Decline of cytology-based cervical cancer screening for COVID-19: A single-center peruvian experience

Introduction Cervical cancer is the second most frequent malignant disease in the Peruvian female population, and the Papanicolaou test is its main screening tool. However, the COVID-19 pandemic can hinder cervical cancer screening, reducing its scope. Objective To analyze the decline of Papanicolaou-based cervical cancer screening due to COVID-19 in a specialized hospital in Lima. Methods We designed a retrospective study (from 2015 to 2020) on 355 029 Papanicolaou smears at the Hospital Nacional Madre Nino San Bartolomé. T-test and one-way ANOVA were used to define differences in the study period and Ljung-Box test with ARIMA (1,0,0) model to describe and forecast monthly expected Papanicolaou smears for 2020. Results Throughout the six years of the study, the average Papanicolaou smears was 59 171.5 ± 8898.7 per year. However, in 2020 only 16 273 (4.58%) Papanicolaou tests were performed with a monthly mean of 1356.1 ± 684.2 (95% confidence interval 149.7 to 2861.9) (p < 0.001). The forecast showed 66 960 Papanicolaou smears for 2020 and a monthly mean of 5580 ± 129.3. Actual screenings during that year were only 16 273 Papanicolaou smears, resulting in a 76.7% reduction in cervical cancer screening during the pandemic. Conclusions Our results suggest a dramatic decrease in cervical cancer screening based on Papanicolaou smears during 2020 in Peru due to prevention and control measures against COVID-19.