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Morbidity and Mortality Weekly Report ; 70(4):109-113, 2021.
Article in English | GIM | ID: covidwho-1395395


The study analysed the screening rates for cervical cancer in women before and after the stay-away order was lifted. It found that the rates were lower after the order was lifted. Women with no cervix or a history of precancerous conditions were excluded from the study. Age-specific screening tests were calculated based on the screening rates for cervical cancer. The 2019 KPSC membership cohort included over four million women. The group's enrollment rate was stable over the previous years. In 2020, the screening rates for women aged 21 to 29 years were lower before and after the stay at home order was placed. These decreases were similar to those for women aged 30 to 65 years. The data collected by KPSC allowed us to evaluate the impact of HPV vaccinations caused by the COVID-19 pandemic. The results of the study showed that the prevalence of HPV screening decreased during the pandemic. The decline in cancer screening rates was similar across all ethnic and racial groups during the stay-at-home order. These findings are compatible with findings of a major decline in cancer screening during 2020 in other parts of the country. The COVID-19 pandemic presented various challenges to the healthcare system, including the need to maintain cancer screening. In California, for instance, many hospitals canceled elective procedures because of the pandemic. While providing care, the clinic staff and providers faced challenges in implementing COVID-19 protocols. Some of these included the use of personal protective equipment and establishing physical barriers. Patients were also reluctant to visit the clinic due to their fear of contracting COVID-19 infection. The closure of the facility led to a spike in telehealth visits.

MMWR Morb Mortal Wkly Rep ; 70(4): 109-113, 2021 Jan 29.
Article in English | MEDLINE | ID: covidwho-1112895


On March 19, 2020, the governor of California issued a statewide stay-at-home order to contain the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* The order reduced accessibility to and patient attendance at outpatient medical visits,† including preventive services such as cervical cancer screening. In-person clinic visits increased when California reopened essential businesses on June 12, 2020.§ Electronic medical records of approximately 1.5 million women served by Kaiser Permanente Southern California (KPSC), a large integrated health care system, were examined to assess cervical cancer screening rates before, during, and after the stay-at-home order. KPSC policy is to screen women aged 21-29 years every 3 years with cervical cytology alone (Papanicolaou [Pap] test); those aged 30-65 years were screened every 5 years with human papillomavirus (HPV) testing and cytology (cotesting) through July 15, 2020, and after July 15, 2020, with HPV testing alone, consistent with the latest recommendations from U.S. Preventive Services Task Force.¶ Compared with the 2019 baseline, cervical cancer screening rates decreased substantially during the stay-at-home order. Among women aged 21-29 years, cervical cytology screening rates per 100 person-months declined 78%. Among women aged 30-65 years, HPV test screening rates per 100 person-months decreased 82%. After the stay-at-home order was lifted, screening rates returned to near baseline, which might have been aided by aspects of KPSC's integrated, organized screening program (e.g., reminder systems and tracking persons lost to follow-up). As the pandemic continues, groups at higher risk for developing cervical cancers and precancers should be evaluated first. Ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important.

COVID-19/prevention & control , Delivery of Health Care, Integrated , Early Detection of Cancer/statistics & numerical data , Quarantine/legislation & jurisprudence , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , COVID-19/epidemiology , California/epidemiology , Female , Humans , Middle Aged , Young Adult