Examining the impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study

Abstract

AbstractBackgroundThe COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed method study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers.MethodsBetween October 2021 and June 2022, a national sample of 148 clinicians completed surveys; a subset (n=13) clinicians completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021-July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients.ResultsCompared to clinicians in OBGYN/Women’s health, those in family medicine and other specialties were less likely to report maintaining or increasing screening compared to pre-pandemic. Advanced practice providers (compared to MDs/DOs,) and Hispanic/Latinx/other clinicians (compared to white non-Hispanic) were more likely to report maintaining or increasing screening vs. pre-pandemic. Most (91%) felt that screening using HPV self-sampling would be helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement.ConclusionsIdentifying barriers to screening and instituting solutions in federally qualified health centers is critical to preventing cervical cancers among patients at highest risk.FundingThis study was funded by the American Cancer Society, who had no role in the study’s design, conduct, or reporting.