Tohoku J. Exp. Med., 2022 May, 257(1)

Disturbance of Gastrointestinal Cancers Diagnoses by the COVID-19 Pandemic in a Depopulated Area of Japan: A Population-Based Study in Akita Prefecture

Katsunori Iijima,¹ Mario Jin,² Masahito Miura,³ Kenta Watanabe,¹ Noboru Watanabe,¹ Yosuke Shimodaira,¹ Shigeto Koizumi,¹ Fumio Tobori² and Satoru Motoyama⁴

¹Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Akita, Japan
²Akita Foundation for Healthcare, Akita, Akita, Japan
³Department of Gastroenterology, Omagari Kosei Medical Center, Daisen, Akita, Japan
⁴Department of Esophageal Surgery, Akita University Graduate School of Medicine, Akita, Akita, Japan

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.

Keywords —— cancer screening; COVID-19 pandemic; depopulated area; esophago-gastric cancers; gastrointestinal cancers

© 2022 Tohoku University Medical Press

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Tohoku J. Exp. Med 2022, 257, 65-71.

Correspondence: Katsunori Iijima M.D., Ph.D., Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita 010-8543, Japan.

e-mail: kiijima@med.akita-u.ac.jp