Scoping review finds no sustainability tools designed for cancer screening

Published in BMC Public Health, the study addresses the challenge of ensuring that cancer screening initiatives remain viable and effective over the long term. Following two decades of policy efforts to implement these programs in many European countries, the sustainability of such initiatives remains a key concern. The authors note that measuring sustainability is a critical step toward improving implementation outcomes and ensuring the long-term impact of these public health interventions.

The primary objective of the review was to identify, synthesize, and evaluate existing sustainability assessment tools developed for public health and assess their applicability to organized cancer screening programs. While several tools have been created to measure sustainability in various community and public health settings, their specific utility for cancer screening has remained unclear. The review sought to clarify whether existing instruments could be directly applied or if significant adaptation is required to fit the unique infrastructure of cancer screening.

To achieve this, the research team updated a previous systematic review by Hall et al. from 2022 and integrated findings from a narrative review by Moullin et al. from 2020. The updated search extended to include studies published between January 2021 and January 2025. The researchers conducted a search across major databases, including PubMed/MEDLINE, Embase, the Cochrane Library, PsycINFO, CINAHL, and Scopus.

The methodological approach involved screening titles and abstracts using AI-assisted prioritization in the Rayyan platform. Full texts of potentially eligible studies were then assessed independently by two reviewers to determine eligibility. The inclusion criteria focused on studies reporting on the development, validation, or application of multi-item tools that assess sustainability or its determinants in public health or community settings.

Out of 37 full-text articles assessed, four newly identified tools met the inclusion criteria. These four tools were integrated with 18 tools retrieved from previous reviews, resulting in a total of 22 tools analyzed in the study. The analysis revealed that quantitative tools predominated, with 19 of the 22 tools being quantitative in nature.

The review also highlighted limitations in the comprehensiveness of these tools regarding specific sustainability domains. A critical finding of the review was that only five of the 22 tools covered all six key domains of sustainability identified by the authors. These domains include stakeholder engagement, planning, monitoring, resource availability, human resources, and communication.

The majority of tools did not cover all these domains. Furthermore, the review found that none of the 22 tools were specifically designed for cancer screening. Only one tool had been applied to a screening context, and this was through a qualitative evaluation of the CDC Colorectal Cancer Control Program in the USA.

The authors conclude that while several comprehensive tools exist in the public health domain, none were designed specifically for cancer screening. Most tools require adaptation to be effectively used in this context. The study suggests that developing a hybrid or tailored tool, informed by validated measures and adapted to national or regional cancer screening infrastructures, may enhance implementation and long-term sustainability.

This scoping review provides an overview of the current landscape of sustainability measurement tools in public health.

Subject of Research: Applicability of public health sustainability measurement tools to cancer screening programs

Article Title: Sustainability measurement tools in public health and their applicability to cancer screening programs: a scoping review within the EUCanScreen joint action

Article References: Guida, A., Togawa, K., Vicentini, M., Venturelli, F., Mazzoleni, E., Mantellini, P., Carvalho, A., Ivanuš, U., Heinävaara, S., Senore, C., Deandrea, S., Bassi, M. C., Giorgi Rossi, P., & EUCanScreen Consortium (2026). Sustainability measurement tools in public health and their applicability to cancer screening programs: a scoping review within the EUCanScreen joint action. BMC Public Health. https://doi.org/10.1186/s12889-026-30032-5

Image Credits: AI Generated

DOI: 10.1186/s12889-026-30032-5

Keywords: sustainability, cancer screening, public health, scoping review, EUCanScreen, health policy, measurement tools, implementation, measurement, tools, public, health