DOI: 10.20518/tjph.1837346 ISSN: 1304-1088

The impact of the COVID-19 pandemic on preventive health services: A five-year assessment of cancer screening in Ankara, Türkiye

Hüsna Sarıca Çevik, Gülsüm Öztürk Emiral, Süleyman Özsarı
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Objective: This study evaluated the impact of the COVID-19 pandemic on population-based breast, colorectal, and cervical cancer screening programs in Ankara, by analysing the five-year screening rates.Method: This descriptive study used routinely collected data from the Ankara Provincial Health Directorate and included HPV, mammography, and faecal occult blood testing (FOBT) results between 2018-2022. The population at risk was obtained from official address-based population statistics. Annual screening rates per 100 individuals were calculated, and trend changes were evaluated using Joinpoint regression analysis.Results: A total of 261,895 HPV, 182,347 mammography, and 228,040 FOBT tests were evaluated. Screening rates declined severely in 2020. HPV screening rates decreased from 4.8 per 100 in 2019 to 1.54 in 2020 (-67.9%). Mammography dropped from 4.9 to 1.5 per 100 (-69.4%), and FOBT from 5.9 to 1.7 per 100 (-71.2%). Across all screening programs, 2020 marked a statistically significant turning point (joinpoint) in the observed screening trends (p<0.05). Partial recovery occurred in 2021–2022: HPV reached 3.0 per 100 (+165% increase from 2021), mammography 4.8 per 100 (+182%), and FOBT 6.6 per 100 (+267%). Only FOBT exceeded pre-pandemic levels, while HPV and mammography screenings remained below baselines. HPV positivity rose to 7.5% in 2020 despite reduced screening volume, whereas FOBT positivity showed year-to-year variability (2.5-6.6%).Conclusion: The pandemic caused major disruptions in cancer screening in Ankara, with 68-71% declines during 2019-2020 and incomplete recovery by 2022 for HPV and mammography. Developing resilient, adaptable screening systems and catch-up strategies to strengthen population-level cancer control efforts for future public health crises is essential.

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