• Kea Turner, TabrizAmir AlishahiAA, Young-Rock Hong, Brandylyn Arredondo, Usha Menon, Karim Hanna, Susan Vadaparampil, Shannon Christy, Jessica Islam, Melody Chavez, Jennifer Kue, and Laura Szalacha.
• Ann Fam Med. 2022 Apr 1; 20 (20 Suppl 1).

AbstractContext: The COVID-19 pandemic required primary care practices to rapidly adapt cancer screening procedures to comply with changing guidelines and policies. Objective: This study sought to: 1) identify cancer screening barriers and facilitators during the COVID-19 pandemic; 2) describe cancer screening adaptations; and 3) provide recommendations. Study design: A qualitative study was conducted (n= 42) with primary care staff. Individual interviews were conducted through videoconference from August 2020 - April 2021 and recorded, transcribed, and analyzed for themes using NVivo 12 Plus. Setting: Primary care practices included federally qualified health centers, tribal health centers, rural health clinics, hospital/health system-owned, and academic medical centers located across ten states including urban (55%) and rural (45%) sites. Population studied: Primary care staff included physicians (n=13), residents (n=10), advanced practice providers (n=9), and administrators (n=10). Outcome measures: The interviews assessed perceptions about cancer screening barriers and facilitators, necessary adaptations, and future recommendations. Results: Barriers to cancer screening included delays in primary and specialty care, staff shortages, lack of personal protective equipment, patient hesitancy to receive in-person care, postal service delays for mail-home testing, COVID-19 travel restrictions (for Mexico-US border-crossing patients) and organizational policies (e.g., required COVID-19 testing prior to screening). Facilitators included better care coordination and collaboration due to the pandemic and more time during telehealth visits to discuss cancer screening compared to in-person visits. Adaptations included delayed screening, patient triage (e.g., prioritizing patients overdue for screening), telehealth visits to discuss cancer screening, mail-home testing, coordinating cancer screenings (e.g., providing fecal immunochemical test materials during cervical cancer screening) and same-day cancer screening. Recommendations included more public health education about the importance of cancer screening during COVID-19, more mail-home testing, and expanded healthcare access (e.g., weekend clinic) to address patient backlogs for cancer screening. Conclusions: Primary care staff developed innovative strategies to adapt cancer screening during the COVID-19 pandemic. Unresolved challenges (e.g., patient backlogs) will require additional implementation stra.© 2021 Annals of Family Medicine, Inc.

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