Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey
IntroductionEarly detection of cancer significantly impacts disease management and contributes to a reduction in cancer mortality rates. This study aims to identify, extract, systematize, and validate a set of indicators for breast, cervical, and colorectal cancer screening programs that are applica...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1491226/full |
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| author | Arezoo Jabbari Zhila Najafpour Sima Ourang Maria Cheraghi |
| author_facet | Arezoo Jabbari Zhila Najafpour Sima Ourang Maria Cheraghi |
| author_sort | Arezoo Jabbari |
| collection | DOAJ |
| description | IntroductionEarly detection of cancer significantly impacts disease management and contributes to a reduction in cancer mortality rates. This study aims to identify, extract, systematize, and validate a set of indicators for breast, cervical, and colorectal cancer screening programs that are applicable and easily understood within any healthcare system.MethodsThis study is conducted in two phases: a literature review and an expert panel evaluation. In the first phase, electronic databases—PubMed, Web of Science, and Scopus—were searched for articles published from January 2000 to November 2023. Two reviewers critically appraised the articles based on predefined inclusion and exclusion criteria. Indicators were extracted from the selected articles through content analysis. In the second phase, the extracted indicators were reviewed by ten experts. Consensus on the indicators was achieved through two consecutive rounds of review.ResultsThe final list comprises 30 indicators categorized into three dimensions: two for input, sixteen for process, and twelve for outcome. The overall content validity index (CVI) and content validity ratio (CVR) determined using the expert panel agreement approach, were high (≥ 0.9). The input dimension includes two indicators: Adequacy and Availability of Human Resources, and Percentage of Health Centers Providing Cancer Screening Services. The process dimension comprises 16 indicators, including Timely Diagnostic Evaluation of Abnormal Screenings, Rescreening, Recall Rate, Percentage of Smears per 1,000 Women Aged 20–29 per Year, Public Education, Data Availability, Referral Rates (to GP and Surgeon), Drop Rate During Referral, Biopsy Rate, Diagnostic and Therapeutic Endoscopy Rate, Proportion of Colonoscopies, Total and Partial Mastectomy Rates, Tumor Diameter, and Tumor Grading. Finally, the outcome dimension features 12 indicators: Screening Coverage, All-Cause Mortality Rate, Cause-Specific Mortality Rate, Invasive Cancer Detection Rate, Interval Cancer Rate, Ductal Carcinoma in Situ (DCIS) Rate, Cancer Detection Rate, Polyp Detection Rate, Fecal Occult Blood Test (FOBt) Positivity Rate, Adenoma Detection Rate, Positive Predictive Value for Cancer Detection (PPV), and Episode Sensitivity.ConclusionThis study identified a robust set of 30 key performance indicators (KPIs) for breast, cervical, and colorectal cancer screening programs, with a high overall content validity index demonstrating strong expert consensus on their relevance and importance. |
| format | Article |
| id | doaj-art-28e77a2b2fc74d61ba9339fb5388ce02 |
| institution | DOAJ |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-28e77a2b2fc74d61ba9339fb5388ce022025-08-20T03:03:12ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.14912261491226Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi surveyArezoo Jabbari0Zhila Najafpour1Sima Ourang2Maria Cheraghi3Department of Health Care Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Health Care Management, School of Public Health, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Non-Communicable Diseases, Deputy of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Public Health, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranIntroductionEarly detection of cancer significantly impacts disease management and contributes to a reduction in cancer mortality rates. This study aims to identify, extract, systematize, and validate a set of indicators for breast, cervical, and colorectal cancer screening programs that are applicable and easily understood within any healthcare system.MethodsThis study is conducted in two phases: a literature review and an expert panel evaluation. In the first phase, electronic databases—PubMed, Web of Science, and Scopus—were searched for articles published from January 2000 to November 2023. Two reviewers critically appraised the articles based on predefined inclusion and exclusion criteria. Indicators were extracted from the selected articles through content analysis. In the second phase, the extracted indicators were reviewed by ten experts. Consensus on the indicators was achieved through two consecutive rounds of review.ResultsThe final list comprises 30 indicators categorized into three dimensions: two for input, sixteen for process, and twelve for outcome. The overall content validity index (CVI) and content validity ratio (CVR) determined using the expert panel agreement approach, were high (≥ 0.9). The input dimension includes two indicators: Adequacy and Availability of Human Resources, and Percentage of Health Centers Providing Cancer Screening Services. The process dimension comprises 16 indicators, including Timely Diagnostic Evaluation of Abnormal Screenings, Rescreening, Recall Rate, Percentage of Smears per 1,000 Women Aged 20–29 per Year, Public Education, Data Availability, Referral Rates (to GP and Surgeon), Drop Rate During Referral, Biopsy Rate, Diagnostic and Therapeutic Endoscopy Rate, Proportion of Colonoscopies, Total and Partial Mastectomy Rates, Tumor Diameter, and Tumor Grading. Finally, the outcome dimension features 12 indicators: Screening Coverage, All-Cause Mortality Rate, Cause-Specific Mortality Rate, Invasive Cancer Detection Rate, Interval Cancer Rate, Ductal Carcinoma in Situ (DCIS) Rate, Cancer Detection Rate, Polyp Detection Rate, Fecal Occult Blood Test (FOBt) Positivity Rate, Adenoma Detection Rate, Positive Predictive Value for Cancer Detection (PPV), and Episode Sensitivity.ConclusionThis study identified a robust set of 30 key performance indicators (KPIs) for breast, cervical, and colorectal cancer screening programs, with a high overall content validity index demonstrating strong expert consensus on their relevance and importance.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1491226/fullcancer screening programkey performance indicatorsystematic reviewcontent validationDelphi |
| spellingShingle | Arezoo Jabbari Zhila Najafpour Sima Ourang Maria Cheraghi Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey Frontiers in Public Health cancer screening program key performance indicator systematic review content validation Delphi |
| title | Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey |
| title_full | Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey |
| title_fullStr | Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey |
| title_full_unstemmed | Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey |
| title_short | Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey |
| title_sort | developing and validating key performance indicators for breast cervical and colorectal cancer screening programs a literature review and delphi survey |
| topic | cancer screening program key performance indicator systematic review content validation Delphi |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1491226/full |
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