Cervical screening during the COVID-19 pandemic: optimising recovery strategies.

Alejandra Castanon* (Corresponding Author), Matejka Rebolj, Emily Annika Burger, Inge M. C. M. de Kok, Megan A. Smith, Sharon J. B. Hanley, Francesca Maria Carozzi, Stuart Peacock, James F. O'Mahony

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)e522-e527
Number of pages6
JournalThe Lancet Public Health
Issue number7
Early online date24 Jun 2021
Publication statusPublished - 1 Jul 2021


  • Female
  • Humans
  • *COVID-19
  • *Early Detection of Cancer
  • *Mass Screening
  • *Pandemics
  • Health Services Accessibility
  • Healthcare Disparities
  • SARS-CoV-2
  • Uterine Cervical Neoplasms/*diagnosis


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