Quantitative Methods for the Evaluation of Cancer Screening

Stephen W. Duffy is Principal Scientist in the Department of Mathematics, Statistics and Epidemiology at the Imperial Cancer Research Fund, UK Catherine Hill is Head of Department of Biostatistics and Epidemiology at the Institut Gustave Roussy, France Jacques Esteve is Professor of Biostatistics at Centre Hospitalier Lyon-Sud, France

Part 1 Fundamentals: introduction and brief history of evaluation techniques in cancer; estimating the efficiency of screening in a randomised trial setting; important influences on effectiveness and costs to be considered in evaluation of cancer screening. Part 2 Modelling approaches and results: evaluating period cancer screening without a randomised control group- a simplified design and analysis; Markov chain models of breast tumour progression and its arrest by screening; importance of metastases at diagnosis in evaluating a population of breast cancer patients; prediction of the effect of screening on mortality, with reference to screening frequency. Part 3 Principles of monitoring service screening: screening evaluation and monitoring; use of routine data to monitor and evaluate cancer screening; interpretation of the effect of population screening using routine incidence and mortality data; optimal use of pap smear screening for cervical cancer. Part 4 Case studies and problem solving: early evaluation of a breast cancer screening programme in Florence; assessment of a colorectal cancer screening programme taking account of the natural history of the disease; screening for neuroblastoma in children - insight gained from the modelling of various screening strategies.