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

Autor:	Castanon A; Faculty of Life Sciences and Medicine, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK. Electronic address: alejandra.castanon@kcl.ac.uk., Rebolj M; Faculty of Life Sciences and Medicine, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK., Burger EA; Harvard T H Chan School of Public Health, Center for Health Decision Science, Boston, MA, USA; Department of Health Management and Health Economics, University of Oslo, Oslo, Norway., de Kok IMCM; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands., Smith MA; Daffodil Centre, University of Sydney-Cancer Council, Sydney, NSW, Australia., Hanley SJB; Department of Obstetrics and Gynaecology, Hokkaido University, Sapporo, Japan., Carozzi FM; ISPRO, Regional Laboratory of Cancer Prevention, Florence, Italy., Peacock S; Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada; Department of Cancer Control Research, BC Cancer, Vancouver, BC, Canada; Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, Canada., O'Mahony JF; Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, Dublin, Ireland.
Jazyk:	angličtina
Zdroj:	The Lancet. Public health [Lancet Public Health] 2021 Jul; Vol. 6 (7), pp. e522-e527. Date of Electronic Publication: 2021 Apr 30.
DOI:	10.1016/S2468-2667(21)00078-5
Abstrakt:	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. Competing Interests: Declaration of interests MR reports funding from Hologic and grants from Public Health England, outside of the submitted work. MAS reports grants from the National Health and Medical Research Council and the Cancer Institute New South Wales. SJBH reports grants from National Cancer Centre Japan. SP reports being a member of the Board of Directors for the Canadian Agency for Drugs and Technologies in Health. All other authors declare no competing interests. (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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