Work Package 10:

Modelling and health technology assessment to optimise cancer screening programs across Europe

WP 10

Modelling

holland

EMC, Netherlands

Work Package Summary

The overall objective is to optimize and prioritize existing and new screening programmes.

 

Specific objectives are as follows:

 

1) To estimate benefits, harms, cost-effectiveness and resource requirements of existing programmes and the impact of addressing barriers and facilitators;

2) To assess the impact of new technologies and approaches of screening (new screening tests, IA, additional cancer sites, and risk-based screening);

3) To develop tools to help countries prioritize screening interventions.

Task NrTask NameDescriptionParticipants
T10.1Adapting cervical
cancer screening
programmes to HPV
vaccinated birth
cohorts
Data on HPV vaccination coverage, screening attendance, cervical cancer related burden
and healthcare costs, and sexual activity when available, will be systematically collected in
reference countries. The data will be transformed for model input. The cervical cancer
screening model will be adjusted to these reference countries and validated using selected
reference countries. A set of screening scenarios will be modelled to identify feasible and
optimal scenarios for each reference country.
This task will be led by THL, Finland.
LU
THL, OIL, SCI
UMIT TIROL,
BIOSISTEMAK, CSF,
RSU, OUS
T10.2Estimation of benefits,
harms, and resource
requirements of
current screening
programs and the
impact of addressing
barriers and facilitators
or enablers
The EU-TOPIA web tool will be extended with data collected for the exemplary countries in
WP4: Slovakia, Romania, Hungary, Estonia, Ukraine and Slovenia. Parts of the tool will be
cross-validated against UMIT TIROL models focusing on CRC. Finally, the tool will be
applied for simulation of current situations and barriers and facilitators for all participating
countries identified in WP6. Non-exemplary countries will be supported in collecting data for
use in the model, application of the web tool and interpretation of model results.
This task will be led by EMC, Netherlands.
LU
IOL, NKIP, TAI, PHC,
UZIS, ICO
EMC, UMIT TIROL,
MSCI
BIOSISTEMAK,
IOCN, NIJZ,
CSF, HSE, DYPEDE,
FISABIO
T10.3Estimation of benefits,
harms, and resource
requirements to
implement new
screening approaches
Regional (North, East, South and West) MISCAN models for prostate, gastric and lung
cancer will be developed, based on data of one exemplary country per region. New
elements in these data collections are smoking history patterns, the amount of opportunistic
PSA testing and the prevalence of H. pylori. The prostate cancer model will be cross
validated by the UMIT TIROL model. Next, the EU-TOPIA web-based tool with options will
be extended to simulate these new cancers. We will assist other countries in collecting data
required in the web tool, application of the web tool and interpretation of the model results.
This task will be led by EMC, Netherlands.
LU
IO L
EMC, NIJZ,
UMIT TIROL,
BIOSISTEMAK
T10.4Comparison of
benefits, harms, and
resource requirements
across screening
programs to help
countries prioritise
screening
interventions
Estimates of effectiveness and costs of screening interventions from tasks 10.2 and 10.3
will be integrated in a predictive model to derive comparative estimates of the impact of
different screening (and possibly primary prevention) interventions, using DALYs as a
common metric to account for the health impact of the interventions. Using the information
about the economic value of a DALY and about the cost of the considered interventions, the
model will allow to estimate the timing of the ROI. Results of these analyses will be used to
inform the prioritisation process adopting the methodology developed in task 4.4, to support
policy decision about which intervention to prioritise by country/region. We will test the
model in exemplary countries from task 4.4 and in non-exemplary countries, to share
experiences and discuss similarities and differences.
This task will be led by CPO, Italy, co-led by EMC, Netherlands.
LU
IOL, PHC, NKIP,
UZIS,
CPO, EMC, CSF,
BIPS, UMIT TIROL,
HSE, DYPEDE, TAI,
IOCN
T10.5Assessment of new
technologies and
approaches in cancer
screening
We will explore the potential for extending the application of the methodology developed in
task 4.4.4 for assessing AI technologies and novel approaches in cancer screening tests
across Europe. The aim is to apply the MAS-AI methodology adopted to the European
context in 2-3 clinical use cases from participating countries. The inclusion criteria for the
use cases is that they are built on or utilize state-of-the-art AI technology as a component in
the national cancer screening programs in participating countries. By applying the model on
specific European use cases, the aim is to assess the feasibility, acceptability and
comprehensibility of the model in different countries across Europe and to validate the
transferability of the model in the context of European cancer screening.
This task will be led by RSYD, Denmark, co-led by CPO, Italy and EMC, the Netherlands
RSYD, PHC, INCa
CPO, EMC,
DYPEDE,
BIOSISTEMAK,
BIPS, IACS, UMIT
TIROL,
T10.6Estimation of benefits,
harms, and resource requirements of riskbased screening
approaches
MISCAN and EU-TOPIA models will be used to estimate additional harms, benefits and
costs of risk-based screening approaches compared to existing uniform screening approaches by region of Europe.
This task will be led by EMC, Netherlands, co-led by UMIT, Austria.
LU, IOL, PHC
EMC, DYPEDE
UMIT TIROL,
BIOSISTEMAK, CSF,
FISABIO
T10.7Medico-economical
modelling and cost
effectiveness of multicancer
early detection
(MCED) tests
Execution of this task entails activities including workshop and consensus of
multidisciplinary experts methodology to assess the potential health impact of different
MCED approaches; review and analysis of all available and upcoming evidence using a
multimodel approach (literature review, workshops, interviews of experts and companies,
final workshop using a consensus methodology) for the purpose of assessing the scientific
and medical value of MCEDs including health technology readiness; review and analysis of
published models and analyses assessing the available evidence, together with an analysis
of gap of knowledge regarding medico-economical modelling and cost effectiveness
analyses of MCEDs; multidisciplinary review and analysis of existing and required evidence
regarding the implementation of MCEDs including equity issues, health organization impact
of MCEDS (need for micro invasive surgery platforms, specific HCP workforces or codevelopment
of cancer interception/prevention approaches), and workshop discussion and
consensus to describe the required framework and policies for the development of MCEDs
This task will be led by UNICANCER, France, co-led by EMC, Netherlands.
Unicancer, EMC,
IOCN,
UMIT TIROL,
IDIVAL, OUS

