Abstract
After disasters, issues pertaining to women's health such as irregular periods and bleeding are well surveyed. However, the management of women's health, especially changes in the rate of health checkups, has not been investigated. In the present study, we focused on the change in the cervical cancer screening rates (CCS-Rs) before and after the Great East Japan Earthquake in Miyagi Prefecture, Japan. The earthquake had a magnitude of 9.0, a profound disaster. We examined the CCS-R from 2009 to 2016 in 45 areas of the Miyagi Prefecture. Screening was completed using mobile vans. In the 4 areas impacted by the tsunami after the earthquake, a marked decrease in the CCS-R was observed in 2011 when the earthquake took place (more than a 3% decrease compared with that in the previous year). The CCS-Rs in these 4 regions remained lower in 2016 than in the previous year. In 2009-2016 except for 2014, CCS-Rs in coastal areas (9 areas) were significantly lower than those in the non-coastal areas (36 areas). A delay in seeking healthcare, also known as "patient's delay," is considered as one of the problems of cancer treatment in affected areas. It is possible that a decrease in the CCS-R may lead to low detection of advanced stages of cancer. Therefore, the establishment of a comprehensive medical system including medical screening after a disaster is important for the management of women's health.
Highlights
The cervical cancer incidence in Japan is 14.7, which is higher than that in other developed countries such as United States (6.5), Australia (6.0), and South Korea (8.4) and similar to that in India (14.7) and the Philippines (14.9) [1]
In Karakuwa (T-2), the cancer screening rates (CCS-Rs) recovered to a decreased rate of less than 2.0% (Δ[CCS-R 2012]), it decreased by 3.0% from (Δ[CCS-R 2013] to Δ[CCS-R 2016]) (Fig 2Ab)
In Shizugawa (U-1a), the CCS-R decreased by 3% in the year following the earthquake (Δ[CCS-R 2012]) but recovered to the level one year before the earthquake (2010) in 2013 after the merger with Utatsu (U-1b) and increased by more than 3.0% in 2015 and 2016 (Table 1)
Summary
The cervical cancer incidence in Japan is 14.7 (age-standardized rates per 100,000 population), which is higher than that in other developed countries such as United States (6.5), Australia (6.0), and South Korea (8.4) and similar to that in India (14.7) and the Philippines (14.9) [1].
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