A modelled evaluation of the impact of COVID-19 on breast, bowel, and cervical cancer screening programmes in Australia - Research article

Sep 24, 2026

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Australia implemented COVID-19 infection prevention and control measures in early 2020 and commissioned a modelled evaluation to support health services. Using the Policy1 modelling platforms, the study predicts outcomes from disruptions to breast, bowel, and cervical cancer screening participation across 3, 6, 9, and 12-month periods. It estimates missed screens, cancer incidence and tumour staging, and diagnostic service impacts, showing substantial reductions for breast and colorectal diagnoses alongside increased cervical diagnoses. Maintaining screening participation is emphasized to prevent population-level cancer burden increases and to inform future programme decisions.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Abstract

Editor's evaluation

Introduction

RESEARCH ARTICLE *For correspondence: [Carolyn.Nickson@nswcc.org.au](Carolyn.Nickson@nswcc.org.au)[ ](Carolyn.Nickson@nswcc.org.au)(CN); [louizav@nswcc.org.au](louizav@nswcc.org.au) (LSV) Competing interest: See page 12 Funding: See page 12 Received: 18 August 2022 Preprinted: 15 September 2022 Accepted: 18 March 2023 Published: 06 April 2023 Reviewing Editor: Talía Malagón, McGill University, Canada Copyright Nickson et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use andredistribution provided that the original author and source are credited. A modelled evaluation of the impact of COVID-19 on breast, bowel, and cervical cancer screening programmes in Australia Carolyn Nickson1,2*, Megan A Smith1, Eleonora Feletto1, Louiza S Velentzis1,2*, Kate Broun3, Sabine Deij1,2, Paul Grogan1, Michaela Hall1, Emily He1, D James St John3,4, Jie-Bin Lew1, Pietro Procopio1,2, Kate T Simms1, Joachim Worthington1, G Bruce Mann5,6, Karen Canfell1 1 Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia; 2 Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; 3 Prevention Division, Cancer Council Victoria, Melbourne, Australia; 4 Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; 5 Breast Service, The Royal Women's and Royal Melbourne Hospital, Melbourne, Australia; 6 Department of Surgery, University of Melbourne, Melbourne, Australia | Abstract Australia introduced COVID-19 infection prevention and control measures in early 2020. To help prepare health services, the Australian Government Department of Health commissioned a modelled evaluation of the impact of disruptions to population breast, bowel, and cervical cancer screening programmes on cancer outcomes and cancer services. We used the Policy1 modelling platforms to predict outcomes for potential disruptions to cancer screening participation, covering periods of 3, 6, 9, and 12 mo. We estimated missed screens, clinical outcomes (cancer incidence, tumour staging), and various diagnostic service impacts. We found that a 12-mo screening disruption would reduce breast cancer diagnoses (9.3% population-level reduction over 2020–2021) and colorectal cancer (up to 12.1% reduction over 2020–21), and increase cervical cancer diagnoses (up to 3.6% over 2020–2022), with upstaging expected for these cancer types (2, 1.4, and 6.8% for breast, cervical, and colorectal cancers, respectively) . Findings for 6–12-mo disruption scenarios illustrate that maintaining screening participation is critical to preventing an increase in the burden of cancer at a population level. We provide programme-specific insights into which outcomes are expected to change, when changes are likely to become apparent, and likely downstream impacts. This evaluation provided evidence to guide decision-making for screening programmes and emphasises the ongoing benefits of maintaining screening in the face of potential future disruptions. | | --- | | Editor's evaluation
This study presents important results on predicted impact of cancer screening disruptions in Australia during the COVID-19 pandemic based on rapid-response consultation with public health stakeholders. The evidence presented is solid as simulations were based on several previously validated breast, cervical, and bowel cancer screening decision models. Although the scenarios were based on hypothetical disruptions that do not always match experienced disruptions, the work will be of interest to local policymakers, public health specialists, and cancer epidemiologists. | Nickson et al. eLife 2023;12:e82818. DOI: [https://doi.org/10.7554/eLife.82818](https://doi.org/10.7554/eLife.82818) 1 of 15 Research article Epidemiology and Global Health Introduction Population cancer screening programmes aim to reduce cancer-

FAQs

What was the purpose of the modelled evaluation in Australia?

To predict how disruptions to breast, bowel, and cervical cancer screening programmes could affect cancer outcomes and cancer services, supporting preparedness for COVID-19-related disruptions.

What disruption timeframes were analyzed for screening participation?

The study modeled potential disruptions over 3, 6, 9, and 12 months.

What were the main predicted effects of a 12-month screening disruption?

A 12-month disruption was predicted to reduce breast cancer diagnoses (9.3% over 2020–2021) and colorectal cancer diagnoses (up to 12.1% over 2020–2021), while increasing cervical cancer diagnoses (up to 3.6% over 2020–2022), with expected upstaging for these cancers.

Sep 24, 2026

Upload by Eliana