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

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

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.

2021

10.1016/S2468-2667(21)00078-5

The Lancet. Public health