Improving the Monitoring of Cancer Screening
SELF-PACED LEARNING PROGRAMME
For cancer screening program managers, screening providers, policymakers and other stakeholders.
8 online learning modules on monitoring of screening
10-15 minutes each
4 online learning modules on uploading data
Guidance on providing data to CanScreen-ECIS platform
References
Quick links to references and further resources
This online learning programme was developed by the Finnish Cancer Registry within the CanScreen-ECIS project. The project received co-funding from the European Union’s EU4Health programme.
The learning programme consists of 8 e-learning modules that may be completed autonomously. The learning programme provides an overview of the essential foundations and practices needed for effective monitoring of cancer screening.
At the end of the programme, you should have a good understanding about different aspects related to monitoring and evaluation of cancer screening programs.
This learning programme page also includes a separate section of 4 videos on providing data to the CanScreen-ECIS platform. This data collection is currently not open, but the videos present the data collection procedures and indicator platform at the end of the pilot project.
Section 1 General principles
1.1 Principles of screening
1.2 Legal framework and governance structure
Section 2 Monitoring of screening
2.1 Indicator approaches
2.2 Dimensions of monitoring and evaluation
2.3 Registration of data
2.4 Using monitoring data in quality improvement
Section 3 Additional considerations
3.1 Scientific evaluation of screening effectiveness
3.2 European steering
Section 4 Providing data to CanScreen-ECIS platform
4.1 Introduction to uploading data
4.2 Introduction to landscape surveys
4.3 Introduction to reporting quantitative data
4.4 Introduction to indicator platform
The learning programme was designed and developed by
Sirpa Heinävaara
Research Director
Finnish Cancer Registry
Veli-Matti Partanen
Development Manager
Finnish Cancer Registry
Ahti Anttila
Research Director (emeritus)
Finnish Cancer Registry
Maiju Pankakoski
Senior Researcher
Finnish Cancer Registry
Tytti Sarkeala
Screening Director
Finnish Cancer Registry
MODULES
Section 1: General principles
1.1 Principles of screening
1.2 Legal framework and governance
Section 2: Monitoring of screening
2.1 Indicator approaches
2.2 Dimensions of monitoring and evaluation
2.3 Registration of data
2.4 Using monitoring data in quality improvement
Section 3: Additional considerations
3.1 Scientific evaluation of screening effectiveness
3.2 European steering
References and further reading
Section 1: General principles
1.1 Principles of screening
Andermann A, Blancquaert I, Beauchamp S, Déry V. Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bull World Health Organ. 2008 Apr;86(4):317–9.
Dobrow MJ, Hagens V, Chafe R, Sullivan T, Rabeneck L. Consolidated principles for screening based on a systematic review and consensus process. CMAJ. 2018 Apr 9;190(14):E422–9.
Wilson JMG, Jungner G, World Health Organization. Principles and practice of screening for disease. 1968; Available from: https://apps.who.int/iris/handle/10665/37650
Zhang L, Carvalho AL, Mosquera I, Wen T, Lucas E, Sauvaget C, et al. An international consensus on the essential and desirable criteria for an ‘organized’ cancer screening programme. BMC Medicine. 2022 Mar 23;20(1):101.
1.2 Legal framework and governance structure
Anttila A, Lönnberg S, Ponti A, Suonio E, Villain P, Coebergh JW, et al. Towards better implementation of cancer screening in Europe through improved monitoring and evaluation and greater engagement of cancer registries. European Journal of Cancer. 2015 Jan;51(2):241–51.
Lynge E, Törnberg S, Von Karsa L, Segnan N, Van Delden JJM. Determinants of successful implementation of population-based cancer screening programmes. European Journal of Cancer. 2012 Mar;48(5):743–8.
Májek O, Anttila A, Arbyn M, Van Veen EB, Engesæter B, Lönnberg S. The legal framework for European cervical cancer screening programmes. European Journal of Public Health. 2019 Apr 1;29(2):345–50.
Zhang L, Carvalho AL, Mosquera I, Wen T, Lucas E, Sauvaget C, et al. An international consensus on the essential and desirable criteria for an ‘organized’ cancer screening programme. BMC Medicine. 2022 Mar 23;20(1):101.
Section 2: Monitoring of screening
2.1 Indicator approaches
Donabedian A. An introduction to quality assurance in health care. Oxford University Press; 2002.
Donabedian A. Evaluating the Quality of Medical Care. The Milbank Quarterly. 2005 Dec 1;83(4):691–729.
