Cancer Screening in the Postpandemic Era: Lessons from Disruption and a Path Forward

The COVID-19 pandemic exposed critical vulnerabilities in cancer screening systems while revealing strategies that enabled resilience. Analysis of data from the National Cancer Institute's Population-based Research to Optimize the Screening Process (PROSPR) consortium across 10 US health systems documented dramatic declines in cervical, colorectal, and lung cancer screening during April to May 2020, with some sites experiencing drops of up to 96%. Systems with established mailed fecal testing programs recovered more rapidly, underscoring the value of home-based screening infrastructure. Drawing on these findings, this commentary outlines actionable strategies for sustaining cancer screening during future public health emergencies: expanding home-based testing options, implementing risk-stratified prioritization frameworks, leveraging digital communication tools, investing in telehealth infrastructure, strengthening patient navigation and community partnerships, and reducing structural barriers through extended hours and mobile services. These strategies are not solely crisis measures. They represent best practices for equitable, patient-centered care delivery in ordinary circumstances. As future disruptions are inevitable, health systems must proactively embed these approaches, conduct regular preparedness planning, and invest in research to model long-term impacts on cancer outcomes. Doing so will protect continuity of care, particularly for the most vulnerable populations. See related article by Del Vecchio et al., p. 1527.