The Development of a Prioritization Framework

The EU currently recommends to perform screening for breast, cervical and colorectal cancer, and to consider introducing screening for lung, prostate and gastric cancer. However, governments have limited budgets for cancer screening and often the running screening programmes can be extended or improved. Therefore, decisions have to be made what is most important to prioritize, for example, to extend the target age range of a breast cancer programme to include more women or start a new programme for lung cancer screening.

Within WP10 and WP4, CPO (Italy) and Erasmus MC (the Netherlands) are working on a prioritization framework.

A Prioritization Framework for Screening

Based on a literature review of existing prioritization frameworks in healthcare, a prioritization framework has been developed to be specifically used in screening. A screening expert should answer the questions for each screening programme that is considered, after which automatically an overview of the results is created, which should be discussed with policy makers.  

The questions are connected to key domains identified through the literature review, including benefits, harms, burden of disease, economic impact, sustainability, acceptability, societal considerations, including equity as a cross-cutting domain. Some questions are quantitative (for example, quantification of benefits, harms, burden of disease, costs, using metrics like life years gained or ICER) of which most can be answered with the use of the MISCAN model, also developed in WP10. Other questions are qualitative, for example about the amount of training or investments needed to implement the change or the new programme, or whether it improves equity.

Testing the Framework

The draft framework has been presented and discussed in small groups during the EUCanScreen consortium meeting at March 10, 2026. Currently we are working on an improved version, including an overview of the results. When the framework is ready, it will be tested by several countries within the EUCanScreen project

Authors 

Eveline Heijnsdijk (Erasmus University Medical Center Rotterdam), Carlo Senore (CPO)