<b><i>Introduction:</i></b> The early identification of precursor lesions followed by appropriate treatment prevents development of cervical cancer and its consequences. <b><i>Objective:</i></b> The present study evaluated the influence of the COVID-19 pandemic on cervical cancer screening by comparing the quantity of tests to detect cervical cellular changes performed in São Paulo state in 2019, prior to the detection of SARS-CoV-2 in Brazil, to the first (2020) and second (2021) years following its appearance. <b><i>Materials and Methods:</i></b> Data from Fundação Oncocentro de São Paulo (FOSP), the agency that analyses approximately 220,000 Papanicolaou (Pap) tests annually, were reviewed. <b><i>Results:</i></b> A median of 1,835 Pap tests were performed in 55 municipalities in 2019. This was reduced to 815 tests in 2020, a 56% decrease (<i>p</i> = 0.0026). In 2021, the median number was 1,745, a 53% increase over 2020 levels (<i>p</i> = 0.0233). The 26 municipalities with &#x3e;1,000 tests in 2020 had a median reduction from 4,433 in 2019 to 2,580 in 2020 (<i>p</i> = 0. 0046). The 29 municipalities with &#x3c;1,000 tests had a median reduction from 951 in 2019 to 554 in 2020 (<i>p</i> &#x3c; 0.0001). There was a 44% reduction in the number of follow-up cytological evaluations from 2019 to 2020, followed by a 30% increase in the following year. However, the percentage of women with a normal finding or with any abnormality remained unchanged. The findings from a histological evaluation of women in São Paulo city indicated that the percent of cases positive for CIN-1 (<i>p</i> &#x3c; 0.0410) and CIN-3 (<i>p</i> &#x3c; 0.0012) increased in 2020 and 2021 as compared to 2019 levels. <b><i>Conclusion:</i></b> A reduction in testing for cervical cancer in the first year of the COVID-19 pandemic, accompanied by an elevated incidence of precancerous lesions in each of the first 2 years following its initiation, may portend a subsequent increased occurrence of cervical cancer in Brazil.