Key indicators of organized cancer screening programs: Results from a Delphi study

Author:

Csanádi Marcell1,de Kok Inge MCM2,Heijnsdijk Eveline AM2,Anttila Ahti3,Heinävaara Sirpa3,Pitter János G1,Széles György1,Ivanuš Urška4ORCID,Priaulx Jennifer5,Veerus Piret6,Senore Carlo7ORCID,Koning Harry J de2,Vokó Zoltán1

Affiliation:

1. Syreon Research Institute, Budapest, Hungary

2. Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands

3. Finnish Cancer Registry, Helsinki, Finland

4. Institute of Oncology Ljubljana, Ljubljana, Slovenia

5. London School of Hygiene & Tropical Medicine, London, UK

6. National Institute for Health Development, Tallinn, Estonia

7. CPO Piemonte and University Hospital “Città della Salute e della Scienza”, Turin, Italy

Abstract

Objective To maximize benefits and reduce potential harms of organized cancer screening programs in Europe, monitoring, quality assurance, and evaluation of long-term impact are required. We aimed to identify the most important indicators to be collected and reported. The study was designed to establish a consensus within a European-level working group and suggest a manageable list of key indicators. Methods We conducted a Delphi study among policymakers, researchers, and program coordinators who were experts in breast, cervical, or colorectal cancer screening. Study participants evaluated the importance of screening indicators on a 5-point Likert scale. Results The top 10 indicators by study participants were interval cancer rate, detection rate, screening attendance, screening coverage, cancer incidence, cause-specific mortality, proportion of persons attending further assessment after a positive screen test result, proportion of persons attending a treatment after diagnosis, invitation coverage, and distribution of cancers by mode of detection. Performance indicators were generally considered more important than outcome indicators. Subgroup analyses by cancer types showed similar results, and only cervical cancer screening experts had slightly different preferences. Subgroup analyses by experts’ roles indicated that policymakers found different indicators important compared with researchers or program coordinators, probably because of their different point of view on screening. Conclusion The implication of our priority ranking is twofold: it serves as an initial guidance for countries that have not yet established a system to collect data, and as a checklist for those where data collection is already established, to assess the comprehensiveness of their system.

Funder

EU-Framework Programme (Horizon 2020) of the European Commission

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

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