Delivering cancer screening programs in a culture of safety

Infection prevention and control practices should be driven by provincial and territorial policies and procedures, to continue cancer screening safely and effectively.

Recommendation 1: Ensure that masks are worn by patients and staff, and provide hand sanitizing stations.

Key evidence and implementation considerations

• Training for Personal Protective Equipment (PPE) and PPE inventory management is recommended by the European Society of Gastrointestinal Endoscopy (ESGE) and The European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA).
• For endoscopy procedures, the British Society of Gastroenterology recommends that enhanced PPE is used for upper GI endoscopic procedures. Use of PPE for lower GI procedures should consider the screening participant’s risk, symptoms, and their COVID-19 screening result.

Recommendation 2: Ensure screening centres are set up to enable patient flow and adequate physical distancing, and maintain a clean environment.

Key evidence and implementation considerations

• Intensified deep cleaning should be performed to protect staff and screening participants.
• Improve the set up and flow of screening centres, by having:
  • Plexiglass barriers.
  • Physical distancing.
  • Marked places to stand in elevators.
  • Limit the number of people in common areas and waiting rooms.
  • Utilize outdoor safe spaces (e.g., personal vehicle, designated outdoor waiting area) to reduce time spent waiting inside.
  • Schedule additional time in between appointments to ensure adequate time for cleaning and reduce wait times.

Assessing individuals for COVID-19 exposure and symptoms prior to attendance for cancer screening or evaluation can reduce risk of exposure for staff and other individuals.

Recommendation 3: Perform pre-screening for COVID-19 symptoms and possible exposures prior to in-person screening tests.

Key evidence and implementation considerations

• Where available, refer to technical guidance available for healthcare works provided by provincial and territorial
  health ministries.
• Screening and monitoring for signs and risk of COVID-19 infection such as pre-procedure participant screening, postprocedure participant follow-up and daily staff assessment for signs or symptoms of infection.
• Follow local public health guidelines to develop an approach to isolate and test for high risk or infected patients.
• Screening participants should be reminded of COVID-19 protocols prior to their appointment.

Recommendation 4: All healthcare providers should play a role in communicating current information on infection control practices within their clinical setting and responding to concerns of screening participants.

Key evidence and implementation considerations

• It is crucial that hospital-based and community-based GI endoscopy units and clinics develop and adhere to a carefully designed IPAC strategy.
  • All GI endoscopy units and clinics should have an infection prevention and control (IPAC) policy that is aligned with hospital, regional or provincial/territorial guidance.
  • All GI endoscopy units and clinics should monitor for changes in hospital, regional, or provincial guidance and adjust their IPAC policy accordingly.
• Members of the care team which includes screening participants, are encouraged to report and act on screening participants infection control concerns and incidents.
• Incidents are disclosed to the screening participant and/or family as soon as known and documented.
• Incidents are analyzed and acted upon by interdisciplinary teams which include patients.

Learn more

For more information and references, download the guidance document Management of Cancer Screening Services During the COVID-19 Pandemic and Building Resilient, Safer & Equitable Screening Services.