The Lancet Public Health, Volume 6, July 2021,
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.
Awareness; Breast Cancer; COVID-19; COVID-19 Testing; Cancer Diagnosis; Cancer Prevention; Cancer Risk; Cancer Screening; Cervical Screening; Colorectal Cancer; Coronavirus Disease 2019; Cytology; Disease Surveillance; Early Cancer Diagnosis; Early Detection Of Cancer; Female; Gynecological Examination; Health Care Delivery; Health Care Disparity; Health Care Policy; Health Services Accessibility; Healthcare Disparities; Human; Humans; Mass Screening; Pandemic; Pandemics; Public Health Campaign; Review; SARS-CoV-2; Uterine Cervical Neoplasms; Uterine Cervix Cancer; Uterine Cervix Tumor; Vaccination; Wart Virus; Global