[Planning, implementation and evaluation of cancer screening programs]

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.