International Agency for Research on Cancer, Lyon, France.
Section Colorectal Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
JCO Glob Oncol. 2021 Mar;7:416-424. doi: 10.1200/GO.21.00033.
The coronavirus-induced pandemic has put great pressure on health systems worldwide. Nonemergency health services, such as cancer screening, have been scaled down or withheld as a result of travel restrictions and resources being redirected to manage the pandemic. The present article discusses the challenges to cancer screening implementation in the pandemic environment, suggesting ways to optimize services for breast, cervical, and colorectal cancer screening.
The manuscript was drafted by a team of public health specialists with expertise in implementation and monitoring of cancer screening. A scoping review of literature revealed the lack of comprehensive guidance on continuation of cancer screening in the midst of waxing and waning of infection. The recommendations in the present article were based on the advisories issued by different health agencies and professional bodies and the authors' understanding of the best practices to maintain quality-assured cancer screening.
A well-coordinated approach is required to ensure that essential health services such as cancer management are maintained and elective services are not threatened, especially because of resource constraints. In the context of cancer screening, a few changes in invitation strategies, screening and management protocols and program governance need to be considered to fit into the new normal situation. Restoring public trust in providing efficient and safe services should be one of the key mandates for screening program reorganization. This may be a good opportunity to introduce innovations (eg, telehealth) and consider de-implementing non-evidence-based practices. It is necessary to consider increased spending on primary health care and incorporating screening services in basic health package.
The article provides guidance on reorganization of screening policies, governance, implementation, and program monitoring.
冠状病毒引发的大流行给全球卫生系统带来了巨大压力。由于旅行限制和资源重新用于管理大流行，非紧急卫生服务（如癌症筛查）已被缩减或暂停。本文讨论了在大流行环境下实施癌症筛查所面临的挑战，并就优化乳腺癌、宫颈癌和结直肠癌筛查服务提出了建议。
本文由公共卫生专家团队撰写，他们在癌症筛查的实施和监测方面具有专业知识。文献范围综述揭示了在感染时起时落的情况下，缺乏有关癌症筛查持续进行的综合指导。本文中的建议基于不同卫生机构和专业机构发布的建议以及作者对维持质量保证的癌症筛查的最佳实践的理解。
需要采取协调一致的方法，以确保维持基本的卫生服务，如癌症管理，并确保非选择性服务不会受到威胁，特别是因为资源有限。在癌症筛查方面，需要考虑对邀请策略、筛查和管理方案以及方案治理进行一些调整，以适应新的正常情况。恢复公众对提供高效和安全服务的信任应该是筛查方案重组的关键任务之一。这可能是引入创新（例如远程医疗）和考虑取消非基于证据的实践的好机会。有必要考虑增加对初级卫生保健的支出，并将筛查服务纳入基本卫生套餐中。
本文提供了有关重新组织筛查政策、治理、实施和方案监测的指导。
