Impact of the COVID-19 pandemic on cancer screening in Europe: a systematic review of disruptions, barriers, and policy responses
File(s)
Published version (pre-proof)
Author(s)
Wang, Zeyu
REN, Bohua
Rawaf, Salman
Tabche, Celine
Type
Journal Article
Abstract
Background
Cancer screening is a cornerstone of cancer control, but the COVID-19 pandemic caused unprecedented disruption to preventive healthcare worldwide. In Europe, national screening programmes were severely affected, with consequences extending beyond screening to diagnosis, treatment, and equity. While several country-specific studies exist, cross-regional syntheses remain scarce. Understanding the scale, determinants, and outcomes of these disruptions is crucial to building resilient, equiTable screening systems.
Aim/objective
This systematic review synthesises evidence on the impact of the COVID-19 pandemic on cancer screening across Europe, examining differences by cancer type, screening modality, and national context. It also explores downstream effects, barriers, enablers, and policy responses to guide future preparedness.
Methods
Following PRISMA guidelines, six databases and grey literature sources were searched for studies published between December 2019 and January 2025. Eligible studies included quantitative and qualitative analyses of screening activity during the pandemic. Data were extracted on study characteristics, outcomes, and contextual factors. Given the heterogeneity of measures, findings were summarised using descriptive statistics and thematic synthesis.
Result
Forty-five studies from 18 European countries revealed a 30-60% reduction in screening participation at peak disruption, varying by cancer type and country. Consequences included delayed diagnoses, stage migration, increased projected mortality, and widening inequalities. Major barriers included service suspension, staff redeployment, and fear of infection. Enablers comprised adaptive communication, safety protocols, and digital innovations.
Conclusion
COVID-19 caused substantial and uneven disruption to European cancer screening. Protecting continuity, institutionalising innovations, and addressing inequities are critical to enhancing resilience for future health crises.
Cancer screening is a cornerstone of cancer control, but the COVID-19 pandemic caused unprecedented disruption to preventive healthcare worldwide. In Europe, national screening programmes were severely affected, with consequences extending beyond screening to diagnosis, treatment, and equity. While several country-specific studies exist, cross-regional syntheses remain scarce. Understanding the scale, determinants, and outcomes of these disruptions is crucial to building resilient, equiTable screening systems.
Aim/objective
This systematic review synthesises evidence on the impact of the COVID-19 pandemic on cancer screening across Europe, examining differences by cancer type, screening modality, and national context. It also explores downstream effects, barriers, enablers, and policy responses to guide future preparedness.
Methods
Following PRISMA guidelines, six databases and grey literature sources were searched for studies published between December 2019 and January 2025. Eligible studies included quantitative and qualitative analyses of screening activity during the pandemic. Data were extracted on study characteristics, outcomes, and contextual factors. Given the heterogeneity of measures, findings were summarised using descriptive statistics and thematic synthesis.
Result
Forty-five studies from 18 European countries revealed a 30-60% reduction in screening participation at peak disruption, varying by cancer type and country. Consequences included delayed diagnoses, stage migration, increased projected mortality, and widening inequalities. Major barriers included service suspension, staff redeployment, and fear of infection. Enablers comprised adaptive communication, safety protocols, and digital innovations.
Conclusion
COVID-19 caused substantial and uneven disruption to European cancer screening. Protecting continuity, institutionalising innovations, and addressing inequities are critical to enhancing resilience for future health crises.
Date Issued
2026-01-24
Date Acceptance
2026-01-22
Citation
Cancer Treatment and Research Communications, 2026
ISSN
2468-2942
Publisher
Elsevier
Journal / Book Title
Cancer Treatment and Research Communications
Copyright Statement
© 2026 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Highlights • Cancer screening participation in Europe declined by 30–60% at the peak of the COVID 19 pandemic. • Breast screening was most affected, followed by cervical and colorectal programmes. • Disruptions led to missed diagnoses, stage migration, and increased inequality. • Major barriers included service suspension, workforce redeployment, and fear of infection. • Recovery was faster in countries using self-sampling, digital tools, and community outreach. • Findings provide policy guidance for building resilient and equitable screening systems.
Publication Status
Published online
Article Number
101115
Date Publish Online
2026-01-24