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Supplementary Table 1. National Cancer Screening Program in Korea (as of 2015)

Cancer Target population Frequency Test or procedure Co-

payment (USD) Stomach 40 and over (adults) Every 2 years Endoscopy or

Upper Gastrointestinal Series 7 Liver 40 and over

(High-risk group*) Every 6 months Ultrasonography and alpha- fetoprotein

Colorectal 50 and over (adults) Every 1 year Fecal Occult Blood Test§ 0.5 Breast 40 and over

(women) Every 2 years Mammography and

Clinical breast exam 3.5

Cervix 30 and over

(women) Every 2 years Pap smear 0

Co-payment is applied only for those with higher income (upper 50%) and accounted for 20% of total price. No co-payment is applicable to low-income individuals (lower 50%). There is no co-payment for cervical cancer screening regardless of income level.

*Patients at high risk for liver cancer include those with chronic hepatitis determined by serological evidence of infection with hepatitis B or C virus or liver cirrhosis.

Colorectal screening was provided every 2 years until 2011and every year since 2012.

§Colonoscopy or barium enema follows if fecal occult blood test is positive.

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Supplementary Table 2. Age- and sex-adjusted liver cancer surveillance rates based on presence, severity, and type of disability over a 10-year period

Year

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Age- and sex-adjusted proportion

People without

disabilities 24.9 30.7 31.9 40.2 45.5 46.0 41.6 45.8 52.2 54.5

People with disabilities 25.7 30.6 33.6 40.3 45.2 43.9 40.4 43.2 48.9 49.6

By Disability Grade

Severe (Grade 1-3) 20.8 26.2 28.4 35.4 39.3 38.9 35.9 38.5 43.9 44.1 Mild (Grade 4-6) 27.7 32.3 35.5 42.1 47.2 46.8 42.0 45.7 51.9 52.9 Grade 1 (Most Severe) 15.4 18.9 19.6 27.0 29.4 34.5 28.5 35.0 39.5 38.6

Grade 2 17.9 23.1 24.3 31.8 34.2 35.6 30.2 35.1 40.8 40.9

Grade 3 24.2 30.3 33.4 40.0 45.5 42.7 41.8 42.3 47.6 48.2

Grade 4 28.1 32.4 35.9 41.2 47.8 46.0 42.9 45.2 50.0 52.4

Grade 5 26.4 30.1 34.0 39.8 44.1 44.2 39.2 43.4 49.6 49.8

Grade 6 (Least Severe) 28.7 34.1 36.5 44.7 50.2 49.7 44.2 48.2 54.8 56.0

By Disability Type

Physical disability 28.0 33.0 36.5 43.7 49.1 47.7 43.8 46.7 53.0 54.4

Visual disability 27.2 33.0 35.1 43.2 47.6 46.6 42.9 45.9 51.8 53.3

Hearing disability 28.2 32.0 34.6 42.4 47.4 45.2 43.1 45.8 50.6 51.8 Speech and language

disability 32.3 30.6 31.0 33.6 38.7 35.1 36.7 43.9 48.4 48.4

Intellectual disability 20.3 23.4 23.5 34.1 29.1 35.7 31.3 34.5 43.6 40.0 Disability due to brain

injury 19.1 25.5 26.5 30.1 39.5 38.2 31.4 35.3 40.4 41.7

Disability due to autism - - - 18.4 18.4 0.0 0.0 0.0 23.7 18.3

Disability due to mental

disorder 18.3 26.1 28.4 37.3 39.5 39.9 35.4 39.5 44.6 42.9

Disability due to renal

failure 8.7 11.6 13.1 20.8 25.1 23.4 20.5 26.1 31.4 32.7

Disability due to heart

problems 23.4 26.2 26.7 31.9 47.0 43.0 45.7 39.3 39.0 46.7

Disability due to

respiratory problems 25.6 31.9 26.5 28.9 32.6 36.7 36.4 33.7 44.2 43.2 Disability due to liver

disease 7.6 7.4 12.1 15.2 19.3 21.4 20.1 28.6 30.4 30.9

Disability due to facial

disfigurement 18.1 35.9 49.6 28.0 47.2 38.5 56.2 52.9 47.1 56.6

Disability due to ostomy 13.9 16.1 20.5 13.0 31.9 26.1 27.1 35.2 37.8 37.7 Epilepsy disability 29.8 30.1 34.2 37.5 41.9 43.1 33.1 42.3 47.9 53.9

