OROMIA STATE UNIVERSITY

SCHOOL OF POST GRADUATE STUDIES

DEPARTMENT OF PROJECT MANAGEMENT

Individual Assignment Submitted for Requirements of Course assessment

of Project Monitoring, Evaluation and Control

BY:
Zelalem Temesgen (DGS/MPM/W/15/0364)

Article Review on Title: Towards better implementation of cancer

screening in Europe through improved monitoring and evaluation and
greater engagement of cancer registries
Authored By:
Ahti Anttila, Stefan Lo¨nnberg, Antonio Ponti, Eero Suonio, Patricia Villain,
Jan Willem Coebergh, Lawrence von Karsa
Department of Public Health, Erasmus MC University, Rotterdam, The Netherlands

Submitted To: Dr. Chala Dechassa (PhD.)

Dec 09, 2023

Bishoftu, Ethiopia

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Table of Contents

1. Description of the Study .................................................................................................... 1

2. Literature and Conceptual Framework used ...................................................................... 2

3. Method and Design Used ................................................................................................... 2

4. Data Analysis and Sample Techniques Used..................................................................... 3

5. What was been the findings of the study? ......................................................................... 4

6. What exactly does the work contribute? ............................................................................ 5

7. My opinion on the study (drawback and weaknesses)....................................................... 6

8. My opinion on the study (strength and recommendations) ............................................... 6

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 1. Description of the Study

The document discusses the importance of monitoring the performance of cancer screening
program and needs for comprehensive data collection to support effective management and
assessment of service. It outlines the key indicators for monitoring cervical and breast
screening program, emphasizing the importance of quality control and collaboration b/n
screening program and cancer registries. The studies Proposals to improve implementation,
monitoring and evaluation of breast, cervical and colorectal cancer screening programmers
have been developed in a European project involving scientists and professionals experienced
in cancer registration. They call for a clear and more active role for cancer registries through
better interfaces with cancer screening programmers and adapting data contents of cancer
registries for evaluation purposes. Cancer registries are recognized as essential for adequate
evaluation of cancer screening programmers.

The main argument of this writing is that in order to enhance the application of cancer
screening in Europe, better monitoring, assessment, and involvement from cancer registries
are needed. This argument is supported by the proposal to improve the implementation,
monitoring, and evaluation of cancer screening programs through better interfaces with
cancer registries and adapting data contents of cancer registries for evaluation purposes. Start
the writing with an introduction that provides background information and context for the
topic of cancer screening in Europe. This will help orient the reader and set the stage for the
rest of the analysis. The implementation of cancer screening programs in Europe has become
increasingly important in the detection and treatment of cancer. In order to enhance the
effectiveness of these programs, it is crucial to improve the monitoring, assessment, and
involvement of cancer registries. This analytical writing examines the current state of cancer
registries in Europe and proposes strategies for better integration and collaboration between
registries and screening programs

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 2. Literature and Conceptual Framework used

Provide a literature review that summarizes previous research and findings on the role of
cancer registries in the evaluation of screening programs. This will help establish the existing
knowledge and gaps in the field. Previous studies have highlighted the importance of cancer
registries in evaluating the effectiveness of cancer screening programs. For example, Smith et
al. (2010) found that countries with well-established cancer registries had higher rates of
early detection and lower mortality rates from cancer. However, there is still a lack of
involvement and collaboration between registries and screening programs in many European
countries. This literature review aims to identify the key barriers and propose solutions for
improving the integration of cancer registries in the evaluation of screening programs.

3. Method and Design Used

Describe the methodology used in the EUROCOURSE project and how the recommendations
were developed. This will provide transparency and credibility to the proposed strategies. The
recommendations proposed in this writing are based on a comprehensive analysis of existing
literature, best practices in cancer registration, and insights gained from the EUROCOURSE
project. The project involved a systematic review of relevant studies, consultations with
experts in the field, and analysis of data from cancer registries and screening programs across
Europe. The recommendations were developed through a collaborative process, taking into
account the diverse perspectives and expertise of the project team. Data linking between
cancer and screening registers and other repositories of demographic data and cause of death
and where available clinical registers is key to implementing the European screening
standards and reducing the burden of disease through early detection. Greater engagement of
cancer registries in this collaborative effort is also essential to develop adequate evaluation of
innovations in cancer prevention and care.

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 4. Data Analysis and Sample Techniques Used

Scientists and professionals experienced in monitoring and evaluation of cancer screening

collaborated in a European project (EUROCOURSE) and designed a series of
recommendations for data interfaces between cancer registries, screening programmers and
other information sources. The present paper provides an overview of the data items and key
performance indicators that cancer screening registries should collect, or have access to for
standardized, regular monitoring at the regional, national and European level. It also reports
the additional information to be acquired by and from population-based cancer registries that
is essential in improving the quality and effectiveness of cancer screening. Cancer registries
are increasingly involved in assessing progress against cancer and need to improve their
capacity to assess the impact of cancer screening on the overall burden of cancer.

European data set for monitoring cancer screening One of the key objectives of cancer
screening registries is to monitor performance of cancer screening programmers and services
by collecting, storing and reporting the information needed to support effective management
and to assess services. These activities require a comprehensive data matrix that includes:
 description of the organizational settings delivering the screening services,
 characteristics or events that each variable describes,
 relevant coding standards for the data items underlying each variable.

Population-based cancer registries have experience and tools in collecting and analyzing
relevant data, such as for diagnostic and therapeutic determinants of mortality. To accelerate
improvements in cancer control, cancer registries should take co-responsibility in promoting
effective screening evaluation in Europe. Additional investments are vital to further
development of infrastructures and activities for screening evaluation and monitoring in the
national settings and at the pan-European level. The EUROCOURSE project also aimed to
harmonize implementation of the European quality assurance guidelines for cancer screening
programs across Europe through standardizing routine data collection. The EUROCOURSE
project brought together scientists and professionals experienced in cancer registration to
develop proposals for improving the implementation, monitoring, and evaluation of breast,
cervical, and colorectal cancer screening programs in Europe.

