Management of cancer screening services during the COVID-19 pandemic

The first wave of COVID-19 led to a scarcity of healthcare resources, and one measure was the pausing of cancer screening programs across Canada. This disruption will lead to cancers being found at a later stage, resulting in poorer health outcomes for many patients. Integrating high value and innovative practices will help to safeguard cancer screening as an essential service, and will support the cancer screening system’s resilience throughout the pandemic, or future pandemics.

To support cancer screening services, the Partnership, in collaboration and consultation with the cancer screening community, governments and government agencies, and patient and family advisors, has identified the best available evidence and expert recommendations for continued service provision and prioritization during future outbreaks or service disruptions in the guidance document Management of Cancer Screening Services During the COVID-19 Pandemic and Building Resilient, Safer and Equitable Screening Services.

Guidance on building resilient screening services and programs

The primary recommendations provided by expert advisors and stakeholders are as follows.

• Managing screening programs when dealing with constrained resources
• Using evidence to focus screening activities on people who stand to benefit the most
• Delivering cancer screening programs in a culture of safety
• Using digital health to optimize the screening journey
• Increasing access to care closer to home
• Supporting healthcare providers
• Supporting communities

Addressing inequities in cancer screening

The COVID-19 pandemic has disproportionately affected some populations in Canada. There is a risk that inequities in access to cancer screening will be exacerbated. Efforts to support screening resilience must address inequities in access to high-quality, timely, and safe screening across the country, and not further deepen the disparities that already exist.

To demonstrate progress towards equitable access to cancer screening services, decision makers are encouraged to:

• Understand the different inequities that exist across communities, the extended marginalization of diverse populations, as well as the impact of systemic racism and other personal and intergenerational experiences with trauma.
• Work with First Nations, Inuit, and Métis and other diverse populations to co-create services, leverage community-based supports and adjust services to meet the needs of communities against the changing face of the pandemic.
• Explore opportunities to provide care closer to home, especially for those living in remote and very remote locations in Canada who experience reduced access to care during the pandemic.

While these recommendations can support planning for continued cancer screening services during the COVID-19 pandemic, and advance efforts to improve access for underserviced populations, there is more work to be done. Leveraging the recommendations in this guidance document on managing cancer screening services will build capacity to respond to healthcare challenges and opportunities afforded by the pandemic, enable focused and co-created interventions to reach those most in need, and improve screening access and health for all people living in Canada.

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