Robles Claudia, Monfil Laura, Ibáñez Raquel, Roura Esther, Font Rebeca, Peremiquel-Trillas Paula, Brotons Maria, Martínez-Bueno Cristina, de Sanjosé Silvia, Espinàs Josep Alfons, Bruni Laia
Unit of Infections and Cancer - Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d'Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP - CB06/02/0073), Madrid, Spain.
Front Oncol. 2024 May 29;14:1338859. doi: 10.3389/fonc.2024.1338859. eCollection 2024.
The COVID-19 pandemic led to a national lockdown and the interruption of all cancer preventive services, including cervical cancer screening. We aimed to assess the COVID-19 pandemic impact on opportunistic screening participation, abnormal cytology (ASCUS+) prevalence and screening interval in 2020 and 2021 within the Public Health System of Catalonia, Spain.
Individual data on cytology and HPV testing of women aged 25-65 from 2014 to 2021 were retrieved from the Information System for Primary Care Services (SISAP). Time-series regression models were used to estimate expected screening participation and abnormal cytology prevalence in 2020 and 2021. The impact was determined by comparing observed and expected values (ratios). Additionally, changes in screening interval trends between 2014 and 2021 were assessed by fitting a Piecewise linear regression model.
Cervical cancer screening participation decreased by 38.8% and 2.2% in 2020 and 2021, respectively, with the most significant impact on participation (-96.1%) occurring in April 2020. Among older women, participation was lower, and it took longer to recover. Abnormal cytology prevalence was 1.4 times higher than expected in 2020 and 2021, with variations by age (range=1.1-1.5). From June 2020 onwards, the screening interval trend significantly changed from an increase of 0.59 to 3.57 months per year, resulting in a median time of 48 months by December 2021.
During the pandemic, fewer women have participated in cervical cancer screening, abnormal cytology prevalence has increased, and the screening interval is more prolonged than before. The potential cervical cancer lifetime risk implications highlight the need for organized HPV-based screening.
新冠疫情导致全国封锁，所有癌症预防服务中断，包括宫颈癌筛查。我们旨在评估2020年和2021年新冠疫情对西班牙加泰罗尼亚公共卫生系统中机会性筛查参与率、异常细胞学（非典型鳞状细胞及以上，ASCUS+）患病率和筛查间隔的影响。
从初级保健服务信息系统（SISAP）中检索2014年至2021年25至65岁女性的细胞学和HPV检测个体数据。采用时间序列回归模型估计2020年和2021年的预期筛查参与率和异常细胞学患病率。通过比较观察值和预期值（比率）来确定影响。此外，通过拟合分段线性回归模型评估2014年至2021年筛查间隔趋势的变化。
2020年和2021年宫颈癌筛查参与率分别下降了38.8%和2.2%，2020年4月参与率下降最为显著（-96.1%）。老年女性的参与率较低，恢复所需时间更长。2020年和2021年异常细胞学患病率比预期高1.4倍，因年龄而异（范围为1.1至1.5）。从2020年6月起，筛查间隔趋势从每年增加0.59个月显著变为增加3.57个月，到2021年12月中位时间为48个月。
在疫情期间，参与宫颈癌筛查的女性减少，异常细胞学患病率增加，筛查间隔比以前延长。宫颈癌终身潜在风险影响凸显了开展有组织的基于HPV的筛查的必要性。
