Every autumn the same question comes back: I'm told I'm due for a check-up this year — what happens if I skip it? There is something to settle first. Are you actually due, and due for what?
Korea's national screening is not one programme but three. General health screening, cancer screening and infant screening each get their eligibility and interval from different provisions. And cancer screening is handed off to an entirely different statute.
One more thing goes astray here. The words “odd or even birth year” appear nowhere in the law.
1. The provision fixes an interval, not a birth year. Article 25(1) of the Enforcement Decree says only “once every two years or more”, with one exception: employee insureds not in office work get it once a year.
2. Some categories carry an age condition and some do not. Employee insureds and self-employed insureds who head a household have no age requirement; other self-employed insureds and dependants start at 20 (Act art. 52(2)1).
3. The six cancers run on six schedules. Liver is every six months, colorectal yearly, the other four every two years — over ten years that is 20 rounds against 5 (our own working).
Four categories, and only two carry an age
Article 52(2)1 of the National Health Insurance Act lists eligibility for general screening in four lines. Read them and the age condition lands on only half of them.
| Who | Age condition |
|---|---|
| Employee insured | None |
| Self-employed insured who heads a household | None |
| Self-employed insured who does not head a household | 20 or over |
| Dependant | 20 or over |
| Act art. 52(2)1. A 19-year-old employee insured is eligible; the same person listed as a dependant is not. | |
The third item of the same paragraph sets infant screening at insureds and dependants under six. The second is cancer screening, and there the provision points somewhere else — to “persons meeting the screening intervals and age criteria by cancer type under article 11(2) of the Cancer Control Act”.
“Every two years” is the rule, with one exception
The interval comes from article 25(1) of the Enforcement Decree. The sentence is short enough to set out as it stands.
| Who | Interval | Where it says so |
|---|---|---|
| General screening — the rule | Once every two years or more | Decree art. 25(1), main text |
| Employee insureds not in office work | Once a year | Same sentence, second clause |
| Cancer screening | Varies by cancer | Proviso → Cancer Control Act Decree |
| Infant screening | Varies by age | Proviso → ministerial notice |
| Enforcement Decree of the National Health Insurance Act (in force 19 February 2026), art. 25(1). “Once every two years or more” is a floor, not a ban on going more often. | ||
That explains where the odd-or-even birth year business comes from. The provision fixes only an interval of two years, and the whole country cannot be screened in one year, so the population had to be split across two years and rotated. Birth-year parity is that method — an operating device for a two-year cycle, not a legal requirement. Which is why parity means nothing to a non-office employee insured screened every year.
The notice may not reach you
Paragraph 3 of the same article decides who gets told. This is where “but nobody told me” comes from.
| Whose screening | Who is notified |
|---|---|
| Employee insured, general and cancer screening | The employer |
| Dependants and self-employed insureds | The person being screened |
| An infant who is an employee insured's dependant | That employee insured |
| An infant who is a self-employed insured | The household head |
| Decree art. 25(3). Results travel screening body → the Service → you under paragraph 4, but the Service may skip its notice if the screening body told you directly. | |
For an office worker, in other words, the notice goes to the company rather than to the person. Asking the HR desk is often faster than waiting. Screening must be done at a body designated under article 14 of the Framework Act on Health Examinations (art. 25(2)), and the test items, methods and costs are set by ministerial notice rather than by the decree (art. 25(5)) — which is why the item list shifts slightly from year to year.
Six cancers, six starting ages
Article 8(1) of the Enforcement Decree of the Cancer Control Act names six — stomach, liver, colorectal, breast, cervical and lung. Paragraph 2 sends the intervals and ages to table 1, and the National Cancer Information Center publishes the same content as a table.
| Cancer | Who | Interval | Main method |
|---|---|---|---|
| Cervical | Women 20 and over | 2 years | Cervical cytology |
| Stomach | Adults 40 and over | 2 years | Gastroscopy |
| Breast | Women 40 and over | 2 years | Mammography |
| Liver | 40 and over, high risk | 6 months | Liver ultrasound + serum AFP |
| Colorectal | Adults 50 and over | 1 year | Faecal occult blood test |
| Lung | 54 to 74, high risk | 2 years | Low-dose chest CT |
| National Cancer Information Center, national cancer screening programme. Lung is the only one with an upper bound (74). Wider statistics are in cancer prevalence in Korea. | |||
Stretch it over ten years and the gap is fourfold
Converting the intervals straight across (our own working):
- Liver, 6 months — 20 rounds in ten years. Effectively twice a year.
