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. 2021 Aug;128(9):1503-1510.
doi: 10.1111/1471-0528.16741. Epub 2021 May 31.

The impact of the COVID-19 pandemic on the Ontario Cervical Screening Program, colposcopy and treatment services in Ontario, Canada: a population-based study

O Meggetto  1 , N Jembere  1 , J Gao  1 , M J Walker  1   2 , M Rey  1 , L Rabeneck  1   3 , K J Murphy  1   4 , R Kupets  1   5 ; Ontario Cervical Screening Program/Colposcopy COVID-19 Working Group
Affiliations

The impact of the COVID-19 pandemic on the Ontario Cervical Screening Program, colposcopy and treatment services in Ontario, Canada: a population-based study

O Meggetto et al. BJOG. 2021 Aug.

Abstract

Objective: To describe the immediate impact of the COVID-19 pandemic on cervical screening, colposcopy and treatment volumes in Ontario, Canada.

Design: Population-based retrospective observational study.

Setting: Ontario, Canada.

Population: People with a cervix age of 21-69 years who completed at least one cervical screening cytology test, colposcopy or treatment procedure for cervical dysplasia between January 2019 and August 2020.

Methods: Administrative databases were used to compare cervical screening cytology, colposcopy and treatment procedure volumes before (historical comparator) and during the first 6 months of the COVID-19 pandemic (March-August 2020).

Main outcome measures: Changes in cervical screening cytology, colposcopy and treatment volumes; individuals with high-grade cytology awaiting colposcopy.

Results: During the first 6 months of the COVID-19 pandemic, the monthly average number of cervical screening cytology tests, colposcopies and treatments decreased by 63.8% (range: -92.3 to -41.0%), 39.7% (range: -75.1 to -14.3%) and 31.1% (range: -43.5 to -23.6%), respectively, when compared with the corresponding months in 2019. Between March and August 2020, on average 292 (-51.0%) fewer high-grade cytological abnormalities were detected through screening each month. As of August 2020, 1159 (29.2%) individuals with high-grade screening cytology were awaiting follow-up colposcopy.

Conclusions: The COVID-19 pandemic has had a substantial impact on key cervical screening and follow-up services in Ontario. As the pandemic continues, ongoing monitoring of service utilisation to inform system response and recovery is required. Future efforts to understand the impact of COVID-19-related disruptions on cervical cancer outcomes will be needed.

Tweetable abstract: COVID-19 has had a substantial impact on cervical screening and follow-up services in Ontario, Canada.

Keywords: COVID-19; Cervical screening; colposcopy; cytology; service utilisation.

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Figures

Figure 1
Figure 1
Cervical screening cytology tests completed in Ontario between January and August 2019 versus January and August 2020.
Figure 2
Figure 2
Colposcopy procedures completed in Ontario between January and August 2019 versus January and August 2020.
Figure 3
Figure 3
Cervical treatment procedures completed in Ontario between January and August 2019 versus January to August 2020.
See this image and copyright information in PMC

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