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Cervical screening during the COVID-19 pandemic: optimising recovery strategies #MMPMID33939965
Castanon A; Rebolj M; Burger EA; de Kok IMCM; Smith MA; Hanley SJB; Carozzi FM; Peacock S; O'Mahony JF
Lancet Public Health 2021[Jul]; 6 (7): e522-e527 PMID33939965show ga
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.