Future challenges and opportunities for cancer screening in the COVID-19 era

Objectives: The COVID-19 pandemic undermines health service provision and poses threats to health systems in general. This study aims to investigate the early and long-term effects of COVID-19 on cancer screening. Method: We conducted a scoping review, in which we nested the Futures Wheel (FW) method and the Future Polygon (FP) method. PubMed, SCOPUS, and Web of Sciences databases were searched electronically to identify relevant studies published between 1 January 2020 and 25 July 2023. The FW method was applied to identify the early and long-term effects; the FP was applied during a focus group discussion with a group of experts with a view to estimating the lag time between COVID-19 and its effects on cancer screening. Results: A total of 79 studies met the inclusion criteria. We identified 31 early effects and 26 long-term effects of COVID-19, and divided them into four clusters: screening centers, at-risk persons, screening methods, and clinical staff. The first long-term effects of COVID-19 involve a tendency to shift from hospital-based to home-based screening, accompanied by an acceleration in the application of remote screening methods and emerging psychological problems among clinical staff. This may result in an increase in the number of people with serious oncological conditions, more intensive use of advanced therapeutic interventions, higher expenditure and worsening of treatment outcomes. Conclusion: The effects of COVID-19 on cancer screening and its long-term effects on cancer treatment and its outcomes are ominous. A redesign of cancer screening programs may be required so as to make them more flexible and resilient to external shocks.