Analyses of data from global cancer screening programmes reveal differences, in terms of organization and performance, between high- and low-income countries, and they highlight gaps in data collection in both settings. The first batch of data, just published in Nature Medicine, shows that screening programmes in Europe are better organized than those in other continents, with colorectal cancer screening programmes being the best organized at specific sites.
“Low- and middle-income countries in particular need to make more intensive efforts to measure performance of cancer screening systematically to ensure that the programmes are more effective and efficient in saving lives from common cancers,” Partha Basu, who led the study, told Univadis.com.
Basu is head of the screening group at the International Agency for Research on Cancer in Lyon, France, the organization that launched the Cancer Screening in Five Continents (CanScreen5) project in 2019. The initiative is a global repository that aims to collect, analyse, and report on the performance and status of breast, cervical, and colorectal cancer screening programmes around the world, based on data collected from ministries of health in 84 countries on 5 continents, including 29 European countries, 27 from the Americas, 17 in Africa, and 10 in Asia.
The researchers found that examination coverage for breast cancer is highest in the United Kingdom (84%), for cervical cancer is highest in Sweden (86.3%), and for colorectal cancer is highest in the Netherlands (64.5%).
In Europe, nearly half of the breast cancer screening programmes are mandated by laws to provide national screening programmes; testing is done by mammography, and double reading of mammograms is widespread.
By contrast, Asia and the Americas have far fewer of these programmes, and Australia and Africa have none. Australia and the Americas also use mammography for breast cancer screening, but only one-third of programmes in Asia have adopted the method.
All 5 continents have laws that mandate cervical screening, and screening services are provided free of charge in the vast majority of the programmes analysed, but most only provide colonoscopy and biopsy at a cost. Screening invitation was reported at varying rates in programmes in all continents except for Africa, where only HIV-positive women were invited.
The data also show that most colorectal cancer screening programmes used the faecal immunochemical test, the vast majority of programmes have a dedicated budget, and that colonoscopy is the main testing method in China and a number of European countries.
Screening coverage for all 3 types of cancer was the most frequently reported indicator of programme performance, but is lowest in Africa and Latin America, which lack strong screening policies and financing.
Basu says that CanScreen5 is an ongoing project. “We have already initiated the process of updating the data collected from European countries through a project supported by the European Commission.”
