Japanese cancer screening programs during the COVID-19 pandemic: Changes in participation between 2017-2020.

BACKGROUND: The impact of the coronavirus disease 2019 (COVID-19) pandemic on cancer screening participation is a global concern. A national database of screening performance is available in Japan for population-based cancer screening, estimated to cover approximately half of all cancer screenings. METHODS: Utilizing the fiscal year (FY) 2017-2020 national database, the number of participants in screenings for gastric cancer (upper gastrointestinal [UGI] series or endoscopy), colorectal cancer (fecal occult blood test), lung cancer (chest X-ray), breast cancer (mammography), and cervical cancer (Pap smear) were identified. The percent change in the number of participants was calculated. RESULTS: Compared with the pre-pandemic period (FY 2017-2019), in percentage terms FY 2020 recorded the largest decline in gastric cancer UGI series (2.82 million to 1.91 million, percent change was -32.2 %), followed by screening for breast cancer (3.10 million to 2.57 million, percent change was -17.2 %), lung cancer (7.92 million to 6.59 million, percent change was -16.7 %), colorectal cancer (8.42 million to 7.30 million, percent change was -13.4 %), cervical cancer (4.26 million to 3.77 million, percent change was -11.6 %), and gastric cancer via endoscopy (1.02 million to 0.93 million, percent change was -9.0 %). CONCLUSION: The number of participants in population-based screenings in Japan decreased by approximately 10-30 % during the pandemic. The impact of these declines on cancer detection or mortality should be carefully monitored.

Impact of the COVID-19 pandemic on the diagnosis of cancer in Japan: analysis of hospital-based cancer registries.

BACKGROUND: There is significant concern that cancer care is adversely impacted due to the coronavirus disease pandemic. Using the national database, we document the impact of the pandemic on cancer diagnosis in Japan. METHODS: Data from 735 hospital-based cancer registries, covering >70% of newly diagnosed cases, were analysed. We compared trends during 2016-2019 and those in 2020 by the type of cancer, diagnostic process, stage and 13 prefectures as requiring special precautions to prevent the spread of infection. RESULTS: Overall, the number of patients who began treatment decreased by 1.9% in 2020 as compared with the average number during 2016-2019. A sharp decline of 13.8% was observed for stomach cases. The decline in cases (22.0% decrease for all cancers) was more pronounced in May. Cancer screening and resulting detection decreased significantly in 2020 (8.1-24.3%). Case registrations of stage I and II gastric cancer, stage II intrahepatic cholangiocarcinoma, stage II oesophageal cancer, stage 0 and I laryngeal cancer and stage II gallbladder cancer decreased by >10% compared with those in 2018 and 2019. The trends in cancer cases by area of residence indicated a decline in 13 prefectures in May 2020 compared with other areas. CONCLUSIONS: The number of cancer diagnoses decreased during the year 2020 under coronavirus pandemic, especially right after the Japanese government declared the first state of emergency in April. We need to carefully observe the consequences of these decrease in diagnosis, or perhaps the delay in care, on patient survival or population mortality.

SARS-CoV-2 Infection and Pancreatic ß Cell Failure.

SARS-CoV-2 infection primarily causes pulmonary symptoms; however, accumulating reports indicate that some patients with COVID-19 have multiple organ dysfunction or failure. Although diabetes is considered a risk factor for severe COVID-19, SARS-CoV-2 infection may also be a causal factor for diabetes mellitus in patients with COVID-19. According to the research reviewed in this paper, the pancreas and pancreatic ß cells appear to be targets of SARS-CoV-2 and are damaged by direct or indirect effects of the infection. However, controversial results have been reported between study groups, mainly due to the limited number of cases with diabetes precipitated by COVID-19. In this review, we comprehensively discuss the published findings on the potential association between SARS-CoV-2 infection or COVID-19 and pancreatic ß-cell damage leading to diabetes onset. These findings will further contribute to our understanding of the pathogenesis of diabetes mellitus.

Prediction of Nonalcoholic Fatty Liver Disease Using Noninvasive and Non-Imaging Procedures in Japanese Health Checkup Examinees.

Access to imaging is limited for diagnosing nonalcoholic fatty liver disease (NAFLD) in general populations. This study evaluated the diagnostic performance of noninvasive and nonimaging indexes to predict NAFLD in the general Japanese population. Health checkup examinees without hepatitis virus infection or habitual alcohol drinking were included. Fatty liver was diagnosed by ultrasonography. The hepatic steatosis index (HSI), Zhejiang University (ZJU) index, and fatty liver index (FLI) were determined, and risk of advanced liver fibrosis was evaluated by the fibrosis-4 index. NAFLD was diagnosed in 1935 (28.0%) of the 6927 subjects. The area under the receiver operating characteristic (AUROC) curve of the HSI, ZJU index, and FLI was 0.874, 0.886, and 0.884, respectively. The AUROC of the ZJU index (p < 0.001) and FLI (p = 0.002) was significantly greater than that for the HSI. In subjects with a high risk of advanced fibrosis, the sensitivity of the HSI, ZJU index, and FLI were 88.8%, 94.4%, and 83.3% with a low cut-off value and the specificity was 98.5%, 100%, and 100% with a high cut-off value. In conclusion, all indexes were useful to diagnose NAFLD in the general Japanese population and in subjects with potentially advanced liver fibrosis.