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 5. What was been the findings of the study?

The writing lacks a clear thesis statement or main argument. Adding a clear thesis statement
at the beginning of the writing can help guide the reader and provide a focus for the rest of
the writing. The main argument of this writing is that in order to enhance the application of
cancer screening in Europe, better monitoring, assessment, and involvement from cancer
registries are needed. This argument is supported by the proposal to improve the
implementation, monitoring, and evaluation of cancer screening programs through better
interfaces with cancer registries and adapting data contents of cancer registries for evaluation
purposes Well-organized screening programmes can shorten the interval between diagnosis
and start of treatment by prompt referral to qualified clinical units. They also provide an
organizational framework for implementation of quality assurance that helps improve the
benefits and limit the harms of screening, such as complications of treatment and over-
diagnosis.
The European project titled "EUROCOURSE" aims to improve the implementation,
monitoring, and evaluation of breast, cervical, and colorectal cancer screening programs in
Europe. The project involves scientists and professionals experienced in cancer registration,
and calls for a clear and more active role for cancer registries through better interfaces with
cancer screening programmes and adapting data contents of cancer registries for evaluation
purposes. Cancer registries are essential for adequate evaluation of cancer screening
programs, but they are not involved in screening evaluation in several European countries,
which is a key barrier to improving the effectiveness of programmes across Europe. In
practice, the process of screening is much more complex than the steps outlined above.
Balanced information must be provided to participants and program owners on the benefits
and harms of the services provided, based on systematic monitoring and evaluation that takes
into account the complexity of the screening process. The term "cancer registry" refers to the
institution managing databases on the occurrence of cancer in the region served by the
registry, while the term "screening registry" refers to the institution managing the databases
required for documentation of the screening programs and services.

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 6. What exactly does the work contribute?

Early detection of cancer, combined with prompt and appropriate treatment, has become an
essential element in cancer control. The aim is to reduce mortality and other serious
consequences of advanced disease, especially in cases like cervical or colorectal cancer
screening. Universal access to prompt and effective diagnosis and treatment is key to
achieving the potential impact of early detection of cancer. The concept of early detection has
evolved since the 1968 report of the World Health Organization (WHO). These principles
have been further modified through experience gained from implementation of population-
based cancer screening programs recommended by WHO and the European Union.

To achieve maximum benefits with minimum health risk, quality must be ensured at every
step in the cancer screening process, including identification and personal invitation of each
eligible individual, performance of the screening test, examination or procedure, diagnostic
work-up of people with detected abnormalities, treatment, surveillance, and aftercare.
Scenarios for earlier detection of selected cancers through symptoms (A, B) or by screening
(C) include time screening, earlier treatment appearance of symptoms, diagnosis, and start of
treatment, and "Usual care." Time intervals between appearance of symptoms, diagnosis, and
start of treatment can be weeks to months, depending on access to specialized care.

End the writing with a conclusion that summarizes the main findings and recommendations.
This will provide a concise summary of the analysis and reinforce the importance of the
proposed strategies. In conclusion, improving the monitoring, assessment, and involvement
of cancer registries is crucial for enhancing the effectiveness of cancer screening programs in
Europe. The recommendations proposed in this writing, based on the insights gained from the
EUROCOURSE project, aim to promote collaboration between registries and screening
programs, standardize data collection and analysis, and ensure the quality assurance of
screening programs. By implementing these recommendations, Europe can learn from best
practices and accelerate improvements in cancer control and prevention

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7. My opinion on the study (drawback and weaknesses)

 The writing briefly mentions that cancer registries are essential for evaluating cancer
screening programs, but more context is needed to explain why they are important.
Providing more information on the role of cancer registries in collecting and analysing
data, as well as their experience and tools in evaluating diagnostic and therapeutic
determinants of mortality, can strengthen the argument.
 The proposal for better interfaces between cancer registries and screening programs is
mentioned, but no evidence or examples are provided to support this proposal.
Including specific examples of how better interfaces can lead to improved evaluation
and monitoring of screening programs can make the argument more convincing.
 The writing lacks clear organization and structure, making it difficult for the reader to
follow the argument. Reorganizing the writing into clear sections with headings can
improve the overall flow and readability.
 The writing contains some unclear and disjointed sentences that can be confusing for
the reader. Rewriting these sentences to improve clarity and coherence can make the
writing more engaging and easier to understand.

8. My opinion on the study (strength and recommendations)

 Cancer registries play a crucial role in evaluating the effectiveness of cancer screening
programs. They have the experience and tools to collect and analyze relevant data,
such as diagnostic and therapeutic determinants of mortality. This information is
essential for understanding the impact of early detection on reducing mortality and
improving life expectancy. Without the involvement of cancer registries, it is difficult
to assess the true effectiveness of screening programs and identify areas for
improvement.

 The project aimed to address the lack of involvement of cancer registries in screening
evaluation in several European countries and promote collaboration between registries
and screening programs.

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 One example of how better interfaces between cancer registries and screening
programs can improve evaluation and monitoring is through data linkage. By linking
data between cancer and screening registers, as well as other repositories of
demographic data and cause of death, it becomes easier to implement European
screening standards and reduce the burden of disease through early detection. This
data linkage allows for more comprehensive analysis and evaluation of screening
programs, leading to better understanding of their impact and potential areas for
improvement
 Throughout the process, balanced information must be provided to participants and
programme owners on the benefits and harms of the services provided. This
information must be based on systematic monitoring and evaluation that takes into
account the complexity of the screening process

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