Accelerating Innovations to Build Resilience in Cancer Screening during COVID-19
The COVID-19 pandemic has required jurisdictions to rethink how cancer screening services can be designed in a way that is responsive and resilient to future COVID-19 waves or other interruptions, demonstrates equitable access to screening services, and complies with health and safety measures. To facilitate this, the Partnership made funding available in 2021 to support jurisdictions’ response to the pandemic. Projects were designed to be focused on well-defined activities and be completed over 1-2 years. These projects will help accelerate the uptake of evidence-based innovation which will increase resiliency of screening services.
Seven provinces have participated in the Accelerating Innovations to Build Resilience in Cancer Screening during COVID-19 initiative for cervical cancer screening.
The program is establishing the infrastructure needed to be able to mail at-home cervix screening kits and input HPV test results into the IT system.
The program is working on a project to revise its cervical cancer screening guidelines, including the implementation of liquid-based cytology and HPV reflex testing. The project involves collaboration with internal and external stakeholders, underserved groups and communities to determine an equity-oriented approach for the advancement of HPV primary screening. To convey key messages on cervical cancer prevention, a tailored knowledge translation strategy was developed and delivered.
The key project priorities are to:
- develop and implement updated screening guidelines
- engage clinicians
- raise awareness and educate on the guidelines
- improve provincial laboratory readiness to implement liquid-based cytology
- enhance engagement with underscreened populations in rural and remote areas, new immigrants, Indigenous populations and LGBTQ2S+ individuals
With the goal to improve cervical cancer screening equity, access and planning, the CervixCheck project explores implementation options should the program transition to HPV testing as a primary screening modality. The project will compare the effectiveness of opt-out versus opt-in methods to determine future sustainability and costs of integrated self-sampling. The results will help inform programmatic implementation of self-sampling in the long-term. Never screened and underscreened eligible people will be invited in efforts to reach a population unlikely to see healthcare services.
The key project priorities are to:
- support equitable participation among underserved groups
- minimize interactions with healthcare providers
- adopt evidence-based practices for screenings and follow ups
The program’s project is assessing the feasibility and providing key recommendations for the introduction of HPV self-sampling. It involves defining process maps, reviewing and updating clinical practice guidelines, defining IT infrastructure requirements, reviewing and updating communication and awareness strategies, and identifying budget and human resource needs to support the implementation of HPV self-sampling.
The program’s project is taking a phased approach for transitioning to primary HPV screening. Exacerbated by the COVID-19 pandemic, primary care is heavily burdened. The program aims to relieve some of the pressures on primary care by adopting a programmatic approach for navigating patients through cervical cancer screening, specifically by developing a centrally managed system that consistently gives results and recommends next steps.
This collaborative approach to navigating cervical cancer screening will relieve providers of the sole responsibility for interpretation of results and will enhance the existing patient safety net. A privacy impact assessment will be completed and changes are being made to the IT infrastructure to enable direct communication of screening results to patients and providers.
Prince Edward Island:
The program has launched an initiative to build the infrastructure needed to implement programmatic primary HPV screening and liquid-based cytology triage, with an emphasis on self-sampling. Once implemented, primary HPV testing with the option of self-sampling will be the standard of care across the province.
Newfoundland and Labrador
The program’s project aims to develop a business and operational plan to support the transition from liquid-based cytology to HPV primary screening for cervical cancer. Clinical guidelines will also be updated and education awareness initiatives will be developed for the healthcare community and general public.