lowest screening likelihood. Tailored interventions tackling co-occurring vulnerabilities are needed.