Work Package 9: Risk-based approaches

WP 9

risk trasp

Risk-based approaches

Italy t
france t

ISPRO, Italy, co-led by UNICANCER, France

Work Package Summary

The overall objective is to enhance understanding of the concepts of risk and risk-based screening and provide MS with recommendations for assessing the potential integration of these approaches into their screening programs.

 

Specific objectives are as follows:

 

1) Review and assess proposed approaches and available tools for risk stratification;

2) Share knowledge, best practices and risk-assessment tools for organising and implementing risk-based interventions;

3) Define relevant scenarios for cost-effectiveness modelling, identify pertinent research questions, and prioritise clinical questions for guideline development;

4) Evaluate available resources per the existing healthcare system and the values, preferences, and social norms of the target population;

5) Propose and develop suitable communication strategies and tools for healthcare professionals and the general public.

Task NrTask NameDescriptionParticipants
T9.1Development and
assessment of
methods for
promoting informed
choice and
communication in
personalised
programs
Methods for measuring informed choices in risk-based screening monitoring systems
considering social and individual barriers/facilitators will be developed. Literature
review on decision aid tools for risk-tailored screening and risk communication
strategies will be performed. Survey (involving European ongoing pilot programs) to
assess risk communication practices including written materials, communication
campaigns, media approaches will be conducted. Focus groups with screening target
populations and use of narrative medicine techniques will be conducted.
Task will be led by IRFMN, Italy, co-led by ISPRO, Italy.
ISPRO, NKIP, SCI, OIL
IRFMN, ICO,
UCY, IRFMN, UNICANCER,
NNGYK, CPO, AUSLRE,
PAT, RSU, IMIM,
NCI, IU NAMSU, DYPEDE,
OUS
T9.2Innovative
approaches to risk
stratification and
available tools
Definitions of risk-stratified screening will be developed. Risk assessment will be
conducted and predictive models and risk calculators will be performed sharing
results with WP10. Questions relevant for the HTA of the risk-stratified screenings will
be identified. WP6 and WP4 tools will be adopted for evaluating barriers and WP4
preparedness to risk-stratified screening. Ethical and privacy concerns (genetic and
non-genetic risks) will be addressed. A workshop to share the framework for
evaluation with tasks 9.3, 9.4, and 9.5 will be organised. Feedback received from
tasks 9.3, 9.4, 9.5 will be used to refine the framework and tools.
Task will be led by AUSLRE, Italy, co-led by CPO, Italy.
SCI, CIPH, ISPRO, OIL
AUSLRE, CPO
UCY, CSF, UNICANCER,
BIPS, UCSC, RSU, NCI,
IU NAMSU, DYPEDE
T9.3Individualised
cervical cancer
screening,
including
integrating state-ofthe-
art triage
methods to
screening
Survey on existing models, organisational approaches, and member states’ data on
risk-based cervical cancer screening will be conducted. Cost-effectiveness scenarios
will be defined, informed by the RISCC project and existing pilots, focusing on two
risk-stratifications levels: whole population and HPV-positive women. Alignment with
existing European recommendations and identification of areas needing new
recommendations will be performed defining relevant clinical questions and
identifying research priorities. A toolbox will be built for implementing strategies
informed by WP4, WP6, and WP10.
This task will be led by AUSLRE, Italy, co-led by ISPRO, Italy.
ISPRO, SCI, UZIS, THL,
SoS,
IOL, PHCI
AUSLRE, CSF, NNGYK,
DOHI, CPO, PAT, RSU,
LSMUKK, OUS, RCC, NCI,
IU NAMSU, DYPEDE, HDH
T9.4Risk-based
colorectal cancer
screening
Survey of the models and examination of organisational approaches, data sources to
stratify the population into risk groups and assessment of data on feasibility,
transferability and implementation of tools addressing screening facilitators and
barriers will be conducted. Clinical questions for guidelines will be prioritized,
including benefits and harms through implementation research, and definitions of
cost-effectiveness. Other activities will include coordination of data analysis plans
from pilot studies with 2 approaches: individual risk assessment and screening
history; analysis of European guidelines for alignment or need for new
recommendations; and development of a toolbox for implementation strategies based
on existing recommendations, and findings from this task, WP4, WP6 and WP10, to
support national/local decision making.
This task will be led by CPO, Italy.
LU
SoS, CIPH,
UZIS, ISPRO,
CPO, CSF,
BIPS, NNGYK, DOHI,
AUSLRE, NIJZ, IMIM,
BIOSISTEMAK, IDIVAL,
RCC, DYPEDE, NCI, UMIT
TIROL,
Iasi RIO
T9.5Breast cancer
screening based on
individual risk
characteristics
The following activities will be carried out: survey of existing, ongoing, and planned
risk assessment experimentations and evaluation of their impact on benefits; review
of guidelines and identification of research gaps and implementation, and prioritised
clinical questions for guideline updates; systematic review and multidisciplinary
analysis (consensus method) of cost-effectiveness models and socio-psychological
impact, and Patient Reported Outcomes (PROMS); collection and analysis of data on
feasibility, transferability, and challenges in different screening approaches; and
development of a toolbox for critical analysis of screening strategies to support
decision makers at national/local level (expected benefits, costs, cost-effectiveness).
This task will be led by Unicancer, France, co-led by CPO, Italy.
ISPRO, OIL,
Unicancer, CPO, UCY, CSF,
ISS, AUSLRE, LoR,
LSMUKK, OUS,
BIOSISTEMAK, IOCN, APHP,
NCI, NNGYK, UMIT
TIROL
T9.6Integrating primary,
secondary and
tertiary prevention
with screening

