Journal Article

Monitoring and evaluation of breast cancer screening programmes: selecting candidate performance indicators

Fitzpatrick, Patricia, Siesling, Sabine, Castells, Xavier, Giordano, Livia, Giorgi Rossi, Paolo, Muratov, Sergei, Ponti, Antonio, Alonso-Coello, Pablo, Canelo-Aybar, Carlos, Torresin, Alberto, Schünemann, Holger, Tarride, Jean-Eric, Dimitrova, Nadya, Nyström, Lennarth, Vialli, Claudia, Duffy, Stephen W., Lebeau, Annette, Follmann, Markus, Quinn, Cecily, Borisch, Bettina, Broeders, Mireille, Hofvind, Solveig

2020

Overview

Background In the scope of the European Commission Initiative on Breast Cancer (ECIBC) the Monitoring and Evaluation (M&E) subgroup was tasked to identify breast cancer screening programme (BCSP) performance indicators, including their acceptable and desirable levels, which are associated with breast cancer (BC) mortality. This paper documents the methodology used for the indicator selection. Methods The indicators were identified through a multi-stage process. First, a scoping review was conducted to identify existing performance indicators. Second, building on existing frameworks for making well-informed health care choices, a specific conceptual framework was developed to guide the indicator selection. Third, two group exercises including a rating and ranking survey were conducted for indicator selection using pre-determined criteria, such as: relevance, measurability, accurateness, ethics and understandability. The selected indicators were mapped onto a BC screening pathway developed by the M&E subgroup to illustrate the steps of BC screening common to all EU countries. Results A total of 96 indicators were identified from an initial list of 1325 indicators. After removing redundant and irrelevant indicators and adding those missing, 39 candidate indicators underwent the rating and ranking exercise. Based on the results, the M&E subgroup selected 13 indicators: screening coverage, participation rate, recall rate, breast cancer detection rate, invasive breast cancer detection rate, cancers > 20 mm, cancers ≤10 mm, lymph node status, interval cancer rate, episode sensitivity, time interval between screening and first treatment, benign open surgical biopsy rate, and mastectomy rate. Conclusion This systematic approach led to the identification of 13 BCSP candidate performance indicators to be further evaluated for their association with BC mortality.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Biomedical and Life Sciences / Biomedicine / Biopsy / Breast - pathology / Breast - surgery / Breast cancer / Breast Neoplasms - diagnosis / Breast Neoplasms - mortality / Breast Neoplasms - prevention & control / Breast Neoplasms - surgery / Breast neoplasms/diagnostic imaging / Business metrics / Cancer diagnosis / Cancer Research / Cancer screening / Decision making / Early Detection of Cancer - standards / Early Detection of Cancer - statistics & numerical data / Early detection of Cancer/methods / Epidemiology / Europe - epidemiology / Female / Health aspects / Health care / Health care/standards / Health Plan Implementation - standards / Health Plan Implementation - statistics & numerical data / Health Promotion and Disease Prevention / Humans / Invasiveness / Lymph nodes / Mammography - standards / Mammography - statistics & numerical data / Mass screening / Mass Screening - organization & administration / Mass Screening - standards / Mass Screening - statistics & numerical data / Mass screening/methods / Mastectomy - statistics & numerical data / Medical screening / Medicine/Public Health / Middle Aged / Mortality / Oncology / Patient Acceptance of Health Care - statistics & numerical data / Population / Practice Guidelines as Topic / prevention and public health / Program Evaluation / Programme evaluation / Public health / Quality control / Quality indicators / Quality Indicators, Health Care - standards / Quality Indicators, Health Care - statistics & numerical data / Research Article / Surgical Oncology / Time Factors