Cancer screening in Japan 2 years after the COVID-19 pandemic: Changes in participation, 2017–2021

The impact of the coronavirus disease (COVID-19) pandemic on cancer screening has become a global concern; compared with pre-pandemic levels, the number of individuals who underwent population-based cancer screening in Japan decreased by 10–30% in fiscal year (FY)2020. Therefore, it is important to monitor subsequent changes in the number of participants. This descriptive study analysed data from a national database to determine changes from 2017 to 2021 in the number of people screened for gastric cancer (upper gastrointestinal UGI series or endoscopy), colorectal cancer (faecal immunochemical test), lung cancer (chest X-ray), breast cancer (mammography), and cervical cancer (Pap smear). Compared with the pre-pandemic period (FY 2017–2019), the number of participants in screening programmes in FY2021 decreased maximally for the gastric cancer UGI series (2.8 million to 2.2 million; −23.3 %), followed by those for lung cancer (7.9 million to 7.3 million; −8.2 %), colorectal cancer (8.4 million to 7.8 million; −7.3 %), breast cancer (3.1 million to 3.0 million; −4.5 %), and cervical cancer (4.3 million to 4.1 million; −3.2 %). Conversely, the number of people screened for endoscopic gastric cancer screening increased (1.0 million to 1.2 million; +13.1 %). The number of participants, which decreased sharply immediately after the onset of the COVID-19 pandemic, recovered only slightly in FY2021 and did not return to pre-pandemic levels yet, except for endoscopic gastric cancer screening. Therefore, the impact of this decline in participation in cancer-detection programmes and changes in mortality should be monitored carefully.