Cancer risk awareness and concrete plans boosted gastric screening during COVID-19

A study conducted by researchers at University of Tsukuba revealed that individuals with higher cancer-related health literacy, perceived susceptibility to gastric cancer, and encouragement from family members or health care providers demonstrated stronger intentions to undergo gastric cancer screening, even during the COVID-19 pandemic. These intentions were significantly associated with subsequent screening participation. In contrast, while fear of COVID-19 increased screening intention in the short term, over time it could suppress screening behavior.

The COVID-19 pandemic led to a substantial decline in cancer screening participation worldwide. Against this backdrop, the research team examined how psychological factors associated with the pandemic influenced decisions related to gastric cancer screening.

The study was conducted in 2022, when socioeconomic activities in Japan were gradually resuming despite continued cases of COVID-19. Two waves of surveys were administered to Japanese adults aged 40–69 years. The researchers examined the effects of three key psychological factors identified in the recently proposed Health Intention Model: perceived susceptibility to gastric cancer, cues to action such as recommendations from family members or physicians, and health literacy related to gastric cancer and its screening. The researchers also assessed the role of implementation intentions, defined as concrete plans specifying when, where, and how to undergo screening, along with risk perception and fear of COVID-19.

The results, published inActa Psychologica, revealed that individuals with higher health literacy regarding gastric cancer and screening, those who perceived themselves to be at risk, and those who received encouragement from others exhibited stronger screening intentions, which predicted actual screening participation four months later. Furthermore, individuals who had formed concrete implementation intentions were significantly more likely to undergo screening. However, although fear of COVID-19 heightened screening intention in the short term, a negative association with actual screening behavior over time was observed, indicating a complex, two-sided effect.

These findings suggest that, even during large-scale infectious disease outbreaks such as the COVID-19 pandemic, promoting accurate information and encouraging concrete action planning may be more effective in sustaining cancer screening participation than relying on fear or anxiety. More broadly, the results indicate that identifying effective strategies to encourage screening uptake under unusual circumstances, such as large-scale outbreaks of infectious diseases, offers valuable insights for public health practice. However, the authors note that the findings are based on self-reported data from a Japanese sample. Therefore, caution is needed when generalizing the results to other populations or settings.

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Gaby Clark

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Andrew Zinin

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