Cervical screening during the COVID-19 pandemic: optimising recovery strategies
Disruptions to cancer screening services have been experienced in most settings as a consequence of the COVID-19 pandemic. Ideally, programmes would resolve backlogs by temporarily expanding capacity; however, in practice, this is often not possible. We aim to inform the deliberations of decision makers in high-income settings regarding their cervical cancer screening policy response. We caution against performance measures that rely solely on restoring testing volumes to pre-pandemic levels because they will be less effective at mitigating excess cancer diagnoses than will targeted measures. These measures might exacerbate pre-existing inequalities in accessing cervical screening by disregarding the risk profile of the individuals attending. Modelling of cervical screening outcomes before and during the pandemic supports risk-based strategies as the most effective way for screening services to recover. The degree to which screening is organised will determine the feasibility of deploying some risk-based strategies, but implementation of age-based risk stratification should be universally feasible.
Journal
The Lancet Public HealthAuthors
Funding
Cancer Research UK Grant 27047Comparative Modeling to Inform Cervical Cancer Control PoliciesComparative Modeling to Inform Cervical Cancer Control PoliciesNational Cancer Center Grant 31-A-20National Cancer Center Japan FundingCancer Research UK (CRUK) Grant C8162/A27047National Health and Medical Research Council Grant APP1159491Cancer Institute NSW Grant ECF181561Public Health England FundingKreftforeningen (Norwegian Cancer Society) Grant 198073Comparative Modeling to Inform Cervical Cancer Control Policies