Cervical Cancer Screening in the United States Military Health System During the COVID-19 Pandemic

Introduction During the COVID-19 pandemic, healthcare systems implemented restrictions on in-person appointments to mitigate viral spread among healthcare workers and patients. This study assesses changes in cervical cancer screening (CCS) rates within the United States Military Health System (MHS) during this period. To date, no such data have been reported on COVID-19's effect on CCS within the MHS. Methods This retrospective cohort study compares CCS rates from the pandemic period of February 1, 2020, to February 28, 2022, to a pre-pandemic cohort spanning January 1, 2013, to January 31, 2020. Screening rates were analyzed using interrupted time series and regression methods. Results Results indicate a statistically significant decline in adequately screened patients, dropping from 77.9% (684,923 of 879,091 eligible patients) in January 2013 to 70.0% (457,109 of 652,507 eligible patients) in February 2021 (p<0.05). A statistically significant drop was also noted when comparing February 2020 (76.5%, 583,941 of 763,692 eligible patients) to February 2021 (70.0%, 457,109 of 652,507 eligible patients; p<0.05) and to February 2022 (72.3%, 496,100 of 686,029 eligible patients; p<0.05). The average pre-pandemic CCS rate of 75.5% significantly differed from the pandemic period's average of 73.3% (p<0.00001), representing 17,452 patients with inadequate screening during the pandemic. Conclusion This study highlights a substantial reduction in CCS within the MHS during the COVID-19 pandemic, aligning with national trends in cancer screening. It underscores the need for sustained healthcare access during crises and emphasizes the importance of planning to uphold essential preventative services. Future research should explore strategies to mitigate pandemic-related disruptions in cancer screening and their long-term implications on public health.