ASPO Abstracts
The association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic (March-December 2021)
Category: Behavioral Science & Health Communication
Conference Year: 2023
Abstract Body:
Purpose of the study: To elucidate factors associated with perceived changes in cervical cancer screening and colposcopy during the COVID-19 pandemic among clinicians and advanced practice professionals who perform cervical cancer screening and abnormal results follow-up. Methods: Using cross-sectional national surveys, clinicians responded to items about whether they were performing fewer, the same, or more cervical cancer screenings and colposcopies in 2021 compared to pre-pandemic. We used separate binomial logistic regression models to determine factors associated with perceptions of conducting fewer (versus the same or more) screenings, and colposcopies in 2021. We conducted qualitative interviews with a subset of clinicians to further explore pandemic-related changes in screening and colposcopy. Interviews were transcribed and coded using thematic content analysis. Results: From March-August 2021, 1,251 clinicians completed surveys, including 675 clinicians who performed colposcopy; a sub-set of 55 clinicians completed qualitative interviews from June-December 2021. Over one year into the pandemic, 47% of all clinicians reported they were currently performing fewer cervical cancer screenings than before the pandemic. 44.1% of colposcopists reported fewer colposcopies than pre-pandemic. One-fifth (18.6%) of colposcopists reported performing fewer LEEPs than prior to the pandemic, while 1.3% reported no longer being able to offer LEEP at their facility. Older, non-white, internal medicine and family medicine clinicians (compared to OB-GYNs), and those in community health centers (compared to private practice) had higher odds of reporting reduced cervical cancer screenings. Among colposcopists, males, internal medicine physicians, those at community health centers, and in the South had higher odds of reporting reduced colposcopies. Qualitative interviews highlighted pandemic-related care disruptions and lack of tracking systems. Conclusions: Reductions in cervical cancer screening and colposcopy among nearly half of clinicians more than one year into the pandemic raise concerns that inadequate screening will lead to increases in preventable cancers. The healthcare workforce should be supported to provide cancer screenings in addition to managing acute care
Keywords: COVID-19 pandemic, cervical cancer screening, colposcopy