EHS-COVID (375) Impact of COVID-19 on cancer services (6) Cancer screening services (3)

4 June, 2021

Throughout this discussion we are using the WHO guidance as our reference document. We also hear from our WHO colleagues that an updated version is planned, which gives all of us the opportunity to provide feedback on how the current guidance can be improved. https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-essential...

The following guidance on cervical screening is given on page 30 in the section on Sexual and reproductive health services:

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- See specific adaptations for HPV vaccination found in the WHO and UNICEF frequently asked questions (57). [*see note below]

- Promote self-sampling for HPV testing, facilitating the collection of specimens through pharmacies or drop-offs at facilities. Promote online advice after a negative screening test and adequate management after a positive screening test.

- Utilize a single-visit approach to screen for and treat precancerous lesions, if the capacity exists and services can be safely delivered.

- Prioritize screening access for women living with HIV.

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Further guidance is given on page 34 in the section on Noncommunicable diseases (page 34):

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Cancer screening (cervical, breast, colorectal)

- Modify and consider temporarily delaying cancer screening programmes, particularly those that are facility based.

- Consider promotion of home-based, self-sampling for cervical cancer (HPV test) and colorectal cancer in settings with appropriate infrastructure and capacity.

- Maintain communication with and diagnostic follow up for those who have a screening test. Remote support can be utilized for counselling after a negative test and planning for management after a positive test. Screening for high-risk individuals (such as cervical cancer screening for women living with HIV) may be prioritized.

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[*Note from HIFA moderator (Neil PW): 57 appears to be the incorrect reference and I was unable to find the correct source for WHO and UNICEF frequently asked questions]

I invite HIFA members to comment on the guidance. How might it be improved in future editions?

Best wishes, Neil

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org