A modelled evaluation of the impact of COVID-19 on breast, bowel, and cervical cancer screening programmes in Australia

Abstract

Australia introduced COVID-19 infection prevention and control measures in early 2020. To help prepare health services, the Australian Government Department of Health commissioned a modelled evaluation of the impact of disruptions to population breast, bowel, and cervical cancer screening programmes on cancer outcomes and cancer services. We used the Policy1 modelling platforms to predict outcomes for potential disruptions to cancer screening participation, covering periods of 3, 6, 9, and 12 mo. We estimated missed screens, clinical outcomes (cancer incidence, tumour staging), and various diagnostic service impacts. We found that a 12-mo screening disruption would reduce breast cancer diagnoses (9.3% population-level reduction over 2020–2021) and colorectal cancer (up to 12.1% reduction over 2020–21), and increase cervical cancer diagnoses (up to 3.6% over 2020–2022), with upstaging expected for these cancer types (2, 1.4, and 6.8% for breast, cervical, and colorectal cancers, respectively). Findings for 6–12-mo disruption scenarios illustrate that maintaining screening participation is critical to preventing an increase in the burden of cancer at a population level. We provide programme-specific insights into which outcomes are expected to change, when changes are likely to become apparent, and likely downstream impacts. This evaluation provided evidence to guide decision-making for screening programmes and emphasises the ongoing benefits of maintaining screening in the face of potential future disruptions.

Disentangling the relationship between cancer mortality and COVID-19 in the US

“…We did not see any delayed pandemic effect on mortality from pancreatic cancer, which may have manifested in 2020 given the very low survival rate of this cancer (Lemanska et al, 2023), but we cannot rule out longer-term effects on breast or colorectal cancers that would not be seen until 2021 or later (Doan et al, 2023;Han et al, 2023;Haribhai et al, 2023;R. Lee et al, 2023;Nascimento de Lima et al, 2023;Nickson et al, 2023;Nonboe et al, 2023;Tope et al, 2023). Additional years of data will be important to evaluate such effects.…”

“…We did not see any delayed pandemic effect on mortality from pancreatic cancer, which may have manifested in 2020 given the very low survival rate of this cancer (Lemanska et al, 2023), but we cannot rule out longer-term effects on breast or colorectal cancers that would not be seen until 2021 or later (Doan et al, 2023;Han et al, 2023;Haribhai et al, 2023;R. Lee et al, 2023;Nascimento de Lima et al, 2023;Nickson et al, 2023;Nonboe et al, 2023;Tope et al, 2023). Interestingly, in the US, all-cause underlying cancer mortality rates do not appear to rise between 2020 and 2023 (Appendix 1 -Figure 10), but data prior to the pandemic show a rise in cancer incidence, largely driven by increasing cancer rates in younger adults (Zhao et al 2023;Siegel et al 2024).…”

Disentangling the relationship between cancer mortality and COVID-19 in the US

“…We did not see any delayed pandemic effect on mortality from pancreatic cancer, which may have manifested in 2020 given the very low survival rate of this cancer (Lemanska et al, 2023 ), but we cannot rule out longer-term effects on breast or colorectal cancers that would not be seen until 2021 or later (Doan et al, 2023 ;Han et al, 2023 ;Haribhai et al, 2023 ;R. Lee et al, 2023 ;Nascimento de Lima et al, 2023 ;Nickson et al, 2023 ;Nonboe et al, 2023 ;Tope et al, 2023 ). Additional years of data will be important to evaluate such effects.…”

Pap Smear Cancer Coverage in Brazilian Capitals including the Pandemic Period Caused by the SARS-CoV-2 Virus: Ecological Study

“…This can be attributed to the impact of the COVID-19 pandemic, which has resulted in mobility restrictions, temporary closures of medical facilities, and concerns about exposure to the virus. The 2021 analysis showed a gradual recovery, indicating a progressive adaptation to the challenges posed by the pandemic [ 29 ]…”

“…This can be attributed to the impact of the COVID-19 pandemic, which has resulted in mobility restrictions, temporary closures of medical facilities, and concerns about exposure to the virus. The 2021 analysis showed a gradual recovery, indicating a progressive adaptation to the challenges posed by the pandemic [29] Data analysis indicates that the pandemic has had a substantial impact on cancer cytology coverage. Mobility restrictions, fear of contagion, and the reorganization of health services have affected the demand and availability of tests.…”