How has COVID-19 impacted cancer screening? Adaptation of services and the future outlook in Australia

Feletto, Eleonora; Grogan, Paul; Nickson, Carolyn; Canfell, Karen

doi:10.17061/phrp3042026

Cited by 47 publications

(51 citation statements)

References 11 publications

(14 reference statements)

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“…In Sweden, during the 1st wave of the COVID epidemic, cervical screening was largely cancelled, including the cancellation of 192 000 cervical screening appointments in Stockholm (42). Concordantly, a number of reports worldwide indicate a precipitous decline in cervical screening (43)(44)(45)(46)(47). The actual and potential consequences of the COVID-19 pandemic vis-à-vis increased cervical cancer incidence, treatment delay and mortality have been underscored (45,48,49).…”

Section: Discussionmentioning

confidence: 98%

“…The actual and potential consequences of the COVID-19 pandemic vis-à-vis increased cervical cancer incidence, treatment delay and mortality have been underscored (45,48,49). Home self-sampling for HPV is widely endorsed as the key strategy to avoid these pandemic-related, adverse consequences (42,44,47,(50)(51)(52)(53). As succinctly stated in a previous study (50): 'The new imperatives of the COVID-19 pandemic support self-sampled HPV testing as the primary cervical screening method'.…”

Section: Discussionmentioning

confidence: 99%

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Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

et al. 2021

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The present study aimed to identify the factors that independently contribute to disease recurrence among women first-time treated for high-grade cervical intraepithelial neoplasia (CIN) during 4-6 years of follow-up. Overall, 529 of 530 eligible patients participated; these patients all attended a 1st follow-up appointment ~6 months post-conization, at which time high-risk human-papillomavirus (HPV) testing, liquid-based cytology and colposcopy were performed. Full data on margin excision status, other aspects of initial treatment and comorbidity were obtained. At least one subsequent follow-up was attended by 88% of patients. A total of 22 recurrent cases were detected during follow-up. Detected recurrence was the outcome of focus for multiple logistic regression analysis, with odds ratios (OR) and 95% confidence intervals (CI) computed. Four significant independent risk factors were identified: Age 45 years or above (OR=3.5, 95% CI=1.3-9.9), one or both unclear or uncertain margins (OR=5.3, 95% CI=2.0-14.2), positive HPV at 1st follow-up (OR=5.8, 95% CI=2.0-16.8), and abnormal cytology at 1st follow-up (OR=3.9, 95% CI=1.4-11.0). Bivariate analysis revealed that persistent HPV positivity was associated with recurrence (P<0.01). These findings indicated that incomplete excision of the CIN lesion may warrant more intensive subsequent screening, regardless of early post-conization HPV findings. Although early post-conization positive HPV was a powerful, independent predictor of recurrent high-grade CIN, over one-third of the patients with detected recurrence had a negative early post-conization HPV finding. These patients returned for routine screening, at which time, in most cases, HPV status was positive, thus indicating the need for repeated HPV evaluation. Especially during the on-going pandemic, home vaginal self-sampling is recommended. Particular attention is required for women aged ≥45 years. In addition, although not statistically significant, relevant comorbidities, especially autoimmune conditions, warrant consideration in clinical decision-making. Women who have been treated for high-grade CIN are at risk for recurrent disease and progression to cervical cancer; therefore, they require careful, individualized follow-up to avoid these adverse consequences.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

et al. 2021

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“…4 9 Examples have been described in Australia, where some programmes mailed kits to women at the request of their provider following a telehealth consultation. 10 The Ancona province is projected to transition to HPV testing in 2022, and thereafter from 3-year to 5-year screening intervals, eventually reducing contacts between clinicians and users. In this context, the use of remote technology coupled with self-sampling (probably mailed at the women's request for those who prefer this method to clinician-collected sampling) could increase uptake, while optimising resource allocation.…”

Section: What Additional Improvements Could Be Made?mentioning

confidence: 99%

Delivering cervical cancer screening during the COVID-19 emergency

Martellucci

Morettini²,

Flacco

et al. 2021

BMJ Sex Reprod Health

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“…Nos Estados Unidos, Califórnia, um estudo de Miller et al (2021) revelou uma redução de 78% na taxa mensal de exames citopatológicos realizados por mulheres entre 21 e 29 anos e de 82% na taxa mensal de TMHPV com citologia, que são realizados em mulheres de 30 a 65 anos. Já na Austrália, Feletto et al (2020) observaram redução na taxa de rastreamento, mas não quantificaram grandes prejuízos devido à mudança do sistema de rastreamento para o TMHPV quinquenalmente, fazendo com que o impacto da pandemia fosse diminuído. Tranberg et al (2018), em estudo randomizado com 9791 mulheres, demonstra essa relação de maior adesão das pacientes quando o exame realizado é o TMHPV em relação ao exame citopatológico.…”

Section: Discussionunclassified

O impacto da pandemia da COVID-19 no rastreamento do câncer de colo uterino em Teresina – PI

Silva

Barros

Lopes

2021

RSD

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O câncer de colo de útero é o quarto tipo de câncer mais frequente em mulheres no mundo e o terceiro tipo de câncer que mais acomete mulheres no Brasil. Essa neoplasia é causada pela infecção pelo papilomavírus humano (HPV) e a prevenção é realizada através da vacinação contra o HPV e de exames de rastreamento. Entretanto, em 2020, com a instalação da pandemia de COVID-19, o rastreamento desse câncer foi afetado pelas restrições nos serviços de saúde. Este artigo tem como objetivo demonstrar o impacto da pandemia no rastreamento do câncer de colo de útero em Teresina – PI, por meio de uma análise comparativa de dados do número de citologias oncóticas realizadas entre março de 2019 e fevereiro de 2021 e do número de casos de COVID-19 registrados entre março de 2020 e fevereiro de 2021. Observou-se uma redução no rastreamento do citado câncer coincidente com o período de restrição de serviços de saúde. Logo, é possível afirmar que a pandemia gerou um grande impacto no rastreamento do câncer de colo de útero, tornando importante a busca ativa de pacientes que apresentavam lesões que necessitavam de seguimento antes da pandemia e das mulheres que não procuraram o serviço de saúde em 2020. Além disso, é importante considerar mudanças no exame utilizado atualmente para o rastreamento do câncer do colo do útero no país, para um que possibilite um maior intervalo no rastreamento.

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How has COVID-19 impacted cancer screening? Adaptation of services and the future outlook in Australia

Cited by 47 publications

References 11 publications

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

Delivering cervical cancer screening during the COVID-19 emergency

O impacto da pandemia da COVID-19 no rastreamento do câncer de colo uterino em Teresina – PI

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