How Health Literacy Kept Gastric Cancer Screenings Going During Pandemic

By VirentaNews Staff — May 16, 2026

Why did some people continue getting screened for gastric cancer during the height of the COVID-19 pandemic, even as healthcare systems strained and fear of infection spread? With hospitals overwhelmed and routine screenings postponed, millions delayed critical preventive care. Yet a notable segment of the population not only maintained their screening intentions but followed through. What set them apart? Research from the University of Tsukuba sheds light on this puzzle, identifying a combination of personal awareness, social support, and health literacy as decisive factors. As global health systems recover from pandemic setbacks, understanding what drove continued screening behavior could inform strategies to strengthen preventive care resilience in future crises.

What Drove Gastric Cancer Screening Intentions During Lockdowns?

The University of Tsukuba study, published in a peer-reviewed public health journal, found that individuals with higher cancer-related health literacy—meaning they could understand, evaluate, and act on health information—were significantly more likely to intend to undergo gastric cancer screening despite pandemic disruptions. This intent was further strengthened by perceived personal susceptibility to gastric cancer and active encouragement from family members or healthcare providers. These factors didn’t just influence intentions; they directly predicted actual screening behavior. Notably, participants who discussed screening with a doctor or received a recommendation were over 60% more likely to complete the procedure. The study tracked over 2,000 adults across Japan, a country with one of the highest gastric cancer rates globally, making early detection through endoscopy or barium imaging a public health priority. These findings suggest that informed, supported individuals were better equipped to prioritize long-term cancer risks over short-term pandemic fears.

What Evidence Supports the Link Between Awareness and Screening?

Data from the longitudinal survey revealed that participants with high health literacy were 73% more likely to follow through with screening compared to those with low literacy, even after adjusting for age, income, and access to care. Perceived susceptibility—the belief that one could develop gastric cancer—also played a critical role: individuals who rated their risk as moderate to high were nearly twice as likely to schedule a screening. Social influences mattered too; 41% of participants who received encouragement from family members completed screening, compared to just 26% of those without such support. The researchers cited World Health Organization reports emphasizing that early detection can reduce gastric cancer mortality by up to 30%. The study also found that public health messaging focusing on the lethality of undiagnosed gastric cancer resonated more effectively with informed audiences, reinforcing the value of targeted education. These behavioral patterns held true across urban and rural settings, suggesting that awareness and support can transcend geographic disparities.

Could Fear of COVID-19 Undermine Long-Term Screening Rates?

While health literacy and social support promoted screening, the study also uncovered a paradoxical role of pandemic fear. In the short term, heightened awareness of mortality—spurred by news of COVID-19 deaths—actually increased screening intentions, as some individuals became more attentive to their health. However, over time, fear of contracting the virus in medical settings suppressed actual screening behavior. By mid-2021, screening rates had dropped by nearly 40% in some Japanese prefectures, despite sustained intention levels earlier in the pandemic. Some participants reported avoiding hospitals even when asymptomatic, fearing exposure during endoscopic procedures. Skeptics argue that structural barriers—such as clinic closures, staff shortages, and rescheduling delays—were more decisive than individual attitudes. Others caution that health literacy alone cannot overcome systemic inequities, particularly among older, low-income, or isolated populations who may lack digital access to information or transportation to screening centers. These edge cases highlight the limits of individual-level interventions in the face of broader public health disruptions.

How Are Health Systems Responding to These Findings?

In response to the study, Japanese public health officials have expanded telehealth consultations to discuss cancer screening risks and benefits, aiming to replicate the impact of in-person provider recommendations. Some clinics now offer pre-screening risk assessments via mail or online platforms, helping patients weigh their personal cancer risk against infection concerns. Community health campaigns in high-incidence regions like Akita and Yamaguchi prefectures now feature testimonials from survivors and emphasize family involvement in screening decisions. Internationally, organizations like the U.S. Centers for Disease Control and Prevention have cited the research to support guidelines encouraging healthcare providers to proactively re-engage patients who missed screenings during the pandemic. These real-world applications underscore a shift toward personalized, socially supported preventive care—a model that could strengthen resilience against future health crises.

What This Means For You

If you’re over 50 or have a family history of gastric cancer, this research underscores the importance of staying informed and discussing screening with your doctor—even during times of crisis. Health literacy isn’t just about reading medical jargon; it’s about understanding your personal risk and feeling empowered to act. Talking to family members about your health can also create a support system that reinforces preventive decisions. As healthcare systems navigate ongoing challenges, being proactive and informed remains one of the most effective ways to protect your long-term well-being.

But how can public health campaigns effectively boost health literacy without overwhelming at-risk populations? And can digital tools bridge the gap for those without consistent access to care? As cancer screening evolves in a post-pandemic world, the balance between education, access, and trust will shape the next frontier of preventive medicine.

Source: MedicalXpress