European Commission, Directorate-General for Health and Consumers, Executive Agency for Health and Consumers, World Health Organization, Karsa L, Patnick J, et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. Karsa L, Patnick J, Segnan N, editors. Publications Office; 2010.
European Commission, Directorate-General for Health and Food Safety, Karsa L, Dillner J, Suonio E, Törnberg S, et al. European guidelines for quality assurance in cervical cancer screening – Second edition – Supplements. Karsa L, Dillner J, Suonio E, Törnberg S, Anttila A, Ronco G, et al., editors. Publications Office; 2015.
Muratov S, Canelo-Aybar C, Tarride JE, Alonso-Coello P, Dimitrova N, Borisch B, et al. Monitoring and evaluation of breast cancer screening programmes: selecting candidate performance indicators. BMC Cancer. 2020 Aug 24;20(1):795.
Ponti A, Anttila A, Ronco G, Senore C. Cancer screening in the European Union (2017). Report on the implementation of the council recommendation on cancer screening. Cancer screening in the European Union (2017) Report on the implementation of the council recommendation on cancer screening [Internet]. 2017; Available from: https://health.ec.europa.eu/system/files/2017-05/2017_cancerscreening_2ndreportimplementation_en_0.pdf
Zhang L, Mosquera I, Lucas E, Rol ML, Carvalho AL, Basu P. CanScreen5, a global repository for breast, cervical and colorectal cancer screening programs. Nat Med. 2023;29(5):1135–45.
2.2 Dimensions of monitoring and evaluation
Lonnberg S, Sekerija M, Malila N, Sarkeala T, Leja M, Májek O, et al. Cancer screening: policy recommendations on governance, organization and evaluation of cancer screening. In 2017. p. 39–76.
Partanen VM, Dillner J, Tropé A, Ágústsson ÁI, Pankakoski M, Heinävaara S, et al. Comparison of cytology and human papillomavirus-based primary testing in cervical screening programs in the Nordic countries. J Med Screen. 2021 Dec 1;28(4):464–71.
Pashayan N, Antoniou AC, Ivanus U, Esserman LJ, Easton DF, French D, et al. Personalized early detection and prevention of breast cancer: ENVISION consensus statement. Nat Rev Clin Oncol. 2020 Nov;17(11):687–705.
Ponti A, Anttila A, Ronco G, Senore C. Cancer screening in the European Union (2017). Report on the implementation of the council recommendation on cancer screening. Cancer screening in the European Union (2017) Report on the implementation of the council recommendation on cancer screening [Internet]. 2017; Available from: https://health.ec.europa.eu/system/files/2017-05/2017_cancerscreening_2ndreportimplementation_en_0.pdf
Trevethan R. Sensitivity, Specificity, and Predictive Values: Foundations, Pliabilities, and Pitfalls in Research and Practice. Front Public Health. 2017;5:307.
Yerushalmy J. Statistical problems in assessing methods of medical diagnosis, with special reference to X-ray techniques. Public Health Rep (1896). 1947 Oct 3;62(40):1432–49.
2.3 Registration of data
Anttila A, Lönnberg S, Ponti A, Suonio E, Villain P, Coebergh JW, et al. Towards better implementation of cancer screening in Europe through improved monitoring and evaluation and greater engagement of cancer registries. European Journal of Cancer. 2015 Jan;51(2):241–51.
DAMA UK. The six primary dimensions for data quality assessment. Defining data quality dimensions. 2013.
OECD, World Health Organization. Improving Healthcare Quality in Europe: Characteristics, Effectiveness and Implementation of Different Strategies [Internet]. OECD; 2019 [cited 2024 Feb 22]. Available from: https://www.oecd-ilibrary.org/social-issues-migration-health/improving-healthcare-quality-in-europe_b11a6e8f-en
Tit Albreht, Régine Kiasuwa, Marc Van den Bulcke, editor. European Guide on Quality Improvement in Comprehensive Cancer Control [Internet]. Ljubljana: Slovenian National Institute of Public Health; 2017. Available from: https://cancercontrol.eu/archived/uploads/images/Guide/pdf/CanCon_Guide_FINAL_Web.pdf
2.4 Using monitoring data in quality improvement
European Commission, Directorate-General for Health and Consumers, Executive Agency for Health and Consumers, World Health Organization, Karsa L, Patnick J, et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. Karsa L, Patnick J, Segnan N, editors. Publications Office; 2010.
