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A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions

We evaluated how temporary disruptions to primary cervical cancer (CC) screening services may differentially impact women due to heterogeneity in their screening history and test modality. We used three CC models to project the short- and long-term health impacts assuming an underlying primary scree...

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Autores principales: Burger, Emily A, de Kok, Inge MCM, O'Mahony, James F, Rebolj, Matejka, Jansen, Erik EL, de Bondt, Daniel D, Killen, James, Hanley, Sharon J, Castanon, Alejandra, Regan, Mary Caroline, Kim, Jane J, Canfell, Karen, Smith, Megan A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: eLife Sciences Publications, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9555861/
https://www.ncbi.nlm.nih.gov/pubmed/36222673
http://dx.doi.org/10.7554/eLife.81711
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author Burger, Emily A
de Kok, Inge MCM
O'Mahony, James F
Rebolj, Matejka
Jansen, Erik EL
de Bondt, Daniel D
Killen, James
Hanley, Sharon J
Castanon, Alejandra
Regan, Mary Caroline
Kim, Jane J
Canfell, Karen
Smith, Megan A
author_facet Burger, Emily A
de Kok, Inge MCM
O'Mahony, James F
Rebolj, Matejka
Jansen, Erik EL
de Bondt, Daniel D
Killen, James
Hanley, Sharon J
Castanon, Alejandra
Regan, Mary Caroline
Kim, Jane J
Canfell, Karen
Smith, Megan A
author_sort Burger, Emily A
collection PubMed
description We evaluated how temporary disruptions to primary cervical cancer (CC) screening services may differentially impact women due to heterogeneity in their screening history and test modality. We used three CC models to project the short- and long-term health impacts assuming an underlying primary screening frequency (i.e., 1, 3, 5, or 10 yearly) under three alternative COVID-19-related screening disruption scenarios (i.e., 1-, 2-, or 5-year delay) versus no delay in the context of both cytology-based and human papillomavirus (HPV)-based screening. Models projected a relative increase in symptomatically detected cancer cases during a 1-year delay period that was 38% higher (Policy1-Cervix), 80% higher (Harvard), and 170% higher (MISCAN-Cervix) for underscreened women whose last cytology screen was 5 years prior to the disruption period compared with guidelines-compliant women (i.e., last screen 3 years prior to disruption). Over a woman’s lifetime, temporary COVID-19-related delays had less impact on lifetime risk of developing CC than screening frequency and test modality; however, CC risks increased disproportionately the longer time had elapsed since a woman’s last screen at the time of the disruption. Excess risks for a given delay period were generally lower for HPV-based screeners than for cytology-based screeners. Our independent models predicted that the main drivers of CC risk were screening frequency and screening modality, and the overall impact of disruptions from the pandemic on CC outcomes may be small. However, screening disruptions disproportionately affect underscreened women, underpinning the importance of reaching such women as a critical area of focus, regardless of temporary disruptions.
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spelling pubmed-95558612022-10-13 A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions Burger, Emily A de Kok, Inge MCM O'Mahony, James F Rebolj, Matejka Jansen, Erik EL de Bondt, Daniel D Killen, James Hanley, Sharon J Castanon, Alejandra Regan, Mary Caroline Kim, Jane J Canfell, Karen Smith, Megan A eLife Computational and Systems Biology We evaluated how temporary disruptions to primary cervical cancer (CC) screening services may differentially impact women due to heterogeneity in their screening history and test modality. We used three CC models to project the short- and long-term health impacts assuming an underlying primary screening frequency (i.e., 1, 3, 5, or 10 yearly) under three alternative COVID-19-related screening disruption scenarios (i.e., 1-, 2-, or 5-year delay) versus no delay in the context of both cytology-based and human papillomavirus (HPV)-based screening. Models projected a relative increase in symptomatically detected cancer cases during a 1-year delay period that was 38% higher (Policy1-Cervix), 80% higher (Harvard), and 170% higher (MISCAN-Cervix) for underscreened women whose last cytology screen was 5 years prior to the disruption period compared with guidelines-compliant women (i.e., last screen 3 years prior to disruption). Over a woman’s lifetime, temporary COVID-19-related delays had less impact on lifetime risk of developing CC than screening frequency and test modality; however, CC risks increased disproportionately the longer time had elapsed since a woman’s last screen at the time of the disruption. Excess risks for a given delay period were generally lower for HPV-based screeners than for cytology-based screeners. Our independent models predicted that the main drivers of CC risk were screening frequency and screening modality, and the overall impact of disruptions from the pandemic on CC outcomes may be small. However, screening disruptions disproportionately affect underscreened women, underpinning the importance of reaching such women as a critical area of focus, regardless of temporary disruptions. eLife Sciences Publications, Ltd 2022-10-12 /pmc/articles/PMC9555861/ /pubmed/36222673 http://dx.doi.org/10.7554/eLife.81711 Text en © 2022, Burger et al https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Computational and Systems Biology
Burger, Emily A
de Kok, Inge MCM
O'Mahony, James F
Rebolj, Matejka
Jansen, Erik EL
de Bondt, Daniel D
Killen, James
Hanley, Sharon J
Castanon, Alejandra
Regan, Mary Caroline
Kim, Jane J
Canfell, Karen
Smith, Megan A
A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
title A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
title_full A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
title_fullStr A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
title_full_unstemmed A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
title_short A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
title_sort model-based analysis of the health impacts of covid-19 disruptions to primary cervical screening by time since last screen for current and future disruptions
topic Computational and Systems Biology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9555861/
https://www.ncbi.nlm.nih.gov/pubmed/36222673
http://dx.doi.org/10.7554/eLife.81711
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