Resilience and adaptation of cancer screening programs to external crises.

ObjectivesTo examine how cancer screening programs resumed during the COVID-19 pandemic, focusing on their resilience in terms of coordination, communication, recovery, participation rates, catch-up efforts, inequities, and preparedness.SettingCancer screening programs represented in the International Cancer Screening Network.MethodsFour cancer-specific questionnaires were developed, piloted, and distributed via SurveyMonkey to purposively selected program managers between February and July 2022. Responses from 79 programs (37% response rate) were aggregated by cancer type and screening delivery mode. Descriptive analyses summarized coordination/prioritization, operational capacity, participation/follow-up rates, communication, catch-up, inequities, and preparedness. Comparisons were made across cancer types and screening delivery, and open comments and shared documents provided contextual insights.ResultsMost programs (52%) were organized and resumed driven primarily by government decisions (57%). Nearly all organized programs resumed by July 2020, with faster recovery to full capacity compared to non-organized settings. Most programs had to adapt their screening services (75%) focusing on infection control, and breast and lung programs recovered capacity quicker than cervical and colorectal. Reduction in participation rates varied by cancer type and organization, and colorectal programs reported less impact. Debriefs (40%) and publication of the data (31%) were the most common preparedness actions, while 21% of the programs reported no preparations.ConclusionsCancer screening programs demonstrated moderate absorptive and adaptive capacity with organized programs resuming faster but experiencing higher reduction in participation rates compared to non-organized screening. Findings highlight the need to integrate resilience and preparedness into the development and management of screening programs to mitigate future disruptions.