TY - JOUR T1 - Delivering cervical cancer screening during the COVID-19 emergency JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health DO - 10.1136/bmjsrh-2021-201099 SP - bmjsrh-2021-201099 AU - Cecilia Acuti Martellucci AU - Margherita Morettini AU - Maria Elena Flacco AU - Lamberto Manzoli AU - Matthew Palmer AU - Giusi Giacomini AU - Francesca Pasqualini Y1 - 2021/04/29 UR - http://jfprhc.bmj.com/content/early/2021/04/28/bmjsrh-2021-201099.abstract N2 - Key messagesDuring the SARS-CoV-2 pandemic, conventional cervical cytology (Pap smear) screening flexible-timing invitations were changed to fixed-timing invitations to ensure social distancing.Due to the scheduling change, the number of tests conducted per hour decreased from 4.1 (July–December 2019) to 3.6 (July–December 2020).Nevertheless, the lockdown backlog was successfully addressed through a substantial, but sustainable, reorganisation of obstetrician activities, obtaining performances comparable to 2019.By the end of January 2021, almost 100 million people were infected with SARS-CoV-2 and over two million had died.1 Disruptions in healthcare delivery occurred in most countries as a direct consequence of the pressures posed by overwhelming numbers of COVID-19 cases, and as an indirect effect of strict infection containment measures such as social distancing and lockdowns.2Italian regions halted cervical screening programmes in March 2020, for about 4 months, when only follow-up colposcopies were guaranteed.3 In the province of Ancona, primary conventional cervical cytology (Pap smear) screening was suspended from 9 March to 30 June 2020 as its organisation did not guarantee social distancing.4 Indeed, the programme was based on flexible-timing invitations: assuming an average 50% participation, more women than the available time slots were invited, without strict timings or having to confirm their appointment.5 This implied the possibility of overcrowding in waiting rooms.The pandemic posed a double challenge: while flexible-timing was eliminated to ensure social distancing, a greater number of tests was needed to clear the 16-week backlog. The adopted strategies differed greatly across Italian regions: several already used fixed appointments (with a precise date and time in the invitation letter, in accordance with national recommendations)6 and only had to allocate more time for each test in order to avoid overcrowding. Most of the other regions, which used flexible-timing, moved to fixed appointments, and some programmes required the women … ER -