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Impact of disruptions and recovery for established cervical screening programs across a range of high-income country program designs, using COVID-19 as an example: A modelled analysis.
Smith, Megan A; Burger, Emily A; Castanon, Alejandra; de Kok, Inge M C M; Hanley, Sharon J B; Rebolj, Matejka; Hall, Michaela T; Jansen, Erik E L; Killen, James; O'Farrell, Xavier; Kim, Jane J; Canfell, Karen.
  • Smith MA; Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Electronic address: megan.smith@nswcc.org.au.
  • 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. Electronic address: eburger@hsph.harvard.edu.
  • Castanon A; King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, London, United Kingdom. Electronic address: alejandra.castanon@kcl.ac.uk.
  • de Kok IMCM; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: i.dekok@erasmusmc.nl.
  • Hanley SJB; Department of Obstetrics and Gynaecology, Hokkaido University, Sapporo, Japan. Electronic address: sjbh1810@med.hokudai.ac.jp.
  • Rebolj M; King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, London, United Kingdom. Electronic address: matejka.rebolj@kcl.ac.uk.
  • Hall MT; Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia; School of Mathematics and Statistics, UNSW, Sydney, Australia. Electronic address: Michaela.Hall@nswcc.org.au.
  • Jansen EEL; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: e.e.l.jansen@erasmusmc.nl.
  • Killen J; Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Electronic address: James.Killen@nswcc.org.au.
  • O'Farrell X; Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Electronic address: Xavier.OFarrell@nswcc.org.au.
  • Kim JJ; Harvard T.H. Chan School of Public Health, Center for Health Decision Science, Boston, MA, USA. Electronic address: jkim@hsph.harvard.edu.
  • Canfell K; Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Electronic address: karen.canfell@nswcc.org.au.
Prev Med ; 151: 106623, 2021 10.
Article in English | MEDLINE | ID: covidwho-1240652
ABSTRACT
COVID-19 has disrupted cervical screening in several countries, due to a range of policy-, health-service and participant-related factors. Using three well-established models of cervical cancer natural history adapted to simulate screening across four countries, we compared the impact of a range of standardised screening disruption scenarios in four countries that vary in their cervical cancer prevention programs. All scenarios assumed a 6- or 12-month disruption followed by a rapid catch-up of missed screens. Cervical screening disruptions could increase cervical cancer cases by up to 5-6%. In all settings, more than 60% of the excess cancer burden due to disruptions are likely to have occurred in women aged less than 50 years in 2020, including settings where women in their 30s have previously been offered HPV vaccination. Approximately 15-30% of cancers predicted to result from disruptions could be prevented by maintaining colposcopy and precancer treatment services during any disruption period. Disruptions to primary screening had greater adverse effects in situations where women due to attend for screening in 2020 had cytology (vs. HPV) as their previous primary test. Rapid catch-up would dramatically increase demand for HPV tests in 2021, which it may not be feasible to meet because of competing demands on the testing machines and reagents due to COVID tests. These findings can inform future prioritisation strategies for catch-up that balance potential constraints on resourcing with clinical need.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Uterine Cervical Neoplasms / Papillomavirus Infections / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans Language: English Journal: Prev Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Uterine Cervical Neoplasms / Papillomavirus Infections / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans Language: English Journal: Prev Med Year: 2021 Document Type: Article