Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review

BackgroundCancer screening tests are recommended to prevent cancer-associated mortality by detecting precancerous and cancerous lesions in early stages. The COVID-19 pandemic disrupted the use of preventive health care services. Although there was an increase in the number of...

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Main Authors: Sumit K Shah, Pearl A McElfish
Format: Article
Language:English
Published: JMIR Publications 2022-02-01
Series:JMIR Cancer
Online Access:https://cancer.jmir.org/2022/1/e34392
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author Sumit K Shah
Pearl A McElfish
author_facet Sumit K Shah
Pearl A McElfish
author_sort Sumit K Shah
collection DOAJ
description BackgroundCancer screening tests are recommended to prevent cancer-associated mortality by detecting precancerous and cancerous lesions in early stages. The COVID-19 pandemic disrupted the use of preventive health care services. Although there was an increase in the number of cancer screening tests beginning in late 2020, screenings remained 29% to 36% lower than in the prepandemic era. ObjectiveThe aim of this review is to assist health care providers in identifying approaches for prioritizing patients and increasing breast, cervical, and colorectal cancer screening during the uncertainty of the COVID-19 pandemic. MethodsWe used the scoping review framework to identify articles on PubMed and EBSCO databases. A total of 403 articles were identified, and 23 articles were selected for this review. The literature review ranged from January 1, 2020, to September 30, 2021. ResultsThe articles included two primary categories of recommendations: (1) risk stratification and triage to prioritize screenings and (2) alternative methods to conduct cancer screenings. Risk stratification and triage recommendations focused on prioritizing high-risk patients with an abnormal or suspicious result on the previous screening test, patients in certain age groups and sex, patients with a personal medical or family cancer history, patients that are currently symptomatic, and patients that are predisposed to hereditary cancers and cancer-causing mutations. Other recommended strategies included identifying areas facing the most disparities, creating algorithms and using artificial intelligence to create cancer risk scores, leveraging in-person visits to assess cancer risk, and providing the option of open access screenings where patients can schedule screenings and can be assigned a priority category by health care staff. Some recommended using telemedicine to categorize patients and determine screening eligibility for patients with new complaints. Several articles noted the importance of implementing preventive measures such as COVID-19 screening prior to the procedures, maintaining hygiene measures, and social distancing in waiting rooms. Alternative screening methods that do not require an in-person clinic visit and can effectively screen patients for cancers included mailing self-collection sampling kits for cervical and colorectal cancers, and implementing or expanding mobile screening units. ConclusionsAlthough the COVID-19 pandemic had devastating effects on population health globally, it could be an opportunity to adapt and evolve cancer screening methods. Disruption often creates innovation, and focus on alternative methods for cancer screenings may help reach rural and underresourced areas after the pandemic has ended.
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spelling doaj.art-1d99cbf5146a4be7af1c1192f894b9c12023-08-28T20:52:27ZengJMIR PublicationsJMIR Cancer2369-19992022-02-0181e3439210.2196/34392Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping ReviewSumit K Shahhttps://orcid.org/0000-0003-2916-8045Pearl A McElfishhttps://orcid.org/0000-0002-4033-6241 BackgroundCancer screening tests are recommended to prevent cancer-associated mortality by detecting precancerous and cancerous lesions in early stages. The COVID-19 pandemic disrupted the use of preventive health care services. Although there was an increase in the number of cancer screening tests beginning in late 2020, screenings remained 29% to 36% lower than in the prepandemic era. ObjectiveThe aim of this review is to assist health care providers in identifying approaches for prioritizing patients and increasing breast, cervical, and colorectal cancer screening during the uncertainty of the COVID-19 pandemic. MethodsWe used the scoping review framework to identify articles on PubMed and EBSCO databases. A total of 403 articles were identified, and 23 articles were selected for this review. The literature review ranged from January 1, 2020, to September 30, 2021. ResultsThe articles included two primary categories of recommendations: (1) risk stratification and triage to prioritize screenings and (2) alternative methods to conduct cancer screenings. Risk stratification and triage recommendations focused on prioritizing high-risk patients with an abnormal or suspicious result on the previous screening test, patients in certain age groups and sex, patients with a personal medical or family cancer history, patients that are currently symptomatic, and patients that are predisposed to hereditary cancers and cancer-causing mutations. Other recommended strategies included identifying areas facing the most disparities, creating algorithms and using artificial intelligence to create cancer risk scores, leveraging in-person visits to assess cancer risk, and providing the option of open access screenings where patients can schedule screenings and can be assigned a priority category by health care staff. Some recommended using telemedicine to categorize patients and determine screening eligibility for patients with new complaints. Several articles noted the importance of implementing preventive measures such as COVID-19 screening prior to the procedures, maintaining hygiene measures, and social distancing in waiting rooms. Alternative screening methods that do not require an in-person clinic visit and can effectively screen patients for cancers included mailing self-collection sampling kits for cervical and colorectal cancers, and implementing or expanding mobile screening units. ConclusionsAlthough the COVID-19 pandemic had devastating effects on population health globally, it could be an opportunity to adapt and evolve cancer screening methods. Disruption often creates innovation, and focus on alternative methods for cancer screenings may help reach rural and underresourced areas after the pandemic has ended.https://cancer.jmir.org/2022/1/e34392
spellingShingle Sumit K Shah
Pearl A McElfish
Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review
JMIR Cancer
title Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review
title_full Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review
title_fullStr Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review
title_full_unstemmed Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review
title_short Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review
title_sort cancer screening recommendations during the covid 19 pandemic scoping review
url https://cancer.jmir.org/2022/1/e34392
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