Change in Breast Cancer Screening Participation during COVID-19 Based on the 2019 and 2022 Comprehensive Survey of Living Conditions in Japan

Abstract

Introduction: The breast cancer screening rate declined worldwide during the COVID-19 pandemic. This cross-sectional study examined the changes in breast cancer screening participation rates in Japan before and during the pandemic and identified subgroups with a larger decline.

Methods: We used data from a 2019 survey evaluating 2017-2018 (pre-pandemic) and a 2022 survey evaluating 2020-2021 (during the pandemic) in the Comprehensive Survey of Living Conditions to describe the breast cancer screening rates by screening settings among women aged 40-74 years. We calculated the changes in the overall participation rate and by subgroup with and without adjustment for other variables (i.e., age, living area, educational level, and health insurance).

Results: The participation rates in breast cancer screening in 2017-2018 and 2020-2021 were 48.3% (51,428/106,446, municipality-based 18.7%, worksite-based 17.0%, and others 12.6%) and 47.1% (45,006/95,610, municipality-based 17.2%, worksite-based 17.5%, and others 12.4%), respectively. The crude difference from 2017-2018 to 2020-2021 was −1.2% (95% confidence interval [CI], −1.7 to −0.8), and the adjusted difference was −1.7% (−2.2 to −1.4). By subgroup, the adjusted difference was the largest in the 45-49 age subgroup (−2.2% [−3.3 to −1.1]) among the age subgroups, in the town/village subgroup (−2.4% [−3.6 to −1.2]) among the living area subgroups, in the high school subgroup (−1.8% [−2.4 to −1.2]) and vocational school/junior or technical college subgroup (−1.8% [−2.6 to −1.0]) among the educational level subgroups, and in the employee insurance (dependent person) subgroup (−2.5% [−3.3 to −1.7]) among the health insurance subgroups.

Conclusions: The breast cancer screening participation rates decreased during the pandemic in Japan, with some variations by subgroup. For the screening setting, the participation rate of the municipality-based screening decreased, while that of the worksite-based screening increased.