Review finds no sustainability tool designed for cancer screening programs

Sustaining organized cancer screening programs remains a challenge, but the suitability of existing public-health sustainability measures is unclear. This scoping review, conducted within the EUCanScreen joint action, updated earlier reviews and searched six databases for studies published from January 2021 to January 2025. It included studies describing the development, validation or application of multi-item sustainability tools and assessed their coverage of six domains: stakeholder engagement, planning, monitoring, resources, human resources and communication.

Of 37 full-text articles assessed, four newly identified tools met the criteria. Combined with 18 tools from previous reviews, these yielded 22 tools for analysis; 19 were quantitative. Five covered all six domains. None was developed specifically for cancer screening, and only one had been used in a screening setting: a qualitative evaluation of the US CDC Colorectal Cancer Control Program.

The authors conclude that most existing tools would need adaptation for screening programs and suggest developing a tailored or hybrid measure informed by validated tools and adapted to national or regional infrastructure. The review maps available instruments rather than testing whether using them improves program sustainability or screening outcomes. It was co-funded by the European Union; the authors declared no competing interests.