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. 2023 Sep 4:12:e86358.
doi: 10.7554/eLife.86358.

Examining the perceived impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study

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Examining the perceived impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study

Lindsay Fuzzell et al. Elife. .

Abstract

Background: The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed methods study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers (FQHCs).

Methods: Between October 2021 and June 2022, we conducted a national web survey of clinicians (physicians and advanced practice providers) who performed cervical cancer screening in FQHCs in the United States during the post-acute phase of the COVID-19 pandemic, along with a sub-set of qualitative interviews via video conference, to examine perceived changes in cervical cancer screening practices during the pandemic.

Results: A total of 148 clinicians completed surveys; a subset (n=13) completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021- July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients. Compared to clinicians in Obstetrics/Gynecology/Women's health, those in family medicine and other specialties more often reported reduced screening compared to pre-pandemic. Most (92%) felt that screening using HPV self-sampling would be very or somewhat helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement.

Conclusions: Findings highlight that in late 2021 and early 2022, many clinicians in FQHCs reported reduced cervical cancer screening and of pandemic-related staffing shortages impacting screening and follow-up. If not addressed, reduced screenings among underserved populations could worsen cervical cancer disparities in the future.

Funding: This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.

Keywords: COVID-19 pandemic; Human papillomavirus; cervical cancer; epidemiology; federally qualified health center; global health; medicine; screening; viruses.

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Conflict of interest statement

LF, PL, NB, HF, AW, AM, MM, SR, SK, SV, RP No competing interests declared

Figures

Figure 1.
Figure 1.. Study flow chart depicting participant exclusions and final analytic sample.
Figure 2.
Figure 2.. Forest plots depicting clinician & practice characteristics associated with odds of reporting conducting the same amount or more cervical cancer screening now/in 2021 vs before the pandemic.

Update of

  • doi: 10.1101/2023.01.27.23285111

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