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2022-RA-631-ESGO The impact of COVID 19 on cervical cancer screening and triage
  1. Jessica M Velasquez1,
  2. Katyayani Papatla1,
  3. Elianna Kaplowitz1,
  4. Arielle C Coughlin1,
  5. Alexis L Zachem1,
  6. Cody Goldberger1 and
  7. Stephianie V Blank2
  1. 1Icahn School of Medicine at Mount Sinai, New York, NY
  2. 2Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY


Introduction/Background Prior studies have demonstrated decreased rates of cervical cancer (CC) screening during the height of the COVID-19 pandemic. Delayed CC screening and management may increase incidence and mortality. This study examines the impact of the COVID-19 pandemic on rates of guideline-indicated colposcopy.

Methodology This study used retrospective data from a large, urban, academic institution-based clinic comprised of publicly-insured patients. Patients were non-pregnant, 21 to 65 years old without HIV or other immunocompromise. Three time periods were used: pre-COVID (pC) (3/1/2019–2/28/2020), COVID (C) (3/1/2020–2/28/2021), post-COVID vaccine (pv) (3/1/2021–2/28/2022). Primary outcomes were compared between groups using T-tests or Wilcoxon-Rank Sum tests for continuous measures and Chi-square or Fisher’s exact tests for categorical measures.

Results N=486. The interval between pap smears significantly increased from a pC mean of 490 days, to a C mean of 607 days, to a pv mean of 670 days (p=0.0128). The proportion of patients who underwent guideline-indicated colposcopy did not differ significantly between time periods (p=0.0740). The interval between abnormal pap smear and colposcopy significantly decreased from 104 days pC (SD 69–188) to 67 days C (SD 42–147), to 57 days pv (SD 33–104) (p=0.0001). There were no significant differences in pap smear cytology, colposcopic pathology or rate of referral for excisional procedure over time. There was a significant increase in the percentage of patients being contacted regarding abnormal pap smear results, specifically by by MD providers from 43% pC, to 53% C, to 61.6% pv (P=0.0029).

Conclusion This study demonstrates an increased interval between pap smears; however, those patients undergoing screening had significantly decreased time from pap to colposcopy which may be secondary to increased MD-to-patient telehealth communication and optimization of systems during the pandemic when routine clinics were limited. Future studies are needed to assess long-term outcomes of delayed CC screening on incidence and mortality.

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