Keywords: Population-based screening, Breast cancer, Colorectal cancer, Cervix cancer, Prostate cancer, Europe

Background:

Early cancer detection through population-based screening is the cornerstone of cancer prevention and control. While European guidelines support organised screening for breast, cervical, and colorectal cancers, the implementation of such programmes varies across countries, while for some cancers like prostate, gastric and lung cancer recommendations vary.

Research questions:

What cancer screening programmes exist across European countries, and how do their characteristics compare?

Method:

We conducted an online survey, combining close- and open-ended questions, in 32 countries. With the help of a ‘national lead’ participant in each country, we collected data from general practitioners, academics and members of government or Health Care Organisations involved in cancer screening. The questionnaire collected information on the population-based screening programmes for breast, cervical, colorectal, and prostate cancer, including the screening method used and the target age groups. National Leads also provided links to official documents and websites describing the organisation of screening in their countries. Data were analysed descriptively to identify patterns and gaps.

Results:

Population-based screening programmes were most commonly established for breast (in 29 countries), cervical (26 countries), and colorectal cancer (26 countries), while organised screening for prostate cancer remains limited (present in 6 countries). Mammography is the standard for breast cancer, while HPV testing or Pap smears are used for cervical cancer. Colorectal screening includes fecal occult blood testing (FOBT), FIT, or colonoscopy, with variation in age ranges and intervals. Prostate screening, where implemented, generally uses PSA testing. Notable differences exist in age criteria.

Conclusions:

Despite the widespread adoption of population-based cancer screening across Europe, significant variations exist in programme design and implementation. Greater harmonisation and improved accessibility could enhance participation rates and facilitate earlier cancer diagnoses.

Points for discussion:

1. What factors could contribute to the variation in implementation of breast, cervical, and colorectal cancer screening programmes across the countries despite common guidelines?

2. What other population-based cancer screening programmes are being developed?