Risk Management and Healthcare Policy (Jul 2021)
Determinants of Postponed Cancer Screening During the COVID-19 Pandemic: Evidence from the Nationally Representative COVID-19 Snapshot Monitoring in Germany (COSMO)
Abstract
André Hajek,1 Freia De Bock,2 Lena Huebl,3 Benedikt Kretzler,1 Hans-Helmut König1 1Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Federal Centre of Health Education, Cologne, Germany; 3Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyCorrespondence: André HajekDepartment of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, GermanyTel +49 40 7410- 52877Fax +49 40 7410- 40261Email [email protected]: The COVID-19 pandemic is accompanied by various challenges for individual health and the health care system. However, preventive examinations such as cancer screenings should not be postponed during a pandemic. Because nationally representative studies describing postponed cancer screenings and identifying its determinants in Germany are lacking, our aim was to close this gap in knowledge.Materials and Methods: We used cross-sectional data from the nationally representative online-survey “COVID-19 Snapshot Monitoring in Germany (COSMO)” (wave 17), which was conducted in July 2020. The analytical sample included 974 individuals (mean age was 45.9 years, SD: 16.5 years; 18 to 74 years). The outcome measure was whether cancer screening had been postponed since March 2020 due to the COVID-19 pandemic (no, attended as planned; yes, postponed).Results: In total, slightly more than 10% of individuals stated to have postponed cancer screenings between March and July 2020 due to the COVID-19 pandemic, particularly women and individuals aged 30 to 49 years. The likelihood of postponed cancer screening was positively associated with higher affect regarding COVID-19 (OR: 1.65, 95% CI: 1.16– 2.35), whereas it was negatively associated with younger age (eg, 18 to 29 years, OR: 0.17, 95% CI: 0.05– 0.64, compared to individuals 30 to 49 years).Conclusion: Study findings showed that one out of ten individuals postponed cancer screenings during the COVID-19 pandemic. We determined two correlates of them (age and affect regarding COVID-19). Individuals with an increased likelihood of postponed cancer screenings should be specifically addressed.Keywords: cancer screening, corona-virus, COVID-19, delayed screening, postponed screening; SARS-CoV-2; access to health care; availability of medical care; health care use; health care utilization; health services research; postponed treatment
