The second report on the implementation status of cancer screening in European Union (EU) was published in 2017. The report described the implementation status, protocols and organization (updated till 2016) and invitation coverage (for index year 2013) of breast, cervical and colorectal cancer screening in the EU. Experts in screening programme monitoring (N = 80) from the EU Member States having access to requisite information in their respective countries provided data on breast, cervical and colorectal cancer screening through online questionnaires. Data was collected for screening performed in the framework of publicly mandated programmes only. Filled in questionnaires were received from 26 Member States for all three sites and from one Member State for breast cancer only. Substantial improvement in screening implementation using population‐based approach was documented. Among the age‐eligible women, 94.7% were residents of Member States implementing or planning population‐based breast cancer screening in 2016, compared to 91.6% in 2007. The corresponding figures for cervical cancer screening were 72.3 and 51.3% in 2016 and 2007, respectively. Most significant improvement was documented for colorectal cancer screening with roll‐out ongoing or completed in 17 Member States in 2016, compared to only five in 2007. So the access to population‐based screening increased to 72.4% of the age‐eligible populations in 2016 as opposed to only 42.6% in 2007. The invitation coverage was highly variable, ranging from 0.2–111% for breast cancer, 7.6–105% for cervical cancer and 1.8–127% for colorectal cancer in the target populations. In spite of the considerable progress, much work remains to be done to achieve optimal effectiveness. Continued monitoring, regular feedbacks and periodic reporting are needed to ensure the desired impacts of the programmes.

Objective To present comparative data about the performance of colorectal cancer (CRC) screening programmes in the European Union Member States (EU MSs). Design Cross-sectional study. We analysed key performance indicators—participation rate, positivity rate (PR), detection rate (DR) and positive predictive value for adenomas and CRC—based on the aggregated quantitative data collected for the second EU screening report. We derived crude and pooled (through a random effects model) estimates to describe and compare trends across different MSs/regions and screening protocols. Results Participation rate was higher in countries adopting faecal immunochemical test (FIT) (range: 22.8%–71.3%) than in those using guaiac faecal occult blood test (gFOBT) (range 4.5%–66.6%), and it showed a positive correlation (ρ=0.842, p<0.001) with participation in breast cancer screening in the same areas. Screening performance showed a large variability. Compliance with referral for colonoscopy (total colonoscopy (TC)) assessment ranged between 64% and 92%; TC completion rate ranged between 92% and 99%. PR and DR of advanced adenomas and CRC were higher in FIT, as compared with gFOBT programmes, and independent of the protocol among men, older subjects and those performing their first screening. Conclusions The variability in the results of quality indicators across population-based screening programmes highlights the importance of continuous monitoring, as well as the need to promote quality improvement efforts, as recommended in the EU guidelines. The implementation of monitoring systems, ensuring availability of data for the entire process, together with initiatives aimed to enhance reproducibility of histology and quality of endoscopy, represent a priority in screening programmes management.

Objective: To report a modelling study using local health care costs and epidemiological inputs from a population-based program to access the cost-effectiveness of adopting hrHPV test.Methods: A cost-effectiveness analysis based on a microsimulation dynamic Markov model. Data and costs were based on data from the local setting and literature review. The setting was Indaiatuba, Brazil, that has adopted the hrHPV test in place of cytology since 2017. After calibrating the model, one million women were simulated in hypothetical cohorts. Three strategies were tested: cytology to women aged 25 to 64 every three years; hrHPV test to women 25–64 every five years; cytology to women 25–29 years every three years and hrHPV test to women 30–64 every five years (hybrid strategy). Outcomes were Quality-adjusted life-years (QALY) and Incremental Cost-Effectiveness Ratio (ICER).Results: The hrHPV testing and the hybrid strategy were the dominant strategies. Costs were lower and provided a more effective option at a negative incremental ratio of US$ 37.87 for the hybrid strategy, and negative US$ 6.16 for the HPV strategy per QALY gained. Reduction on treatment costs would influence a decrease in ICER, and an increase in the costs of the hrHPV test would increase ICER.Conclusions: Using population-based data, the switch from cytology to hrHPV testing in the cervical cancer screening program of Indaiatuba is less costly and cost-effective than the old cytology program.