Task NrTask NameDescriptionParticipantsRoleIn-kind Contributions/Subcontracting
T10.1Adapting cervical
cancer screening
programmes to HPV
vaccinated birth
cohorts
Data on HPV vaccination coverage, screening attendance, cervical cancer related burden
and healthcare costs, and sexual activity when available, will be systematically collected in
reference countries. The data will be transformed for model input. The cervical cancer
screening model will be adjusted to these reference countries and validated using selected
reference countries. A set of screening scenarios will be modelled to identify feasible and
optimal scenarios for each reference country.
This task will be led by THL, Finland.
LU
THL, OIL, SCI
UMIT TIROL,
BIOSISTEMAK, CSF,
RSU, OUS

COO

BEN
AE

No
T10.2Estimation of benefits,
harms, and resource
requirements of
current screening
programs and the
impact of addressing
barriers and facilitators
or enablers
The EU-TOPIA web tool will be extended with data collected for the exemplary countries in
WP4: Slovakia, Romania, Hungary, Estonia, Ukraine and Slovenia. Parts of the tool will be
cross-validated against UMIT TIROL models focusing on CRC. Finally, the tool will be
applied for simulation of current situations and barriers and facilitators for all participating
countries identified in WP6. Non-exemplary countries will be supported in collecting data for
use in the model, application of the web tool and interpretation of model results.
This task will be led by EMC, Netherlands.
LU
IOL, NKIP, TAI, PHC,
UZIS, ICO
EMC, UMIT TIROL,
MSCI
BIOSISTEMAK,
IOCN, NIJZ,
CSF, HSE, DYPEDE,
FISABIO

COO

BEN
AE

No
T10.3Estimation of benefits,
harms, and resource
requirements to
implement new
screening approaches
Regional (North, East, South and West) MISCAN models for prostate, gastric and lung
cancer will be developed, based on data of one exemplary country per region. New
elements in these data collections are smoking history patterns, the amount of opportunistic
PSA testing and the prevalence of H. pylori. The prostate cancer model will be cross
validated by the UMIT TIROL model. Next, the EU-TOPIA web-based tool with options will
be extended to simulate these new cancers. We will assist other countries in collecting data
required in the web tool, application of the web tool and interpretation of the model results.
This task will be led by EMC, Netherlands.
LU
IO L
EMC, NIJZ,
UMIT TIROL,
BIOSISTEMAK