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Supplementary Table 3. Specialty physicians who can issue medical certificates for disability diagnosis by area

  Specialist who can provide disability diagnosis

(should be board-certified in relevant areas)

Physical disability Rehabilitation medicine physician, Orthopedic surgeon, Neurosurgeon, Neurologist, Rheumatologist

Visual disability Ophthalmologist

Hearing disability Otorhinolaryngologist

Speech and language disability Otorhinolaryngologist, Psychiatrist, Neurologist, Maxillofacial surgeon

Intellectual disability Psychiatrist, Neurologist, Rehabilitation medicine physician Disability due to brain injury Rehabilitation medicine physician, Neurosurgeon, Neurologist Disability due to autism Pediatric psychiatrist

Disability due to mental disorder Psychiatrist

Disability due to renal failure Internal medicine physician, General surgeon (Transplant) Disability due to heart problems Cardiologist, Pediatrician, Thoracic surgeon

Disability due to respiratory problems Pulmonologist, Allergologist

Disability due to liver disease Hepatologist, General surgeon (hepatobiliary), Pediatrician Disability due to facial disfigurement Plastic surgeon, Dermatologists, General surgeon (burn

specialty)

Disability due to ostomies General surgeon, Gynecologist, Urologist, Internal medicine physician

Epilepsy disability Neurologist, Neurosurgeon, Psychiatrist, Pediatrician, Pediatric neurologists

Supplementary Table 4. Grading in the Korean disability registration system, an example of visual

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Grade 1 ≥ 85% Visual acuity <0.02 (Better side)

Grade 2 75~84% Visual acuity <0.04 (Better side)

Grade 3 60~74% Visual acuity <0.06 (Better side)

or visual field <5︒ in all directions

Grade 4 45~59% Visual acuity <0.1 (Better side)

or visual field <10︒ in all directions

Grade 5 35~44% Visual acuity <0.2 (Better side)

or loss of visual field >50% in both eyes

Grade 6 25~34% Visual acuity <0.2 (Worse side)

Supplementary Table 5. Grading in the Korean disability registration system, an example of disability due to renal failure

Example for kidney disability

Grade 2 Those who are on hemodialysis or peritoneal dialysis for 3 months or more due to chronic kidney disease

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Grade 5 Those who have received kidney transplantation

Supplementary Table 6. Grading in the Korean disability registration system, an example of disability due to liver failure

Example for liver disability

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Grade 1 Those diagnosed with chronic liver disease (cirrhosis, hepatocellular carcinoma, etc.), whose residual liver function is grade C on the Child-Pugh scale, or those with hepatic encephalopathy or refractory ascites that is not controlled by medical treatment

Grade 2 Those diagnosed with chronic liver disease (cirrhosis, hepatocellular carcinoma, etc.), whose residual liver function is grade C on the Child-Pugh scale, or those with hepatic encephalopathy or spontaneous bacterial peritonitis within 2 years

Grade 3 No. 1 Those diagnosed with chronic liver disease (cirrhosis, hepatocellular carcinoma, etc.) or whose residual liver function is grade C on the Child-Pugh scale

Grade 3 No. 2 Those diagnosed with chronic liver disease (cirrhosis, hepatocellular carcinoma, etc.), whose residual liver function is grade B on the Child-Pugh scale, or those with hepatic encephalopathy or refractory ascites

Grade 5 Those who have received liver transplant

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