Assessment of the fear of COVID-19 and its impact on lung cancer screening participation among the Korean general population

BACKGROUND: We aimed to assess the fear of COVID-19 and how much it affected the behaviors of the general population towards cancer screening. METHODS: The Korean National Cancer Screening Survey is an annual population-based, cross-sectional survey to investigate cancer screening rates of five major malignancies. We extracted data on 3,557 cancer-free respondents aged ≥40 years in 2020, including sociodemographic characteristics, comorbidities, family history of cancer, self-perceived general health status, attitudes towards screening, and fear of COVID-19 compared with lung cancer. We collected information on health check-ups participation including cancer screening with or without schedule during the pandemic and analyzed the participation rate according to the degree of fear of COVID-19. RESULTS: Among 3,557 respondents, 1,066 (29.97%) people were more worried by COVID-19 than by lung cancer. 2,392 (67.25%) did not participate in health check-ups, of which 573 (24.0%) had a schedule for health check-ups but did not receive. We observed a significant increase (P<0.05) in the proportion of non-participation with schedule when the fear of COVID-19 exceeds lung cancer. In multivariate logistic analysis, the respondents with more fear of COVID-19 compared with lung cancer showed decreased likelihood of attendance in health check-ups (OR, 0.84; 95% CI: 0.71–0.98). CONCLUSIONS: A considerable proportion of the general population perceived more fear of COVID-19 than lung cancer, which significantly hampered their engagement in regular medical check-ups including cancer screening. This finding highlights the need for providing appropriate information to the target population of lung cancer screening to minimize disruption in cancer prevention activities.