Desiderata for an adequate evaluation of cancer screening

Three main problems in the evaluation of mass screening are obtaining reliable estimates of the impact of cancer screening on morbidity and mortality, taking account of the large number of factors that together determine the impact of cancer screening, and dealing adequately with all three stages (explanation, prediction, and planning) of evaluation. Mathematical models, implemented in computer programs, should preferably be used for the evaluation. Fourteen desiderata for adequate model-based evaluation of mass screening are formulated; they concern the model, the computer program, and the methodology used. Satisfying these desiderata is essential in overcoming the three main problems mentioned. As yet, no evaluation research group is close to fulfilling all 14 desiderata. Sticking to one model only should thus be avoided.