Disturbance of Gastrointestinal Cancers Diagnoses by the COVID-19 Pandemic in a Depopulated Area of Japan: A Population-Based Study in Akita Prefecture
Disturbance of Gastrointestinal Cancers Diagnoses by the COVID-19 Pandemic in a Depopulated Area of Japan: A Population-Based Study in Akita Prefecture
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DOI：
10.1620/tjem.2022.j020
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发表时间：
2022-05-01
影响因子：
2.2
通讯作者：
Motoyama, Satoru
中科院分区：
文献类型：
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作者：
Iijima, Katsunori;Jin, Mario;Motoyama, Satoru
据报道，COVID-19大流行扰乱了癌症筛查计划和胃肠道癌症的诊断;然而，很少有人关注感染率低的人口稀少地区的情况。秋田县是日本人口最少的地区之一，人均COVID-19感染率最低;与此同时，该县多年来一直是胃肠癌死亡率最高的地区。本研究以秋田县为研究对象，利用秋田县医院癌症登记系统的数据库，调查了2016- 2020年5年间胃肠道癌的发生率和癌症筛查次数。与2016-2019年的平均水平相比，2020年，由于COVID-19大流行影响了整个医疗保健系统，胃肠道癌症（尤其是食管-胃癌）的发病率下降了11.0%。尽管如此，晚期（IV期）胃癌的发病率于二零二零年上升7. 2%。2020年胃肠道癌症诊断率下降的同时，常规人群筛查项目总数下降了30%。在持续的COVID-19疫情下，日本全国统一暂停癌症筛查。因此，COVID-19大流行严重扰乱了癌症筛查系统，导致胃肠道癌症的诊断延迟，即使在感染率较低的日本人口稀少地区（秋田县）。应根据各地区的癌症发病率和感染状况，全面考虑在传染病大流行期间暂停癌症筛查程序。
Disruption of cancer screening programs and diagnoses of gastrointestinal cancers by the COVID-19 pandemic has been reported; however, little attention has been paid to the situation in depopulated areas with low infection rates. Akita Prefecture is one of the most depopulated areas of Japan and has the lowest COVID-19 infection rate per capita; at the same time, the prefecture has been top-ranked for mortality due to gastrointestinal cancer for years. In this population-based study in Akita Prefecture, we investigated the occurrence of gastrointestinal cancers and the number of cancer screening procedures over the five-year period of 2016- 2020, employing a database from the collaborative Akita Prefecture hospital-based registration system of cancers. The occurrence of gastrointestinal cancers, especially esophago-gastric cancers, declined by 11.0% in 2020, when the COVID-19 pandemic affected the overall healthcare system, compared with the average of 2016-2019. Nonetheless, the occurrence of advanced-stage (stage IV) esophago- gastric cancers increased by 7.2% in 2020. The decrease in the gastrointestinal cancer diagnosis rate in 2020 coincided with a 30% decline in the total number of regular population-based screening programs. Under the ongoing COVID-19 pandemic, cancer screening was uniformly suspended throughout Japan. Accordingly, the COVID-19 pandemic has substantially disrupted the cancer screening system, leading to delays in diagnoses of gastrointestinal cancer, even in depopulated areas (Akita Prefecture) of Japan with a low prevalence of infection. Suspension of cancer screening procedures during an infectious disease pandemic should be thoroughly considered for each region based on the cancer incidence and infection status in that area.