Journal of Cancer Policy 41 (2024) 100486 Available online 1 June 2024 2213-5383/© 2024 Published by Elsevier Ltd. Global review of COVID-19 mitigation strategies and their impact on cancer service disruptions Richa Shah a, * , Ching Ee Loo b , Nader Mounir Hanna c , Suzanne Hughes d , Allini Mafra e , Hanna Fink a , Ethna McFerran f , Montse Garcia g , Suryakanta Acharya h, i , Oliver Langselius a , Clara Frick a , Jean Niyigaba a , Nwamaka Lasebikan j , Julia Steinberg d , Richard Sullivan k , Freddie Bray a , Andr´e Michel Ilbawi l , Ophira Ginsburg m , Karen Chiam d , Jonathan Cylus n, o , Michael Caruana d , Michael David d, p , Harriet Hui d , Karen Canfell d , Isabelle Soerjomataram a a Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France b Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia c Department of Surgery, Queen’s University, Kingston, Ontario, Canada d The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia e Cancer Epidemiology and Prevention Team, Public Health Expertise, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg f Queen’s University Belfast, United Kingdom g Cancer Screening Unit, Institut Catal` a d’Oncologia (ICO), Early Detection of Cancer Group, Institut d’Investigaci´o Biom`edica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Spain h Assam Cancer Care Foundation, Assam, India i PAY-W Clinic, Odisha, India j University of Nigeria Teaching Hospital, Enugu, Nigeria k King’s College London, Institute of Cancer Policy, Guy’s Hospital, London, UK l Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland m Center for Global Health, National Cancer Institute, USA n WHO Barcelona Office for Health Systems Financing, World Health Organization Regional Office for Europe, Barcelona, Spain o London School of Hygiene and Tropical Medicine Faculty of Public Health, London, UK p School of Medicine & Dentistry, Griffith University, Gold Coast, Australia A R T I C L E INFO Keywords: cancer care services covid-19 pandemic mitigation strategies review ABSTRACT During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19. Included studies reported on individuals with cancer or cancer care services, focusing on strategies/programs aimed to reduce delays and disruptions. Extracted data were grouped into four functions (governance, financing, service delivery, and resource generation) and sub-functions of the health system performance assessment framework. We included 30 studies from 16 countries involving 192,233 patients with cancer. Multiple mitigation ap- proaches were implemented, predominantly affecting sub-functions of service delivery to control COVID-19 infection via the suspension of non-urgent cancer care, modified treatment guidelines, and increased telemedi- cine use in routine cancer care delivery. Resource generation was mainly ensured through adequate workforce supply. However, less emphasis on monitoring or assessing the effectiveness and financing of these strategies was observed. Seventeen studies suggested improved service uptake after mitigation implementation, yet the resulting impact on cancer diagnosis and care has not been established. This review emphasizes the importance of developing effective mitigation strategies across all health system (sub)functions to minimize cancer care service disruptions during crises. Deficiencies were observed in health service delivery (to ensure equity), governance (to monitor and evaluate the implementation of mitigation strategies), and financing. In the wake of Abbreviations: CT, computed tomography; LMICs, low- and middle-income countries; OR, operating rooms; PPE, personal protective equipment; PRISMA-ScR, Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews; SMS, short messaging service; UHC, universal health coverage; WHO, World Health Organization. * Correspondence to: Cancer Surveillance Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier CS 90627, Lyon 69366, France. E-mail addresses: shahr@iarc.who.int, richa.np@gmail.com (R. Shah). Contents lists available at ScienceDirect Journal of Cancer Policy journal homepage: www.elsevier.com/locate/jcpo https://doi.org/10.1016/j.jcpo.2024.100486 Received 16 October 2023; Received in revised form 15 April 2024; Accepted 24 May 2024