Response to COVID-19
The COVID-19 pandemic has had a profound impact on health services across the country, including the reduction or pausing of cancer screening. Jurisdictions have been impacted in different ways, and many have developed innovative tools and processes to respond and adapt to the impact of COVID-19.
The program currently does not offer organized cervical cancer screening. As a result of offering opportunistic cervical cancer screening, delays may have been experienced during COVID-19 due to decreased availability of clinical appointments (non-emergent) and due to staffing shortages and development to support pandemic efforts.
An integrated cancer screening initiative, led by nurse practitioners, has been implemented to provide cervical and colorectal cancer screening using Screen Test mobile screening mammography units in rural and remote communities.
There is an increased interest in providing as much of the colposcopy visit information online as possible. Compared to 2019, Alberta Health Services’ YouTube video about colposcopy visits observed an increase in viewership with the onset of COVID-19.
In spring 2020, the Ontario Ministry of Health paused all non-essential healthcare services (e.g., cancer screening), which resulted in a pause to some cervical screening correspondence letters. The resumption of correspondence for the Ontario Cervical Screening Program began in summer 2021 and as of January 2022 all campaigns (i.e., invitation, recall and reminder letters) have been restarted. The program continues to monitor screening trends and provide supports to Regional Cancer Programs (RCPs) as needed.
Tools that have been developed include:
- Tip sheets for primary care and colposcopy providers to support the gradual resumption and prioritization of cervical screening and colposcopy services. These have been widely distributed and promoted by communities of practice webinars.
- A COVID-19 regional monitoring and planning tool that is shared with RCPs monthly to help monitor and improve COVID-19 recovery metrics (e.g., cervical cytology test volumes, number of people awaiting colposcopy following a high-grade cervical cytology test result, colposcopy and treatment volumes).
The program also developed a media kit with materials (e.g., key messages, robo-call scripts) to support regional public awareness campaigns.
Increased monitoring of cervical screening statistics during the pandemic has shown that cervical screening rates decreased between April and August 2020 but have since returned to pre-COVID-19 rates. Cervical screening correspondence and awareness campaigns were put on hold from March through June 2020 and have since resumed.
Routine cervical cancer screening was suspended from mid-March until mid-June 2020. Reintroduction of cervical cancer screening was based on available local resources. In the central zone, routine Pap screening was limited to patients who were at least three months overdue for their Pap. During the pandemic, new colposcopy visits and those for high-grade abnormalities detected on Pap tests were prioritized and maintained.
Prince Edward Island
The program did not implement new tools and instead adjusted Pap appointments by adding more time for cleaning.