Entwicklung, durchführung und evaluation von programmen zur krebsfrüherkennung ein positionspapier

Members of the Cancer Epidemiology Work Group within the German Epidemiology Society and Dr Antes of the German Cochrane Center will present a review of the epidemiological aspects of cancer screening programs. Prior to the implementation of a cancer screening program, there should be clear evidence from randomized controlled trials showing a disease-specific mortality reduction by screening. For target entities with the potential to reduce incident invasive cancers - such as cervical and colorectal cancer - the search of evidence should also include cancer incidence reduction. Monitoring of the screening program is essential and should include: the test, the assessment of test-positives, therapy or other interventions, and a cause of death evaluation. It is important to show that the benefit of a mortality reduction is not outweighed by adverse screening effects. In the past, German cancer screening activities were lacking essential components of screening programs like a central unit inviting the target population, standardized documentation and reporting as well as independent audits. The new Mammography Screening Program for the first time offers a screening test in Germany that is embedded in a quality monitoring program evaluating at least intermediate outcome parameters.