Impact of the COVID-19 Pandemic on Population-based Cancer Screening in Taiwan

Abstract

Background: The Coronavirus disease 2019 (COVID-19) pandemic has been a great burden on the health care system. It has also had a great impact on other public health issues, including cancer screening. Delayed cancer screening was also noticed in the U.S, which may have led to both delayed diagnosis and poor prognosis. In Taiwan, population-based cancer screening for breast cancer, oral cancer, colon cancer and cervical cancer has been executed for years. Method: In this study we have analyzed the change in screening numbers during the period of 2019 to 2021 during COVID-19 outbreak in Taiwan. Result: Through our results we found that total cancer screening numbers decreased from 307,547 to 103,289 (66% decrease) from the years 2020 to 2021. There was a 63%, 79%, 65% and 71% decrease in screening cases for colon cancer, oral cancer, cervical cancer and breast cancer, respectively during that period. A similar condition was noticed when comparing 2019 to 2021 when the disclosed total cancer screening numbers decreased by 70% (2019-2021); 65%, 83%, 70% and 76% in colon cancer, oral cancer, cervical cancer and breast cancer, respectively. Among these various cancer screenings, oral cancer screening showed the greatest reduction rate. We also compared the reduction rates taken from different regions in Taiwan. It was in Taipei, where most COVID-19 cases were noted, that the greatest reduction rate of cancer screening numbers occurred. A proportional decrease of screening cases was also noticed in all areas when confirmed COVID-19 cases rose. Conclusion: Screening for cancers has dropped significantly due to the pandemic and its effect on long-term health needs to be evaluated. Additionally, efforts should be taken to address this cancer screening number deficit which has taken place during the COVID-19 pandemic.