A framework provided an outline toward the proper evaluation of potential screening strategies

Wim J. Adriaensen*, Cathy Mathei, Frank J. Buntinx, Marc Arbyn

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Citations (Web of Science)


Objectives: Screening tests are often introduced into clinical practice without proper evaluation, despite the increasing awareness that screening is a double-edged sword that can lead to either net benefits or harms. Our objective was to develop a comprehensive framework for the evaluation of new screening strategies. Study Design and Setting: Elaborating on the existing concepts proposed by experts, a stepwise framework is proposed to evaluate whether a potential screening test can be introduced as a screening strategy into clinical practice. The principle of screening strategy evaluation is illustrated for cervical cancer, which is a template for screening because of the existence of an easily detectable and treatable precursor lesion. Results: The evaluation procedure consists of six consecutive steps. In steps 1-4, the technical accuracy, place of the test in the screening pathway, diagnostic accuracy, and longitudinal sensitivity and specificity of the screening test are assessed. In steps 5 and 6, the impact of the screening strategy on the patient and population levels, respectively, is evaluated. The framework incorporates a harm and benefit trade-off and cost-effectiveness analysis. Conclusion: Our framework provides an outline toward the proper evaluation of potential screening strategies before considering implementation.
Original languageEnglish
Pages (from-to)639-647
JournalJournal of Clinical Epidemiology
Issue number6
Publication statusPublished - Jun 2013


  • Cancer screening
  • Screening evaluation
  • Cervical cancer
  • Screening strategy
  • Harm benefit
  • Framework

Cite this