Colorectal Cancer Screening Amid COVID-19 in Japan: Analysis From the 2021–2022 JACSIS Study

Background

Maintaining a high participation rate is crucial for effective colorectal cancer (CRC) screening. The COVID-19 pandemic placed a significant burden on healthcare facilities, which hindered CRC screening efforts. However, the effects of the prolonged pandemic on CRC screening remain unclear.

Methods

We analyzed data from the Japan COVID-19 and Society Internet Survey in September 2021 and 2022 to examine CRC screening participation over the past year. We also evaluated the association between CRC screening participation in 2022 and the participation status, future screening intentions, background characteristics, and anxiety about COVID-19 measured using the fear of coronavirus disease 2019 scale (FVC-19S) from the 2021 survey..

Results

Of the 13,261 respondents, 40.5% reported undergoing CRC screening in 2021, while 48.7% did so in 2022. Multivariable Poisson regression analysis showed that significant factors associated with CRC screening participation in 2022 included being male (adjusted incidence risk ratio [aIRR] 1.07, 95% confidence interval [CI]; 1.00–1.14, p = 0.026), age in the 40s (aIRR 0.89, 95% CI; 0.81–0.97, p = 0.012) and 50s (aIRR 0.89, 95% CI; 0.82–0.98, p = 0.011), being unmarried (aIRR 0.88, 95% CI; 0.82–0.95, p = 0.001), and employment status such as self-employed (aIRR 0.86, 95% CI; 0.76–0.97, p = 0.012) or unemployed (aIRR 0.86, 95% CI; 0.81–0.92, p < 0.01). Having an FVC-19S score below 21 was also a factor (aIRR 0.95, 95% CI; 0.90–1.00, p = 0.032).

Conclusions

Although CRC screening rates increased from 2021 to 2022, a significant proportion of respondents still reported not undergoing screening, highlighting the importance of assessing the long-term impact of COVID-19 and identifying factors that make screening less accessible.