J Gynecol Oncol.  2023 Jan;34(1):e7. 10.3802/jgo.2023.34.e7.

Monitoring the activities of Italian colposcopy clinics before and during the COVID-19 pandemic

• Carpini GD
• Rossi PG
• Giannella L
• Giuseppe JD
• Clemente N
• Sopracordevole F
• Barbero M
• Bogani G
• Vincenzo RD
• Origoni M
• Cantatore F
• Gardella B
• Dominoni M
• Monti E
• Liverani CA
• Viscardi A
• Pagan A
• Amadori A
• Alessi C
• Andolfatto M
• Cattani P
• Pieralli A
• Stevenazzi G
• Ciavattini A

• KMID: 2552486
• DOI: http://doi.org/10.3802/jgo.2023.34.e7

Abstract

Objective
To evaluate the impact of healthcare reorganization during the severe acute respiratory syndrome coronavirus 2 pandemic on Italian colposcopy clinic activities, focusing on cervical excision procedures, follow-ups for conservative management of low-grade lesions, and follow-ups post cervical excision.
Methods
Retrospective study conducted in 14 Italian colposcopy clinics. The number and clinical characteristics of cervical excisions, follow-ups for conservative management of low-grade lesions, and follow-ups after cervical excision were compared between the period March 1, 2019 to February 29, 2020 (pre-pandemic) and March 1, 2020 to February 28, 2021 (pandemic) with a Poisson regression analysis.
Results
In the pandemic period, the number of cervical excisions was reduced by 8.8% (95% confidence interval [CI]=−15.6% to −2%; p=0.011). Excisions were less frequently performed in the operating room (−35.1%; 95% CI=−47.6% to −22.6%; p<0.001), the number of patients from spontaneous screening was reduced by −14.0% (95% CI=−23.4% to −4.6%; p=0.003), and the CO2-laser technique was used less frequently (−30%; 95% CI=−45.1% to −15.0%; p<0.001). As compared to the pre-pandemic period, the number of follow-ups for conservative management of low-grade lesions was reduced by −26.7% (95% CI=−39.0% to −14.4%; p<0.001), and the follow-up appointments after cervical excision were reduced by −51.0% (95% CI=−58.1% to −43.9%; p<0.001).
Conclusion
The most significant impact of the healthcare reorganization during the coronavirus disease 2019 pandemic was on follow-ups after cervical excision. The resumption of disrupted activities should follow a risk-based prioritization, starting from women in follow-up after cervical excision. It is advisable that the trend of performing cervical excision as an outpatient procedure is maintained in the post-pandemic period.

Keyword

Colposcopy; Cervical Cancer; COVID-19 Pandemic; Conization; Screening