A health systems approach to identifying barriers to breast cancer screening programmes. Methodology and application in six European countries

Eleanor Turnbull, Jennifer Priaulx, Nicolien T. van Ravesteyn, Sirpa Heinävaara, Ilona Siljander, Carlo Senore, Nereo Segnan, Zoltán Vokó, Judit Hagymásy, Katja Jarm, Piret Veerus, Harry J. de Koning, Martin McKee

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The benefits of population-based screening for breast cancer are now accepted although, in practice, programmes often fail to achieve their full potential. In this paper, we propose a conceptual model that situates screening programmes within the broader health system to understand the factors that influence their outcomes. We view the overall screening system as having multiple sub-systems to identify the population at risk, generate knowledge of effectiveness, maximise uptake, operate the programme, and optimise follow-up and assurance of subsequent treatment. Based on this model we have developed the Barriers to Effective Screening Tool (BEST) for analysing government-led, population-based screening programmes from a health systems perspective. Conceived as a self-assessment tool, we piloted the tool with key informants in six European countries (Estonia, Finland, Hungary, Italy, The Netherlands and Slovenia) to identify barriers to the optimal operation of population-based breast cancer screening programmes. The pilot provided valuable feedback on the barriers affecting breast cancer screening programmes and stimulated a greater recognition among those operating them of the need to take a health systems perspective. In addition, the pilot led to further development of the tool and provided a foundation for further research into how to overcome the identified barriers.

Original languageEnglish
JournalHealth Policy
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Systems Analysis
Early Detection of Cancer
Breast Neoplasms
Health
Estonia
Population
Slovenia
Hungary
Finland
Netherlands
Italy
Research

Keywords

  • Breast cancer
  • Cancer screening
  • Health systems

ASJC Scopus subject areas

  • Health Policy

Cite this

A health systems approach to identifying barriers to breast cancer screening programmes. Methodology and application in six European countries. / Turnbull, Eleanor; Priaulx, Jennifer; van Ravesteyn, Nicolien T.; Heinävaara, Sirpa; Siljander, Ilona; Senore, Carlo; Segnan, Nereo; Vokó, Zoltán; Hagymásy, Judit; Jarm, Katja; Veerus, Piret; de Koning, Harry J.; McKee, Martin.

In: Health Policy, 01.01.2018.

Research output: Contribution to journalArticle

Turnbull, E, Priaulx, J, van Ravesteyn, NT, Heinävaara, S, Siljander, I, Senore, C, Segnan, N, Vokó, Z, Hagymásy, J, Jarm, K, Veerus, P, de Koning, HJ & McKee, M 2018, 'A health systems approach to identifying barriers to breast cancer screening programmes. Methodology and application in six European countries', Health Policy. https://doi.org/10.1016/j.healthpol.2018.08.003
Turnbull, Eleanor ; Priaulx, Jennifer ; van Ravesteyn, Nicolien T. ; Heinävaara, Sirpa ; Siljander, Ilona ; Senore, Carlo ; Segnan, Nereo ; Vokó, Zoltán ; Hagymásy, Judit ; Jarm, Katja ; Veerus, Piret ; de Koning, Harry J. ; McKee, Martin. / A health systems approach to identifying barriers to breast cancer screening programmes. Methodology and application in six European countries. In: Health Policy. 2018.
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