Loeb Anisha M, Gravitt Patti, Frank Allison, Puricelli Perin Douglas M, Duncan Kalina, Eckert Linda, Almonte Maribel, Broutet Nathalie, Rodman Joseph, Oyebamiji Oyeleke A, Adsul Prajakta
Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America.
Center for Global Health, National Cancer Institute, Rockville, Maryland, United States of America.
PLOS Glob Public Health. 2025 Apr 28;5(4):e0004419. doi: 10.1371/journal.pgph.0004419. eCollection 2025.
The COVID-19 pandemic disrupted many public health programs; understanding these disruptions is critical for directing future resources. In a project studying the implementation of human papillomavirus (HPV) testing-based cervical cancer screening, we queried about the impact of the pandemic on screening programs globally. In consultation with World Health Organization's Regional Advisors, program managers, government officials, and clinicians involved in the implementation of HPV testing-based cervical cancer screening programs were invited to participate in semi-structured, in-depth, interviews. Interview notes and transcripts were used for inductive analysis, focusing on responses to the impact of COVID-19 pandemic on screening programs. Thirty-two interviews were conducted with participants between the age of 29 and 61 years, representing programs from 25 countries. Six key themes were noted. Regarding disruptions, (1) the entire cancer continuum was affected, leading to delays or, in some cases even cessation of vaccination, screening, and treatment programs; and (2) a heightened sense of fear around contracting and transmitting COVID-19 shifted government priorities and impacted healthcare delivery. Nonetheless, participants noted constructive ways in which programs leveraged the impact of the pandemic: (1) at the community level, participants were able to leverage an increased understanding and acceptance surrounding the importance of preventive health behaviors; (2) for HPV-testing: molecular laboratories became well-equipped with better technician training, increasing overall HPV-testing capacities; (3) the pandemic promoted virtual healthcare systems; and (4) for planning: shutdowns allowed time to plan for program scale-up. In many ways, the pandemic response provided evidence supporting countries' abilities to mobilize resources. While disruptions were noted, the pandemic provided implementers with opportunities to strengthen screening programs, which should be further assessed in future sustainability research on cervical cancer prevention and control.
新冠疫情扰乱了许多公共卫生项目；了解这些干扰因素对于指导未来资源分配至关重要。在一个研究基于人乳头瘤病毒（HPV）检测的宫颈癌筛查实施情况的项目中，我们询问了疫情对全球筛查项目的影响。经与世界卫生组织区域顾问协商，邀请参与基于HPV检测的宫颈癌筛查项目实施的项目经理、政府官员和临床医生参加半结构化的深入访谈。访谈记录和文字记录用于归纳分析，重点关注对新冠疫情对筛查项目影响的回应。对年龄在29岁至61岁之间的参与者进行了32次访谈，他们代表了来自25个国家的项目。注意到六个关键主题。关于干扰因素，（1）整个癌症防治连续过程受到影响，导致疫苗接种、筛查和治疗项目延迟，在某些情况下甚至停止；（2）对感染和传播新冠病毒的高度恐惧改变了政府的优先事项并影响了医疗服务的提供。尽管如此，参与者指出了项目利用疫情影响的建设性方式：（1）在社区层面，参与者能够利用人们对预防性健康行为重要性的理解和接受度的提高；（2）对于HPV检测：分子实验室因技术人员培训更好而设备完善，提高了整体HPV检测能力；（3）疫情推动了虚拟医疗系统的发展；（4）对于规划：停工使得有时间规划项目的扩大规模。在许多方面，疫情应对提供了支持各国调动资源能力的证据。虽然注意到了干扰因素，但疫情为实施者提供了加强筛查项目的机会，这一点应在未来宫颈癌预防和控制的可持续性研究中进一步评估。
