The Impact of COVID-19 on Cervical Cancer Screening in Primary Care

Introduction: The COVID-19 pandemic has reduced the number of elective in-person visits to primary care practices. This study examined how the pandemic may have affected cervical cancer (CC) screening rates in primary care settings across the United States. Methods: We conducted a retrospective cross-sectional study using data from the PRIME Registry of the American Board of Family Medicine from March 15, 2017, to March 14, 2022. We included 2,207,355 women aged 21 to 65 years who had visited a clinician (n = 1,052) from any of 472 primary care practices. We compared CC screening rates among eligible women during in-person visits over the 3 prepandemic years with those during the 2 years of the pandemic. Results: Screening rates (per 100 eligible patients with in-person visits) decreased from 1.85 to 1.12 in the first quarter of the first year and remained lower throughout both years of the pandemic compared with prepandemic year, had not returned to prepandemic levels by the end of the second year. Hispanic or Latino (odds ratio [OR] = 1.96) and Black or African American (OR = 1.37) women were more likely to be screened, whereas those receiving care from male clinicians (OR = 0.34) were less likely to be screened. Conclusions: CC screening rates remained below prepandemic levels throughout the 2 years of the pandemic. Policy makers and health care professionals should strategize approaches to enhance CC screening rates, including the exploration of alternative methods, such as home-based CC screening. New screening approaches are needed to ensure preparedness for future health crises.