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. 2023 Jul-Aug;37(4):1455-1476.
doi: 10.21873/invivo.13230.

The Impact of the COVID-19 Pandemic on Breast and Cervical Cancer Screening: A Systematic Review

Stylianos Elemes  1 , Panagiotis Stachteas  2 , Anna-Bettina Haidich  3 , Apostolos Mamopoulos  3 , Emmanouil Smyrnakis  4
Affiliations

The Impact of the COVID-19 Pandemic on Breast and Cervical Cancer Screening: A Systematic Review

Stylianos Elemes et al. In Vivo. 2023 Jul-Aug.

Abstract

Background/aim: COVID-19 has dramatically impacted non-pandemic-related care, including preventive medicine. Our objective was to quantify the alterations in the volume of screening tests for breast and cervical cancer during the COVID-19 era compared to pre-pandemic levels. Secondarily, we discussed the causes responsible for this change, presented suggestions for screening optimization and conducted a targeted search of the relevant literature for worsening of future mortality due to screening setback.

Materials and methods: We systematically searched Pubmed, Google Scholar and Epistemonikos for articles in English or Greek, published from March 11th, 2020, until September 14th, 2022, that illustrated quantitative variations of mammograms or Pap/HPV tests. Preprint articles, editorials and speeches were excluded. Quality of included studies was assessed via the JBI critical appraisal checklist for studies reporting prevalence data. The evidence was narratively synthesized.

Results: A total of 56 articles were included, being either observational studies or reports from cancer registries. Large reductions were universally identified, peaked during the first wave but partially persisted after easing of the restrictions.

Conclusion: Our systematic review provides an updated record of the variations in screening volume and approaches screening neglect from a multidimensional perspective answering why it happened and how we could achieve recovery. A strong awareness campaign is proposed, in conjunction with triaging citizens more likely to benefit from screening. Cervical self-sampling is emphasized in the literature. Various studies displayed a potential increase in cancer mortality in the future based on predictive statistical models.

Keywords: COVID-19; Pap test; cancer; mammography; pandemic; review; screening.

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Conflict of interest statement

The Authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1. Flow diagram demonstrating the selection process of appropriate records based to PRISMA 2020 guidelines.
Figure 2
Figure 2. Quality assessment of included articles using JBI checklist for prevalence studies. Y: Yes; N: no; UN: unclear; N/A: not applicable.
Figure 2
Figure 2. Quality assessment of included articles using JBI checklist for prevalence studies. Y: Yes; N: no; UN: unclear; N/A: not applicable.
Figure 2
Figure 2. Quality assessment of included articles using JBI checklist for prevalence studies. Y: Yes; N: no; UN: unclear; N/A: not applicable.
See this image and copyright information in PMC

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