COO

BEN
AE

No
T10.4Comparison of
benefits, harms, and
resource requirements
across screening
programs to help
countries prioritise
screening
interventions
Estimates of effectiveness and costs of screening interventions from tasks 10.2 and 10.3
will be integrated in a predictive model to derive comparative estimates of the impact of
different screening (and possibly primary prevention) interventions, using DALYs as a
common metric to account for the health impact of the interventions. Using the information
about the economic value of a DALY and about the cost of the considered interventions, the
model will allow to estimate the timing of the ROI. Results of these analyses will be used to
inform the prioritisation process adopting the methodology developed in task 4.4, to support
policy decision about which intervention to prioritise by country/region. We will test the
model in exemplary countries from task 4.4 and in non-exemplary countries, to share
experiences and discuss similarities and differences.
This task will be led by CPO, Italy, co-led by EMC, Netherlands.
LU
IOL, PHC, NKIP,
UZIS,
CPO, EMC, CSF,
BIPS, UMIT TIROL,
HSE, DYPEDE, TAI,
IOCN
COO
BEN
AE
No
T10.5Assessment of new
technologies and
approaches in cancer
screening
We will explore the potential for extending the application of the methodology developed in
task 4.4.4 for assessing AI technologies and novel approaches in cancer screening tests
across Europe. The aim is to apply the MAS-AI methodology adopted to the European
context in 2-3 clinical use cases from participating countries. The inclusion criteria for the
use cases is that they are built on or utilize state-of-the-art AI technology as a component in
the national cancer screening programs in participating countries. By applying the model on
specific European use cases, the aim is to assess the feasibility, acceptability and
comprehensibility of the model in different countries across Europe and to validate the
transferability of the model in the context of European cancer screening.
This task will be led by RSYD, Denmark, co-led by CPO, Italy and EMC, the Netherlands
RSYD, PHC, INCa
CPO, EMC,
DYPEDE,
BIOSISTEMAK,
BIPS, IACS, UMIT
TIROL,
BEN
AE
No
T10.6Estimation of benefits,
harms, and resource requirements of riskbased screening
approaches

MISCAN and EU-TOPIA models will be used to estimate additional harms, benefits and
costs of risk-based screening approaches compared to existing uniform screening approaches by region of Europe.
This task will be led by EMC, Netherlands, co-led by UMIT, Austria.

LU, IOL, PHC
EMC, DYPEDE
UMIT TIROL,
BIOSISTEMAK, CSF,
FISABIO

COO

BEN
AE

No
T10.7Medico-economical
modelling and cost
effectiveness of multicancer
early detection
(MCED) tests
Execution of this task entails activities including workshop and consensus of
multidisciplinary experts methodology to assess the potential health impact of different
MCED approaches; review and analysis of all available and upcoming evidence using a
multimodel approach (literature review, workshops, interviews of experts and companies,
final workshop using a consensus methodology) for the purpose of assessing the scientific
and medical value of MCEDs including health technology readiness; review and analysis of
published models and analyses assessing the available evidence, together with an analysis
of gap of knowledge regarding medico-economical modelling and cost effectiveness
analyses of MCEDs; multidisciplinary review and analysis of existing and required evidence
regarding the implementation of MCEDs including equity issues, health organization impact
of MCEDS (need for micro invasive surgery platforms, specific HCP workforces or codevelopment
of cancer interception/prevention approaches), and workshop discussion and
consensus to describe the required framework and policies for the development of MCEDs
This task will be led by UNICANCER, France, co-led by EMC, Netherlands.
Unicancer, EMC,
IOCN,
UMIT TIROL,
IDIVAL, OUS
AENo

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Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or European Health and Digital Executive Agency (HADEA). Neither the European Union nor HADEA can be held responsible for them.

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The general objective of EUCanScreen is to assure sustainable implementation of high-quality screening for breast, cervical and colorectal cancers, as well as implementation of the recently recommended screening programs – for lung, prostate and gastric cancers. EUCanScreen will facilitate the reduction of cancer burden and achieving equity across the EU.

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This project has received funding from the European Union’s EU4HEALTH Programme under the Grant Agreement no 101162959

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