Cancer screening during the COVID-19 pandemic: A systematic review and meta-analysis.

Objective: To assess the impact of measures designed to mitigate the spread of COVID-19 on worldwide cancer screening. Patient and Methods: We systematically searched PubMed.gov, Ovid Medline, the Cochrane COVID-19 study register, ClinicalTrials.gov, and Embase without language restrictions for studies published between January 1, 2021 and February 10, 2021. Studies were selected for full text review which contained data on patients screened for any type of cancer during the COVID-19 pandemic and comparison data from a time interval just prior to the pandemic. Data was obtained through dual extraction. All the included studies were assessed for quality and risk of bias. A meta-analysis was performed on 13 studies: seven on screening mammography; five on colon cancer screening, and three on cervical cancer screening. The screening outcomes were reported as pooled incidence rates ratios using the inverse variance method and random effects models. All studies included in our meta-analysis reported the number of patients screened for cancer in defined time intervals before and during the COVID-19 pandemic. Results: Incidence rate ratios (IRRs) were significantly lower for screening during the COVID-19 pandemic for breast cancer (0.63, 95% CI=.53,.77, P=<.001), colon cancer (0.11, 95% CI=.05,.24, P=<.001), and cervical cancer (0.10, 95% CI =.04,.24,P=< 0.001). Conclusion: We found moderate level evidence showing significant decreases in cancer screening for breast, colon, and cervical cancers during the COVID-19 pandemic, which may add further morbidity and mortality to this public health crisis.