Department of Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
Cancer Detection Center, Miyagi Cancer Society, Sendai, Japan.
PLoS One. 2020 Mar 11;15(3):e0229924. doi: 10.1371/journal.pone.0229924. eCollection 2020.
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.
灾难后，经常会对女性健康问题进行调查，如月经不规律和出血等。然而，对女性健康的管理，特别是健康检查率的变化，尚未得到调查。在本研究中，我们主要关注日本宫城县在东日本大地震前后宫颈癌筛查率（CCS-R）的变化。这次地震震级为 9.0 级，是一场严重的灾害。我们检查了 2009 年至 2016 年宫城县 45 个地区的 CCS-R。筛查是使用流动车完成的。在地震发生后的海啸影响的 4 个地区，2011 年 CCS-R 明显下降（与前一年相比下降超过 3%）。这些 4 个地区的 CCS-R 在 2016 年仍低于前一年。在 2009-2016 年期间（除 2014 年外），沿海地区（9 个地区）的 CCS-R 明显低于非沿海地区（36 个地区）。寻求医疗保健的延迟，也称为“患者延迟”，被认为是受灾地区癌症治疗的问题之一。CCS-R 的下降可能导致癌症晚期的检出率降低。因此，建立一个包括灾难后医疗筛查的综合医疗体系，对女性健康管理非常重要。