- Colorectal, 1 year — 10 rounds.
- Stomach, breast, cervical, 2 years — 5 rounds each.
So “get it all done in one visit” does not hold. Some cancer screenings fall in the same year as general screening; others have to be tracked separately. For someone in the liver high-risk group the appointment comes round every six months regardless of the general cycle.
High risk is not decided by age
Two of the six do not open on age alone. The definitions published by the National Cancer Information Center read as follows.
| Cancer | High-risk group |
|---|---|
| Liver | Cirrhosis, hepatitis B surface antigen positive, hepatitis C antibody positive, or chronic liver disease caused by hepatitis B or C virus |
| Lung | A current smoker with a smoking history of 30 pack-years or more [packs per day × years smoked], plus anyone the Minister designates by notice as being at high need |
| Thirty pack-years is reached by a pack a day for 30 years and equally by two packs a day for 15 (our own working). How to read liver figures on a result sheet is in liver and kidney numbers. | |
A few things worth asking back
Is there a penalty for skipping it?
The National Health Insurance Act attaches no penalty to the insured inside this provision. Occupational health examinations for workers sit under the Occupational Safety and Health Act, which was not checked here. If the notice came through your employer, ask about that framework as well.
Can I go to any clinic?
Article 25(2) requires a body designated under article 14 of the Framework Act on Health Examinations. Designation is the test, so proximity alone does not qualify a clinic.
When do results arrive?
Article 25(4) sends them from the screening body to the Service, and from the Service to you — with a proviso that the Service may skip its notice where the body told you directly. If the clinic handed you a report, no separate letter may follow.
Why do the test items differ between people?
Article 52(3) of the Act requires items to be “designed to suit sex, age and other characteristics and the life cycle”, and article 25(5) of the Decree leaves the specifics to a ministerial notice. Because the item list is a notice rather than a decree, it changes on its own schedule.
Sources
- Statute — National Health Insurance Act, article 52. Source of the three screening types, eligibility and the age-20 line.
- Statute — Its Enforcement Decree, article 25 (in force 19 February 2026). Source of the two-year interval, the yearly exception, the notification rules, the designated-body requirement and the delegation to notice.
- Statute — Enforcement Decree of the Cancer Control Act, article 8, which lists the six cancers.
- Agency guidance — National Cancer Information Center (National Cancer Center), national cancer screening programme. Source of the ages, intervals, methods and the liver and lung high-risk definitions.
- Our own working — the 20 / 10 / 5 rounds over ten years and the two ways to reach 30 pack-years were calculated from the tables above.
Where to check further
- The general screening item list — not obtained. Article 25(5) delegates it to a ministerial notice, so it is not in the decree text. For the items themselves, look up the Health Examination Implementation Standards notice directly. We did not copy an item list quoted elsewhere.
- Whether you are due this year is best confirmed through the National Health Insurance Service after identity verification. This article covers the criteria in the provisions only.
- Workplace health examinations under the Occupational Safety and Health Act are a separate regime. What a company arranges is not always the same thing as national screening.
Written as of August 2026. Eligibility, intervals and notification come from the National Health Insurance Act and its Enforcement Decree, the six cancers from the Cancer Control Act Decree, and the ages, intervals, methods and high-risk definitions from the National Cancer Information Center. The ten-year conversion and the pack-year arithmetic are ours, marked as such. None of this substitutes for clinical judgement, so follow up any abnormal finding with a doctor. If a thyroid figure caught your eye, thyroid cancer in Korea follows; when symptoms are urgent rather than routine, see choosing between the ER and a clinic. Common myths about cancer covers the folklore around screening, and if your insurance category is about to change, health insurance after retirement is the one to read.
