Cervical cancer screening rates before and after the Great East Japan Earthquake in the Miyagi Prefecture, Japan

Abstract

After disasters, issues pertaining to women's health such as irregular periods and bleeding are well surveyed. However, the management of women's health, especially changes in the rate of health checkups, has not been investigated. In the present study, we focused on the change in the cervical cancer screening rates (CCS-Rs) before and after the Great East Japan Earthquake in Miyagi Prefecture, Japan. The earthquake had a magnitude of 9.0, a profound disaster. We examined the CCS-R from 2009 to 2016 in 45 areas of the Miyagi Prefecture. Screening was completed using mobile vans. In the 4 areas impacted by the tsunami after the earthquake, a marked decrease in the CCS-R was observed in 2011 when the earthquake took place (more than a 3% decrease compared with that in the previous year). The CCS-Rs in these 4 regions remained lower in 2016 than in the previous year. In 2009-2016 except for 2014, CCS-Rs in coastal areas (9 areas) were significantly lower than those in the non-coastal areas (36 areas). A delay in seeking healthcare, also known as "patient's delay," is considered as one of the problems of cancer treatment in affected areas. It is possible that a decrease in the CCS-R may lead to low detection of advanced stages of cancer. Therefore, the establishment of a comprehensive medical system including medical screening after a disaster is important for the management of women's health.

Interruption of cancer screening services due to COVID-19 pandemic: lessons from previous disasters

“…General characteristics of the seven original research studies included in the review are found in Table 1 . Three studies were based in Japan [15] , [16] , [17] , two in the United States [18] , [19] , one in South Korea 20 and one in Denmark 21 . The remaining four studies were reviews that offered a global perspective on interruptions in health services [22] , [23] , [24] , [25] , and their characteristics are described on Table 2 .…”

“… Lobato et al (2007) 18 Cross sectional study Hurricane Newborn diseases United States Hospitals in the Great New Orleans area, August 15 to September 21, 2005 64 hospitals in the Great New Orleans area Survey Number of live births, number of newborn screening specimens, number of missing results Examine the extent to which newborn screening was disrupted in the immediate period before and after Hurricane Katrina. Miki et al (2020) 16 Trend analysis Earthquake, tsunami and nuclear power plant disaster Cancer Japan Areas of the Miyagi Prefecture, 2009 to 2016 (April 1 to March 31) 45 areas of the Miyagi Prefecture Annual reports Cervical cancer screening rates Changes in the cervical cancer screening rates before and after the Great East Japan Earthquake in Miyagi Prefecture, Japan. Nogueira et al (2019) 19 Cohort study Hurricane Cancer United States U.S. National Cancer Database, 2004 to 2014 1,734 patients undergoing definitive radiotherapy for nonoperativelocally advanced non-small cell lung cancer (NSCLC) who were exposed to a hurricane disaster1,734 matched unexposed patients Hospital-based registry data, hurricane disaster declarations by the U.S. Federal Emergency Management Agency Treatment duration, risk of death Investigate whether hurricane disasters occurring during radiotherapy were associated with poorer survival for patients with non-small cell lung cancer.…”

“…Eight studies included information about a health services interruption during a natural or human-caused disaster [15] , [16] , [17] , [18] , [19] , [22] , [23] , [24] . The remaining three studies provided a perspective of events that may indirectly disrupt the provision of health services, including a maritime incident 20 , a systematic error in screening registration 21 , and a financial crisis 25 .…”

“…No articles covered an interruption in regular health services due to a pandemic. There were no selection criteria for study design resulting in a wide range of study types, including three narrative reviews [22] , [24] , [25] , three cohort studies [17] , [19] , [21] , two cross-sectional studies [18] , [20] , one systematic review 23 , one trend analysis 16 , and one case study 15 .…”

Public health impact and cost effectiveness of routine and catch-up vaccination of girls and women with a nine-valent HPV vaccine in Japan: a model-based study

“…The program was modified in 2004 to allow women of age 20 years old and over to receive cervical screening test every other year [ 7 ]. However, uptake rate of cervical cancer screening is relatively low, estimated at 35 to 40% [ 7 , 8 ].…”