Quantification of impact of COVID-19 pandemic on cancer screening programmes -a case study from Argentina, Bangladesh, Colombia, Morocco, Sri Lanka and Thailand

Abstract It is quite well-documented that the COVID-19 pandemic disrupted cancer screening services in all countries, irrespective of their resources and healthcare settings. While quantitative estimates on reduction in volume of screening tests or diagnostic evaluation are readily available from the high-income countries, very little data is available from the low- and middle-income countries (LMICs). From the CanScreen5 global cancer screening data repository we identified six LMICs through purposive sampling based on the availability of cancer screening data at least for the years 2019 and 2020. These countries represented different human development index (HDI) categories and were from Asia (Bangladesh and Thailand), Africa (Morocco) and Latin America (Argentina and Colombia). The reduction in the volume of tests in 2020 compared to the previous years ranged from 14.1% in Bangladesh to 72.9% in Argentina (regional programme) for cervical screening, from 14.1% in Bangladesh to 52.2% in Morocco for breast cancer screening and 30.7% in Thailand for colorectal cancer screening. Number of colposcopies was reduced in 2020 compared to previous year by 88.9% in Argentina, 38.2% in Colombia, 27.4% in Bangladesh and 52.3% in Morocco. The reduction in detection rates of CIN 2 or worse lesions ranged from 20.7% in Morocco to 45.4% in Argentina. Reduction of breast cancer detection by 19.2% was reported from Morocco. No association of the impact of pandemic could be seen with HDI categories. Quantifying the impact of service disruptions in screening and diagnostic tests will allow the programmes to strategize how to ramp up services to clear the backlogs in screening and more crucially in further evaluation of screen-positives. The data can be used to estimate the impact on stage distribution and avoidable mortality from these common cancers.