National Health Screening Committee: "Low Cost-Effectiveness"
Temporary Support for High-Risk Occupational Groups Aged 20 to 49 Only
Until now, chest radiography (X-ray) exams have been uniformly administered as part of the national health screening program, but going forward, the eligible population will be limited to those aged 50 and older, who have a higher incidence rate.
The Ministry of Health and Welfare announced on the 31st that it held the "3rd National Health Screening Committee of 2025" and deliberated and approved the "Improvement Plan for Chest Radiography in National Health Screenings" containing these changes.
Chest radiography exams have mainly been conducted to detect pulmonary tuberculosis; however, the actual prevalence rate of pulmonary tuberculosis has remained at just 0.04%.
According to the Ministry of Health and Welfare, as of 2023, the detection rate of pulmonary tuberculosis through chest radiography exams was only 0.03%, while the annual cost of these exams reached 142.6 billion won. This accounts for about 21% of the total national health screening costs. In addition, the inefficiency of duplicate testing has been continuously pointed out, as approximately 9 million people undergo chest X-rays annually through general medical care outside of screenings.
Under the revised plan, starting in 2027, regular chest radiography exams will be administered only to those aged 50 and above. However, to minimize gaps in tuberculosis control, individuals aged 20 to 49 who are in high-risk occupational groups for infection will be temporarily included as eligible for screening. The eligible groups include 70 occupations as defined by the Korean Standard Classification of Occupations, such as healthcare workers and other legally mandated tuberculosis screening professions, employees at workplaces vulnerable to infectious diseases, and those handling hazardous respiratory agents.
The Ministry of Health and Welfare plans to implement the new criteria starting in 2027 after a one-year preparation period, which will include legal and institutional reviews for selecting high-risk occupational groups, building a database of eligible individuals, system upgrades, and revisions to the health screening standards.
Additionally, beginning with this reform of chest radiography exams, the government will comprehensively review changes in disease patterns, medical and scientific evidence, and exam effectiveness. Existing screening items with low effectiveness will be revised, and items that need to be newly introduced will be included after a pilot period, thereby systematically restructuring the national health screening system based on evidence.
Second Vice Minister Lee Hyunghoon stated, "This committee's deliberation is significant as it is the first time that national health screening items have been revised based on cost-effectiveness," adding, "We will continue to periodically review the validity of screening items to establish a more effective screening system for public health management."
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