HSD9 Impact of Participation in Colorectal Cancer Screening during the COVID-19 Pandemic in Japan

Abstract

Participation in cancer screening has been affected and has decreased due to the dissemination of the COVID-19 infection nationwide. In Japan, the COVID-19 disease has been disseminated since early 2020. We compared the direct impact of participation in colorectal cancer (CRC) screening during the pandemic. The pandemic was disseminated in early 2020, it was the first confusing year affected by the pandemic. Based on the national cancer screening survey, the decreased rates of participants in 2020 were calculated, referred to those in 2018, and compared by a chi-square test. Correlation between decreased rates of participants in CRC screening and cumulative patients with COVID-19 infection was also calculated. The total number of participants in colorectal cancer screening was 5,115,993 and 4,404,775 in 2018 and 2020, respectively. Total participation in CRC screening decreased by 13.9% in 2020 compared with 2018. The decrease rate was lower in men than in women (13.2% vs. 13.9%, P<0.01). However, the decrease rates differed among age groups;19.1%, 14.2%, 24.0%, and 6.6% in those aged 40-49 years, 50-59 years, 60-69 years and over 70's, respectively. In providing CRC screening, rates reported by the mass survey decreased by a greater amount than those reported among GP practices (22.1% vs. 7.3%, P<0.01). Although participants' decrease rates differed among 47 prefectures, these were not correlated with cumulative patients with COVID-19 infection (correlation= -0.0279, P=0.8525). Although participation in CRC screening decreased during the pandemic, the impact was different among age groups, providing systems and prefectures. Most GP practices could continue their regular activities, including cancer screening while avoiding COVID-19 infection. Insufficient medical resources including number of GPs might lead to decrease participation in CRC screening, particularly in rural areas. The results suggest revising a plan for supplying CRC screening in the post-pandemic era.