Background: We identify how CHCs adapted cancer preventive care to the COVID-19 context, and the changes employed to realign care with cancer prevention guidelines using data from two hundred seventeen community health centers located in 13 states and 29 semi structured interviews from 13 community health centers.

Useful findings: Delivery of colorectal and cervical cancer screenings declined at the onset of the pandemic with a reduction of 75% for colonoscopy and 87% for Pap tests. CHCs responded with operational changes that allowed them to reprioritize preventive care. CHC were able to maintain screening services and/or achieve speedier recovery of services when the following organizational factors were present: prioritization of preventive care, supportive and engaged leadership, QI skills and capacity, and established processes for conducting patient outreach.

Bottom line: These findings published in Medical Care helped us understand the impact of COVID-19 on cancer prevention in CHCs and identify the factors that facilitated more rapid recovery and will inform future health system redesign efforts, especially those aimed at improving health equity.