The following activities will be carried out: map ongoing primary, secondary, and
tertiary prevention and screening projects in Europe aligned with the Europe’s
Beating Cancer Plan (EBCP); examination of projects’ global health impact, benefits,
opportunities, risks, cost-effectiveness, socio-behavioural aspects, and organisational
readiness on best practices focusing on cancer literacy; development of a roadmap
on best practices considering social, practical and organisational dimensions,
including findings of tasks, 9.1, 9.3-9.5; focus group discussions with practitioners
and stakeholders involved in prevention strategies on EHDS utilisation and
behavioural surveillance; and collaboration with JA Prevent and Can.Heal and
PERCH to leverage their outputs.

This task will be led by SCI, Belgium, co-led by Unicancer, France

SCI, ISPRO, OIL,
ICO, CIPH, TAI
Unicancer, CCRef, CvKO,
BRUPREV, AUSLRE, CPO,
UCSC, OUS, RSU, NCI
T9.7The role of risk
stratification in new
screenings (lung,
prostate, gastric)
The following activities will be carried out: survey of risk stratification models and
organisational approaches for new screening; analysis of European guidelines and
options; definition of cost-effectiveness scenarios and conduction of pooled data
analysis from pilot studies. with feedback fromWP10 for relevant models; systematic
reviews and multidisciplinary analyses (consensus method) to identify knowledge and
research gaps in risk-stratified screening for lung, prostate, and gastric cancers
(informed by 8.1, 8.2, 8.3, 8.4, 8.5); feedback provision to WP10 on costeffectiveness
analysis.
This task will be led by Unicancer, France, co-led by ISPRO, Italy.
ISPRO, PHC, INCa, NKIP
Unicancer, CPO,
BIOSISTEMAK, IDIVAL, OIL,
AUSLRE, LoR, NCI, IU
NAMSU, AP-HP

Task NrTask NameDescriptionParticipantsRoleIn-kind Contributions/Subcontracting
T9.1Development and
assessment of
methods for
promoting informed
choice and
communication in
personalised
programs
Methods for measuring informed choices in risk-based screening monitoring systems
considering social and individual barriers/facilitators will be developed. Literature
review on decision aid tools for risk-tailored screening and risk communication
strategies will be performed. Survey (involving European ongoing pilot programs) to
assess risk communication practices including written materials, communication
campaigns, media approaches will be conducted. Focus groups with screening target
populations and use of narrative medicine techniques will be conducted.
Task will be led by IRFMN, Italy, co-led by ISPRO, Italy.
ISPRO, NKIP, SCI, OIL
IRFMN, ICO,
UCY, IRFMN, UNICANCER,
NNGYK, CPO, AUSLRE,
PAT, RSU, IMIM,
NCI, IU NAMSU, DYPEDE,
OUS
BEN
AE

Yes (subcontracting)
T9.2Innovative
approaches to risk
stratification and
available tools
Definitions of risk-stratified screening will be developed. Risk assessment will be
conducted and predictive models and risk calculators will be performed sharing
results with WP10. Questions relevant for the HTA of the risk-stratified screenings will
be identified. WP6 and WP4 tools will be adopted for evaluating barriers and WP4
preparedness to risk-stratified screening. Ethical and privacy concerns (genetic and
non-genetic risks) will be addressed. A workshop to share the framework for
evaluation with tasks 9.3, 9.4, and 9.5 will be organised. Feedback received from
tasks 9.3, 9.4, 9.5 will be used to refine the framework and tools.
Task will be led by AUSLRE, Italy, co-led by CPO, Italy.
SCI, CIPH, ISPRO, OIL
AUSLRE, CPO
UCY, CSF, UNICANCER,
BIPS, UCSC, RSU, NCI,
IU NAMSU, DYPEDE
BEN
AE
No
T9.3Individualised
cervical cancer
screening,
including
integrating state-ofthe-
art triage
methods to
screening
Survey on existing models, organisational approaches, and member states’ data on
risk-based cervical cancer screening will be conducted. Cost-effectiveness scenarios
will be defined, informed by the RISCC project and existing pilots, focusing on two
risk-stratifications levels: whole population and HPV-positive women. Alignment with
existing European recommendations and identification of areas needing new
recommendations will be performed defining relevant clinical questions and
identifying research priorities. A toolbox will be built for implementing strategies
informed by WP4, WP6, and WP10.
This task will be led by AUSLRE, Italy, co-led by ISPRO, Italy.
ISPRO, SCI, UZIS, THL,
SoS,
IOL, PHCI
AUSLRE, CSF, NNGYK,
DOHI, CPO, PAT, RSU,
LSMUKK, OUS, RCC, NCI,
IU NAMSU, DYPEDE, HDH