IARC. Cancer Over time – Data version: 1.0 [Internet]. Available from: https://gco.iarc.fr/overtime/en
OECD, World Health Organization. Improving Healthcare Quality in Europe: Characteristics, Effectiveness and Implementation of Different Strategies [Internet]. OECD; 2019 [cited 2024 Feb 22]. Available from: https://www.oecd-ilibrary.org/social-issues-migration-health/improving-healthcare-quality-in-europe_b11a6e8f-en
Quinn M, Babb P, Jones J, Allen E. Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ. 1999 Apr 3;318(7188):904–8.
Raffle AE, Mackie A, Gray JAM. Screening: Evidence and Practice [Internet]. 2nd ed. Oxford University Press; 2019 [cited 2024 Feb 22]. Available from: https://academic.oup.com/book/25046
Sasieni P, Cuzick J. Routine audit is an ethical requirement of screening. BMJ. 2001 May 12;322(7295):1179.
Toes-Zoutendijk E, van Leerdam ME, Dekker E, van Hees F, Penning C, Nagtegaal I, et al. Real-Time Monitoring of Results During First Year of Dutch Colorectal Cancer Screening Program and Optimization by Altering Fecal Immunochemical Test Cut-Off Levels. Gastroenterology. 2017 Mar;152(4):767-775.e2.
Section 3: Additional considerations
3.1 Scientific evaluation of screening effectiveness
Bretthauer M, Hoff G. Comparative effectiveness research in cancer screening programmes. BMJ. 2012 May 24;344:e2864.
Gordis L. Epidemiology. 5th ed. Elsevier Health Sciences; 2014.
Miettinen J, Malila N, Hakama M, Pitkäniemi J. Spillover improved survival in non-invited patients of the colorectal cancer screening programme. J Med Screen. 2018 Sep;25(3):134–40.
Raffle AE, Mackie A, Gray JAM. Screening: Evidence and Practice [Internet]. 2nd ed. Oxford University Press; 2019.
Spix C, Berthold F, Hero B, Michaelis J, Schilling FH. Correction factors for self-selection when evaluating screening programmes. J Med Screen. 2016 Mar;23(1):44–9.
3.2 European steering
Council of the European Union. Council recommendation of 2 December 2003 on cancer screening. Official Journal of the European Union [Internet]. 2003; Available from: https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2003:327:0034:0038:EN:PDF
Council of the European Union. Council Recommendation on strengthening prevention through early detection: A new EU approach on cancer screening replacing Council Recommendation 2003/878/EC [Internet]. 2022. Available from: https://data.consilium.europa.eu/doc/document/ST-14770-2022-INIT/en/pdf
European Commission, Directorate-General for Health and Consumers, Broeders M, Wolf C, Perry N. European guidelines for quality assurance in breast cancer screening and diagnosis. Broeders M, Wolf C, Perry N, editors. Publications Office; 2006.
European Commission, Directorate-General for Health and Consumers, Arbyn M, Anttila A, Jordan J. European guidelines for quality assurance in cervical cancer screening. Arbyn M, Anttila A, Jordan J, editors. Publications Office of the European Union; 2008.
European Commission, Directorate-General for Health and Consumers, Executive Agency for Health and Consumers, World Health Organization, Karsa L, Patnick J, et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. Karsa L, Patnick J, Segnan N, editors. Publications Office; 2010.
European Commission, Directorate-General for Health and Consumers, Karsa L, Holland R, Broeders M, Wolf C, et al. European guidelines for quality assurance in breast cancer screening and diagnosis – Fourth edition, supplements. Karsa L, Holland R, Broeders M, Wolf C, Perry N, Törnberg S, editors. Publications Office; 2013.
European Commission, Directorate-General for Health and Food Safety, Karsa L, Dillner J, Suonio E, Törnberg S, et al. European guidelines for quality assurance in cervical cancer screening – Second edition – Supplements. Karsa L, Dillner J, Suonio E, Törnberg S, Anttila A, Ronco G, et al., editors. Publications Office; 2015.
Ponti A, Anttila A, Ronco G, Senore C. Cancer screening in the European Union. Report on the implementation of the council recommendation on cancer screening. Cancer screening in the European Union (2017) Report on the implementation of the council recommendation on cancer screening [Internet]. 2017; Available from: https://health.ec.europa.eu/system/files/2017-05/2017_cancerscreening_2ndreportimplementation_en_0.pdf