Activities Report 2022 / 2023
Public Health Rotterdam

Section

Evaluation of Screening

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“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, unfavourable 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. We do this, among other things, by running trials and by monitoring and evaluating of implemented screening programs. With the collected data, we also develop mathematical simulation models to simulate the development of disease in a population to analyse the impact of determinants and risk factors on that development and to evaluate and compare the effects of different screening protocols and primary prevention measures.

Highlight

Implementing cancer screening in EU-TOPIA-EAST

Our department is PI of the EU-TOPIA-EAST project, funded by Horizon2020. In this project, interventions are implemented to improve cancer screening in Georgia (breast cancer), Romania (cervical cancer) and Montenegro (colorectal cancer). For example, in Georgia, there was a national breast cancer screening programme since 2011. However, in 2018 the coverage rate was only 17% in Tbilisi, and it was below 9% in the rest of the country. In the EU-TOPIA-EAST project, the region of Guria – the western region of Georgia that encompasses three municipalities (total population around 135,000) with one of its biggest cities – Lanchkhuti has been selected as a location for a new regional screening centre because there was no breast cancer screening unit in Guria region and women had to travel long distances to be screened. Throughout 2022, a building was selected and entirely renovated and rehabilitated. A mammography machine and an ultrasound machine have been purchased and installed. Also, medical equipment (gynaecological chair, colposcope) required for cervical cancer screening was purchased, to offer cervical cancer screening in near future. In June 2023, the new regional screening center was opened.

Cost-effectiveness analysis that supported the decision to implement lung cancer screening in Australia

We conducted a cost-effectiveness analysis with partners from Flinders University and Cancer Australia for a targeted lung cancer screening program in Australia. This has informed the Medical Services Advisory Committee of Australia in their decision-making on lung cancer screening. Based on their final report, the ministry decided on May 2, 2023 to invest $263.8 million Australian dollars in establishing a national screening program, which is expected to prevent 500 lung cancer deaths each year. A scientific publication is currently being prepared.

Section: Evaluation of screening