Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Linda Niccolai

Second Advisor

Daniel Weinberger


INTRODUCTION: Cervical cancer is almost entirely preventable through a combination of vaccination, timely screening, and treatment. There is strong evidence that cervical cancer screening services were disrupted during the COVID-19 pandemic; these disruptions may lead to preventable increases in cases of high-grade squamous intraepithelial lesions of the cervix (HSIL cases), cervical cancer cases, and cervical cancer deaths. OBJECTIVE: The objective of this analysis was to offer insight into possible future trends in HSIL cases, cervical cancer cases, and cervical cancer deaths. METHODS: A model was built to simulate cervical cancer progression and was fit to data on HSIL cases, cervical cancer cases, and cervical cancer deaths reported in 2008 and 2016. A disruption due to COVID-19 that reduced screening based on a range of plausible values was introduced into the model and the impact on cases of HSIL, cervical cancer, and cervical cancer deaths was observed. RESULTS: A substantial increase in total HSIL cases (combined undetected and detected), cervical cancer cases, and cervical cancer deaths may be expected due to this disruption (4.2%, 6.7%, and 4.9%, respectively, in the next 5 years). However, the number of detected HSIL cases may decrease (-3.4%), potentially masking the true impact from medical providers and public health practitioners. CONCLUSIONS: There may be a decrease in detected HSIL cases in the coming years, but the true number of HSIL cases is likely to increase, as are cervical cancer cases and cervical cancer deaths. Results could inform efforts to reach patients who missed screening and aid in interpretation of surveillance and registry data in coming years.


This is an Open Access Thesis.

Open Access

This Article is Open Access