Effects of cancer screening restart strategies after COVID-19 disruption

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Background: Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods: Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results: The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions: Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.

Original languageEnglish
Pages (from-to)1516-1523
Number of pages8
JournalBritish Journal of Cancer
Issue number9
Publication statusPublished - 27 Apr 2021

Bibliographical note

Funding information: This research was funded by the Centre for Population Screening (CvB) of the Dutch National Institute for Public Health and the Environment (RIVM). The funding source had no involvement in the study design, modelling decisions, interpretation of the results, writing of the report, or in the decision to submit the paper for publication.

Publisher Copyright: © 2021, The Author(s).


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