The COVID-19 pandemic had a major effect on access to gynecologic care for women of all races and ethnicities, according to a study. Peter Ketch, MD, Teresa Boitano, MD, and colleagues found that two-thirds of women received delayed care or did not adhere to care. “The greatest difference was seen with Black women who were adherent less than 20% of the time,” the study authors wrote.
The study team evaluated the pandemic’s impact on women’s preventative healthcare with regards to cervical cancer screening. They conducted a retrospective chart review, analyzing a randomized selection of women scheduled for a colposcopy from February 2020-January 2021 (COVID group, N=77) compared with those scheduled for the procedure the year prior (pre-COVID group, N=237).
Nearly 40% Decrease Noted in Patients Presenting for Colposcopy
Patients were sorted into three categories: 1) Adherent, for following up after their scheduled appointment; 2) Delayed, for presenting more than 3 months after their original referral; and 3) Not Adherent, for not keeping their appointment after referral.
“During the study period, we saw a 39.5% decrease in patients presenting for their scheduled colposcopy appointment,” the study authors wrote. “Within the COVID group, 71.2% of were Not Adherent or Delayed in their care compared with 57.4% in the pre-COVID group. There were no major differences in race, age, or Pap abnormality between the groups.”
Need Exists to Assess Barriers to Care & Targeted Interventions to Narrow Gap
Most women in the study were Black (65.2%), followed by non-Hispanic Whites (20.0%) and Latinx (14.8%). “Overall, 81.8% of Black women were either Delayed or Not Adherent during COVID compared with 61.5% and 50.0% of White and Hispanic women, respectively,” the researchers noted, adding that this was the case in the pre-COVID group, where Black women were more likely to be Not Adherent (45.6%) and Hispanic women had the highest rate of Delayed presentation (28.1%). In the COVID group, however, they observed that all races and ethnicities had a higher percentage of being Not Adherent (Black, 47.7%; White, 61.5%; and Hispanic, 42.9%) compared with the pre-COVID group (Black, 46.6%; White, 35.6%; and Hispanic, 15.6%).
“Moving forward, it will be especially important to provide culturally relevant assessment of barriers to care and targeted interventions to narrow the gap and reach these women who were lost to care,” the researchers wrote.