Improving Cancer Screening Program Evaluation Through Principal Component Analysis-Driven Composite Indicators:...

Area of Science:

• Public Health
• Health Services Research
• Biostatistics

Background:

• Cancer screening programs are crucial for early detection and reducing mortality.
• Individual performance metrics may not provide a comprehensive view of screening program effectiveness.
• A unified approach is needed to objectively assess and compare screening initiatives.

Purpose of the Study:

• To develop and validate a composite indicator for evaluating cancer screening programs.
• To objectively weight key performance metrics using Principal Component Analysis (PCA).
• To identify geographical variations in screening effectiveness within Lombardy, Italy.

Main Methods:

• Utilized data from breast and colorectal cancer screening activities in Lombardy, Italy (2023).
• Applied PCA to standardize and derive weights for structural, organizational, clinical-diagnostic, and impact indicators.
• Calculated a weighted composite indicator and performed sensitivity analyses for robustness.

Main Results:

• The composite indicator highlighted significant geographical disparities in screening performance across Lombardy's health authorities.
• Examination coverage and participation rates were the most influential factors for both breast and colorectal cancer screening.
• Clinical-diagnostic, impact measures, and invitation coverage had a lesser impact on the composite score.

Conclusions:

• A composite indicator offers a more integrated and objective framework for evaluating cancer screening initiatives.
• This approach facilitates better resource allocation, adherence strategies, and targeted interventions.
• The methodology proved reliable through sensitivity analyses, supporting its application in public health.