Impact of the COVID-19 pandemic on cancer screening in Europe: A systematic review of disruptions, barriers, and policy responses

Zeyu Wang; Bohua Ren; Salman Rawaf; Celine Tabche

doi:10.1016/j.ctarc.2026.101115

Impact of the COVID-19 pandemic on cancer screening in Europe: A systematic review of disruptions, barriers, and policy responses

Cancer Treat Res Commun. 2026 Jan 24:47:101115. doi: 10.1016/j.ctarc.2026.101115. Online ahead of print.

Authors

Zeyu Wang¹, Bohua Ren¹, Salman Rawaf¹, Celine Tabche²

Affiliations

¹ School of Public Health, Imperial College London, London, UK.
² School of Public Health, Imperial College London, London, UK. Electronic address: celine.tabche@imperial.ac.uk.

PMID: 41702131
DOI: 10.1016/j.ctarc.2026.101115

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.

Keywords: Cancer screening; Early detection; Health equity; Health systems resilience; Preventive services.

Publication types

Review