Evaluation of Screening
“The possibilities of screening for diseases are growing rapidly due to technological developments. We aim to quantify the effects of screening for a wide range of diseases to help policymakers, clinicians and individuals make an informed choice about implementation of and participation in screening.”
Screening is a popular concept, because early detection of disease has the potential to considerably improve survival and/or quality of life. However, screening can also result in serious harms such as false-positive test results or detection of clinically irrelevant disease, leading to unnecessary interventions. It is therefore important that new screening tests are only implemented if their benefits outweigh their harms. Our research focuses on quantifying these health benefits, unfavorable side-effects, impact on quality of life, and cost consequences, resulting in recommendations for screening policies, both in settings with organized programs and in clinical care.
Highlights
of Evaluation of Screening in 2020
VENI grant
Emerging research suggests that adapting screening regimens to individual risk (“personalized screening”) has the potential to improve the effectiveness, while reducing participant harms and costs. While current recommendations for personalized screening often define risk-groups based on one-time risk assessments, a person’s risk may change over their lifetime. Furthermore, screening efficacy may vary across different combinations of risk factors (i.e. a person’s risk profile) which needs to be taken into consideration for personalized screening approaches.
Kevin ten Haaf was awarded a VENI grant from the Dutch government for his project: Towards dynamic personalized cancer screening: integrating risk-factors, test results and natural-history modeling. In this project, he will investigate how screening regimens can dynamically adapt to changes in the composition of a person’s risk profile in order to enable personalized screening programs for breast, colon and lung cancer.
Overview of changes in a risk-profile over a person’s lifetime
Impact of COVID-19 on colorectal cancer screening programmes
As a response to disruptions of colorectal cancer screening programs and drops in cancer diagnoses, the COVID-19 and Cancer Global Modelling Consortium was established to support decision making in cancer control during and after the pandemic. Its screening working group, co-chaired by Iris Lansdorp-Vogelaar, performed a comparative modelling study to estimate the impact of disruptions to the colorectal cancer screening programs in the Netherlands, Australia and Canada. Our study showed that colorectal cancer screening should be continued to the extent possible to avoid increases in long-term incidence and mortality. In case screening has to be disrupted, providing affected individuals with catch-up screening can mitigate these increases (Figure). Countries should further take action to prevent decreases in screening participation due to fear of infection or of burdening the health care system. This study was presented at the European Society for Gastrointestinal Endoscopy and Digestive Disease Week, and was published in the Lancet Gastroenterology and Hepatology.