BEN
AE

Yes (subcontracting)
T9.4Risk-based
colorectal cancer
screening
Survey of the models and examination of organisational approaches, data sources to
stratify the population into risk groups and assessment of data on feasibility,
transferability and implementation of tools addressing screening facilitators and
barriers will be conducted. Clinical questions for guidelines will be prioritized,
including benefits and harms through implementation research, and definitions of
cost-effectiveness. Other activities will include coordination of data analysis plans
from pilot studies with 2 approaches: individual risk assessment and screening
history; analysis of European guidelines for alignment or need for new
recommendations; and development of a toolbox for implementation strategies based
on existing recommendations, and findings from this task, WP4, WP6 and WP10, to
support national/local decision making.
This task will be led by CPO, Italy.
LU
SoS, CIPH,
UZIS, ISPRO,
CPO, CSF,
BIPS, NNGYK, DOHI,
AUSLRE, NIJZ, IMIM,
BIOSISTEMAK, IDIVAL,
RCC, DYPEDE, NCI, UMIT
TIROL,
Iasi RIO
COO
BEN
AE
No
T9.5Breast cancer
screening based on
individual risk
characteristics
The following activities will be carried out: survey of existing, ongoing, and planned
risk assessment experimentations and evaluation of their impact on benefits; review
of guidelines and identification of research gaps and implementation, and prioritised
clinical questions for guideline updates; systematic review and multidisciplinary
analysis (consensus method) of cost-effectiveness models and socio-psychological
impact, and Patient Reported Outcomes (PROMS); collection and analysis of data on
feasibility, transferability, and challenges in different screening approaches; and
development of a toolbox for critical analysis of screening strategies to support
decision makers at national/local level (expected benefits, costs, cost-effectiveness).
This task will be led by Unicancer, France, co-led by CPO, Italy.
ISPRO, OIL,
Unicancer, CPO, UCY, CSF,
ISS, AUSLRE, LoR,
LSMUKK, OUS,
BIOSISTEMAK, IOCN, APHP,
NCI, NNGYK, UMIT
TIROL
BEN
AE
No
T9.6Integrating primary,
secondary and
tertiary prevention
with screening

The following activities will be carried out: map ongoing primary, secondary, and
tertiary prevention and screening projects in Europe aligned with the Europe’s
Beating Cancer Plan (EBCP); examination of projects’ global health impact, benefits,
opportunities, risks, cost-effectiveness, socio-behavioural aspects, and organisational
readiness on best practices focusing on cancer literacy; development of a roadmap
on best practices considering social, practical and organisational dimensions,
including findings of tasks, 9.1, 9.3-9.5; focus group discussions with practitioners
and stakeholders involved in prevention strategies on EHDS utilisation and
behavioural surveillance; and collaboration with JA Prevent and Can.Heal and
PERCH to leverage their outputs.

This task will be led by SCI, Belgium, co-led by Unicancer, France

SCI, ISPRO, OIL,
ICO, CIPH, TAI
Unicancer, CCRef, CvKO,
BRUPREV, AUSLRE, CPO,
UCSC, OUS, RSU, NCI
BEN
AE
No
T9.7The role of risk
stratification in new
screenings (lung,
prostate, gastric)
The following activities will be carried out: survey of risk stratification models and
organisational approaches for new screening; analysis of European guidelines and
options; definition of cost-effectiveness scenarios and conduction of pooled data
analysis from pilot studies. with feedback fromWP10 for relevant models; systematic
reviews and multidisciplinary analyses (consensus method) to identify knowledge and
research gaps in risk-stratified screening for lung, prostate, and gastric cancers
(informed by 8.1, 8.2, 8.3, 8.4, 8.5); feedback provision to WP10 on costeffectiveness
analysis.
This task will be led by Unicancer, France, co-led by ISPRO, Italy.
ISPRO, PHC, INCa, NKIP
Unicancer, CPO,
BIOSISTEMAK, IDIVAL, OIL,
AUSLRE, LoR, NCI, IU
NAMSU, AP-HP
BEN
AE
No

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Logo EU EUCanScreen VerticalThe 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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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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Instagram

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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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