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.


Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. https://creativecommons.org/licenses/by/4.0/

Cite as

Castanon, A., Rebolj, M., Burger, E., de Kok, I., Smith, M., Hanley, S., Carozzi, F., Peacock, S. & O'Mahony, J. 2021, 'Cervical screening during the COVID-19 pandemic: optimising recovery strategies', Lancet Public Health, 6(7), pp. E522-E527. https://doi.org/10.1016/S2468-2667(21)00078-5

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Last updated: 27 January 2023
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