Change in practice in cervical cancer screening during covid 19 pandemic

ABSTRACT

Objective: This study aims to analyse changes in practice for cervical cancer screening in rural districts of West Bengal before and after the COVID-19 pandemic led to disruption of preventive healthcare services. Design: Retrospective cross-sectional study. Method: Data from March 2019-March 2020 and April 2020-March 2021 was retrospectively analysed from women aged 30-59 years who underwent screening in rural districts of West Bengal as part of Integrated Programme on Non-Communicable Diseases Prevention project, which has been implemented at our institute since March 2017. After onset of nationwide lockdown due to the pandemic, screening services were withheld for 2 months. From June 2020, HPV testing kits (QIAGEN) were distributed and collected by our team of health workers, while maintaining all precautions. Women who tested positive underwent colposcopy with or without treatment (by thermal ablation or LEEP) at their nearby primary health centre by our clinicians. Results: From April 2019-March 2020, 6748 women were screened using either HPV DNA testing (Hybrid Capture 2) or VIA. Cervical samples for HC2 testing were collected from 5581 women, either by provider (57.28%, n = 3197) or self-sampling (42.71%, n = 2384). VIA was done in 1167 women, 25 were positive (2.14%). From the 200 women (3.58%) who were HC2 test positive, colposcopy was performed on 113 women (56.5%). Treatment was done in 87 (76.99%) women. Thermocoagulation was the most common method used (77.02%) followed by LEEP (21.8%). From June 2020-March 2021, 5875 women were screened using only self-sampling method for HPV testing, of which 268 were HC2 positive (4.56%), of whom 183 (68.28%) underwent colposcopy. Treatment was done in 149 women (81.4%), thermocoagulation being the most common (81.87%) procedure followed by LEEP (16.77%). Conclusions: HPV self-sampling can be promoted during COVID-19 pandemic as it curtails travel and reduces human contact.