The impact of the Covid-19 pandemic on Italian population-based cancer screening activities and test coverage: results from national cross-sectional repeated surveys

Abstract

Background<br />In Italy, population-based screening programs for breast, cervical and colorectal cancers are mandatory, and Regions are in charge of their delivery. From March to May 2020, a severe lockdown was imposed due to the Covid-19 pandemic by the Italian Ministry of Health, with the suspension of screening programs. This paper describes the impact of the pandemic on Italian screening activities and test coverage in 2020.<br /><br />Methods<br />The regional number of subjects invited and of screening tests performed in 2020 were compared with those in 2019. Invitation and examination coverage were also calculated. PASSI surveillance system, through telephone interviews, investigated the population screening test coverage, before and during the pandemic, accordingly to educational attainment, perceived economic difficulties and citizenship.<br /><br />Results<br />A reduction of subjects invited and tests performed, with differences among periods and geographic macro areas, was observed in 2020 vs. 2019. The reduction in examination coverage was larger than that in invitation coverage for all screening campaigns. From the second half of 2020, the trend for test coverage showed a decrease in all the macro areas for all the screening campaigns. Compared with the pre-pandemic period, there was a greater difference according to level of education in the odds of having had a test last year vs. never having been screened or not being up to date with screening tests. In addition, foreigners had less access to screening than Italians did.<br /><br />Conclusions<br />The lockdown and the ongoing Covid-19 emergency caused an important delay in screening activities. This increased the pre-existing individual and geographical inequalities in access. The opportunistic screening did not mitigate the pandemic impact.<br /><br /> FundingThis study was partially supported by Italian Ministry of Health – Ricerca Corrente Annual Program 2023.

Equity in the recovery of elective and oncological surgery volumes after the COVID-19 lockdown: a multicentre cohort study in Italy

“…At the national level, the sustained contraction of oncological surgery, especially the breast cancer surgery, can be partially explained by the important delays in the organised screening activities caused by the lockdown first and the ongoing COVID-19 emergency later [18]. Additionally, this decrease in the organised screening testing has been reported to be unequal, that is greater among the lower educated and the immigrants [19]. The good news is that volumes of most of the indicators of planned surgery considered in this study came back to pre-pandemic levels.…”

Equity in the recovery of elective and oncological surgery volumes after the COVID-19 lockdown: a multicentre cohort study in Italy

“…At the national level, the sustained contraction of oncological surgery, especially the breast cancer surgery, can be partially explained by the important delays in the organised screening activities caused by the lockdown rst and the ongoing COVID-19 emergency later 18 . Additionally, this decrease in the organised screening testing has been reported to be unequal, that is greater among the lower educated and the immigrants 19 .…”

Surviving the Storm: The Impact of COVID-19 on Cervical Cancer Screening in Low- and Middle-Income Countries

“…The strain on healthcare systems caused by the pandemic is expected to disproportionately impact LMICs with limited resources. While the impact of the COVID-19 pandemic on cancer screening in high-income countries is well-documented [9][10][11][12][13][14], less is known about LMICs primarily due to insufficient research and documentation. Based on the limited evidence available, LMICs such as Bangladesh, Morocco, and Argentina also experienced a substantial reduction in cancer screening uptake [15].…”