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

Alejandra Castanon; 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

doi:10.1016/S2468-2667(21)00078-5

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 journal › Article › peer-review

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Abstract

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 language	English
Pages (from-to)	e522-e527
Number of pages	6
Journal	The Lancet Public Health
Volume	6
Issue number	7
Early online date	24 Jun 2021
DOIs	https://doi.org/10.1016/S2468-2667(21)00078-5
Publication status	Published - 1 Jul 2021

Bibliographical note

Acknowledgments
This work was done on behalf of the Screening Working Group of the COVID-19 and Cancer Global Modelling Consortium (CCGMC) and we acknowledge all members of the CCGMC Steering Committee, Secretariat, and Working Group 2. This work was supported by Ireland's Health Research Board (grant number EIA-2017–054 to JFOM), the National Health and Medical Research Council (Australia; grant APP1159491 to MAS), Cancer Research UK (grant number C8162/A27047 to MR and AC), Cancer Institute NSW (ECF181561 to MAS), National Institutes of Health (USA; U01CA199334 to EAB), Norwegian Cancer Society (#198073 to EAB), and the National Cancer Centre (Japan; 31-A-20 to SJBH). These funders had no role in directing or the writing of the manuscript, or the decision to submit for publication.

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/S2468-2667(21)00078-5Licence: CC BY

Castanan_etal_TLPH_Cervical_Screening_During_VoR
Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. https://creativecommons.org/licenses/by/4.0/
Final published version, 92 KBLicence: CC BY

Cite this

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title = "Cervical screening during the COVID-19 pandemic: optimising recovery strategies.",

abstract = "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.",

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note = "Acknowledgments This work was done on behalf of the Screening Working Group of the COVID-19 and Cancer Global Modelling Consortium (CCGMC) and we acknowledge all members of the CCGMC Steering Committee, Secretariat, and Working Group 2. This work was supported by Ireland's Health Research Board (grant number EIA-2017–054 to JFOM), the National Health and Medical Research Council (Australia; grant APP1159491 to MAS), Cancer Research UK (grant number C8162/A27047 to MR and AC), Cancer Institute NSW (ECF181561 to MAS), National Institutes of Health (USA; U01CA199334 to EAB), Norwegian Cancer Society (#198073 to EAB), and the National Cancer Centre (Japan; 31-A-20 to SJBH). These funders had no role in directing or the writing of the manuscript, or the decision to submit for publication.",

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AU - Hanley, Sharon J. B.

AU - Carozzi, Francesca Maria

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N1 - Acknowledgments This work was done on behalf of the Screening Working Group of the COVID-19 and Cancer Global Modelling Consortium (CCGMC) and we acknowledge all members of the CCGMC Steering Committee, Secretariat, and Working Group 2. This work was supported by Ireland's Health Research Board (grant number EIA-2017–054 to JFOM), the National Health and Medical Research Council (Australia; grant APP1159491 to MAS), Cancer Research UK (grant number C8162/A27047 to MR and AC), Cancer Institute NSW (ECF181561 to MAS), National Institutes of Health (USA; U01CA199334 to EAB), Norwegian Cancer Society (#198073 to EAB), and the National Cancer Centre (Japan; 31-A-20 to SJBH). These funders had no role in directing or the writing of the manuscript, or the decision to submit for publication.

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N2 - 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.

AB - 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.

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KW - Health Services Accessibility

KW - Healthcare Disparities

KW - SARS-CoV-2

KW - Uterine Cervical Neoplasms/diagnosis

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ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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