Determinants of Postponed Cancer Screening During the COVID-19 Pandemic: Evidence from the Nationally Representative COVID-19 Snapshot Monitoring in Germany (COSMO)

Risk Manag Healthc Policy. 2021 Jul 14;14:3003-3011. doi: 10.2147/RMHP.S297326. eCollection 2021.


Purpose: 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: COVID-19; cancer screening; corona-virus; 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.

Grant support

DFG 3970/11-1; further funding via BZgA, RKI, ZPID, University of Erfurt (no funding numbers). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.