ABSTRACT
PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted cancer screening services worldwide. We aimed to measure the impact of COVID-19 on gastric cancer screening rates based on age, sex, household income, and residential area. MATERIALS AND METHODS: We analyzed data from the Korean National Cancer Screening Survey from 2017 to 2021 for adults aged 40-74 years. We evaluated the gastric cancer screening rate within two years in accordance with the National Cancer Screening Program protocol recommendations and that within the previous year. We compared the trends in the pre- and post-COVID-19 outbreak periods. RESULTS: Before the COVID-19 outbreak, there was little change in the gastric cancer screening rates until 2019. After the COVID-19 outbreak, the screening rate as per recommendation decreased from 70.8% in 2019 to 68.9% in 2020 and that for one year decreased from 32.7% in 2019 to 27.2% in 2020. However, as the COVID-19 pandemic continued after 2020, both gastric cancer screening rates as per recommendations and for one year rebounded. Although a similar trend was observed for the upper endoscopy screening rate, the upper gastrointestinal series screening rate decreased from 7.8% in 2020 to 3.1% in 2021. During the pandemic, the screening rate decreased among younger adults (40-49), those residing in metropolitan regions, and those with high incomes. CONCLUSIONS: Despite a decline in gastric cancer screening rate during the COVID-19 pandemic, the rate surged in 2021. Further studies are needed to estimate the impact of cancer screening delays on future cancer-related mortalities.
ABSTRACT
The coronavirus disease (COVID-19) pandemic significantly declined cancer screening rates worldwide. Its impact on the South Korean population is unclear, depending on socioeconomic status (SES), residence, and history of chronic disease. This study utilized data (2018-2020) from the Korean National Cancer Screening Survey, an annual cross-sectional study employing nationally representative random sampling. Cancer screening rates were defined as the proportion of the eligible population who received respective cancer screening within the last 1 year and investigated four major cancers (stomach, colorectal, breast, and cervical). Screening rates every year were compared with screening rate ratios (SRRs) and the corresponding 95% confidence intervals (CIs). Between 2019 and 2020, screening rates declined significantly by 23%, 17%, 12%, and 8% for colorectal cancer (SRR 0.77; 95% CI 0.73-0.82), stomach cancer (SRR 0.83; 95% CI 0.79-0.87), breast cancer (SRR 0.88; 95% CI 0.82-0.93), and cervical cancer (SRR 0.92; 95% CI 0.87-0.97), respectively. Regardless of cancer type, screening was significantly lower in metropolitan residents, those with higher SES, and, interestingly, those without a history of chronic diseases. The significant decline in cancer screening during the pandemic requires urgent political intervention to reduce the burden of future cancer incidence and mortality.
Subject(s)
COVID-19 , Uterine Cervical Neoplasms , COVID-19/diagnosis , COVID-19/epidemiology , Cross-Sectional Studies , Early Detection of Cancer , Female , Humans , Republic of Korea/epidemiology , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & controlABSTRACT
OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has negatively affected every aspect of medical care. However, information regarding the impact of the pandemic on cancer screening is lacking. This study aimed to explore cancer screening changes by geographic region before and during the pandemic in Korea. METHODS: Korean National Cancer Screening Survey data for 2019 and 2020 were used. Changes in the screening rate before and during the COVID-19 pandemic were calculated by subtracting the rate in 2020 from the rate in 2019. Multivariate logistic regression analyses examined the differences in screening rates at the national and 16 provincial levels before and after the COVID-19 outbreak. RESULTS: The 1-year screening rates for the four types of cancer decreased during the pandemic (stomach cancer: -5.1, colorectal cancer: -3.8, breast cancer: -2.5, cervical cancer: -1.5%p). In metropolitan areas, the odds of undergoing screening tests during the pandemic were significantly lower than before the pandemic for stomach (adjusted odds ratio [aOR], 0.66; 95% confidence interval [CI], 0.56 to 0.76), colorectal (aOR, 0.63; 95% CI, 0.50 to 0.79), and breast cancers (aOR, 0.75; 95% CI, 0.60 to 0.94). Furthermore, the likelihood of undergoing stomach cancer screening during the pandemic was significantly lower than before the pandemic in non-metropolitan urban areas (aOR, 0.81; 95% CI, 0.70 to 0.94), while it was higher in rural areas (aOR, 1.54; 95% CI, 1.10 to 2.16). CONCLUSIONS: Since the COVID-19 pandemic, the cancer screening rate has decreased significantly, especially in large cities. Public health efforts are required to improve cancer screening rates.