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

Alejandra Castanon*, Matejka Rebolj, Emily Annika Burger, Inge M.C.M. de Kok, Megan A. Smith, Sharon J.B. Hanley, Francesca Maria Carozzi, Stuart Peacock, James F. O'Mahony

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

12 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)e522-e527
JournalThe Lancet Public Health
Issue number7
Publication statusPublished - 30 Apr 2021


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