Impact of COVID-19 on cervical cancer screening: A cohort study

Reduction of cancer screening volume has been reported globally during the COVID-19 pandemic. We aim to investigate the impact of interruption in cervical cancer screening during the pandemic on women's health.

We conducted a multicenter, retrospective cohort study of all female participants who received a Papanicolaou (Pap) test at two hospitals in Taiwan. The study compared the total volume of Pap smears, screening location, positive Pap smear rate, and time to diagnosis between the prepandemic (from 2017 to 2019) and pandemic (from 2020 to 2022) cohorts.

Overall cervical cancer screening volume decreased by 4.5 % during the pandemic (87 259 vs 79 724). The abnormal Pap smear rate increased from 2.44 % to 3.61 % in the pandemic cohort. Within this subgroup, a significant increase in the proportion of ASCUS and AGC/AIS was reported in the pandemic cohort, as was a decrease in cancer diagnosis rate. A delay of 6.67 days in time to definitive diagnosis was also observed during the pandemic. In subgroup analysis, screening from a mobile vehicle was major contributing factor for Hospital B to maintain a consistent total number of screenings during the pandemic.

The COVID-19 pandemic is associated with increased abnormal Pap smear rates and a substantial reduction of total screened volume. The study highlights the value of proactive measures-such as implementing mobile vehicle screenings for the high risk or underserved population-for maintaining essential health-care services and screening programs during global health emergencies to minimize the consequences of disruptions in cancer screenings.