COVID-19疫情需要基层医疗机构迅速调整癌症筛查程序以遵守不断变化的指南和政策。本研究的目的是：1）确定COVID-19疫情期间癌症筛查的障碍和促进因素；2）描述癌症筛查的适应措施；3）提供建议。研究设计：采用定性研究(n=42) 和基层医务人员进行个别视频面试，包括联邦合格健康中心，部落卫生中心，农村卫生诊所，医院/健康系统，和学术医疗中心，覆盖10个州的城市(55%)和农村(45%)地区。研究人群：基层医务人员包括医生(n=13)，住院医生(n=10)，高级执业医疗提供者(n=9)和管理人员(n=10)。结果：癌症筛查的障碍包括初级保健和专科保健的延迟，人员短缺，缺乏个人防护装备，患者对于进行面对面接诊犹豫不决，以及邮寄筛查测试的服务延迟等。促进因素包括由于疫情的原因而实现更好的协调和合作，并且远程医疗访问相比于面对面访问拥有更多的时间来讨论癌症筛查等问题。适应措施包括延迟筛查，就诊患者分级（如将筛查疏忽的患者优先处理），远程医疗访问以讨论癌症筛查，邮寄测试，协调癌症筛查（如在宫颈癌筛查时提供粪便免疫化学试验物资）和当日癌症筛查等。建议包括更多公共卫生宣传关于COVID-19期间癌症筛查的重要性，进行更多邮寄测试和扩大医疗服务覆盖面（如周末诊所）以解决癌症筛查的患者积压问题。基层医务工作人员开发出了创新的策略，以适应COVID-19疫情期间的癌症筛查。未解决的挑战（如患者的积压问题）将需要进一步的实施策略。

Context: The COVID-19 pandemic required primary care practices to rapidly adapt cancer screening procedures to comply with changing guidelines and policies. Objective: This study sought to: 1) identify cancer screening barriers and facilitators during the COVID-19 pandemic; 2) describe cancer screening adaptations; and 3) provide recommendations. Study design: A qualitative study was conducted (n= 42) with primary care staff. Individual interviews were conducted through videoconference from August 2020 - April 2021 and recorded, transcribed, and analyzed for themes using NVivo 12 Plus. Setting: Primary care practices included federally qualified health centers, tribal health centers, rural health clinics, hospital/health system-owned, and academic medical centers located across ten states including urban (55%) and rural (45%) sites. Population studied: Primary care staff included physicians (n=13), residents (n=10), advanced practice providers (n=9), and administrators (n=10). Outcome measures: The interviews assessed perceptions about cancer screening barriers and facilitators, necessary adaptations, and future recommendations. Results: Barriers to cancer screening included delays in primary and specialty care, staff shortages, lack of personal protective equipment, patient hesitancy to receive in-person care, postal service delays for mail-home testing, COVID-19 travel restrictions (for Mexico-US border-crossing patients) and organizational policies (e.g., required COVID-19 testing prior to screening). Facilitators included better care coordination and collaboration due to the pandemic and more time during telehealth visits to discuss cancer screening compared to in-person visits. Adaptations included delayed screening, patient triage (e.g., prioritizing patients overdue for screening), telehealth visits to discuss cancer screening, mail-home testing, coordinating cancer screenings (e.g., providing fecal immunochemical test materials during cervical cancer screening) and same-day cancer screening. Recommendations included more public health education about the importance of cancer screening during COVID-19, more mail-home testing, and expanded healthcare access (e.g., weekend clinic) to address patient backlogs for cancer screening. Conclusions: Primary care staff developed innovative strategies to adapt cancer screening during the COVID-19 pandemic. Unresolved challenges (e.g., patient backlogs) will require additional implementation stra.© 2021 Annals of Family Medicine, Inc.