TY - JOUR
T1 - Navigating the risks
T2 - Stakeholder views on risk-based cervical cancer screening
AU - Remmel, Maali-Liina
AU - Suija, Kadri
AU - Markina, Anna
AU - Tisler, Anna
AU - Ķīvīte-Urtāne, Anda
AU - Stankūnas, Mindaugas
AU - Nygård, Mari
AU - Aasbø, Gunvor
AU - Maļina, Laura
AU - Uusküla, Anneli
N1 - Copyright: © 2025 Remmel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/3
Y1 - 2025/3
N2 - BACKGROUND: The development of risk-based cancer screening programs requires a paradigm shift in existing practices and healthcare policies. Therefore, it is crucial to not only assess the effectiveness of new technologies and risk prediction models but also to analyze the acceptability of such programs among healthcare stakeholders. This study aims to assess the acceptability of risk-based cervical cancer screening (RB CCS) in Estonia from the perspectives of relevant stakeholders.METHODS AND MATERIALS: This qualitative study employed semi-structured interviews with healthcare policy and service level stakeholders in Estonia. The Theoretical Framework of Acceptability guided the interview design, and the findings were charted using framework analysis based on the Consolidated Framework for Implementation Research.RESULTS: 17 interviews were conducted with stakeholders, including healthcare professionals, cancer registry representatives, technology specialists, policymakers, and health insurance providers. While stakeholders generally supported the concept and potential benefits of RB CCS, recognizing its capacity to improve screening outcomes and resource allocation, they raised significant concerns about feasibility, complexity, and ethical challenges. Doubts were expressed about the readiness of the healthcare system and population, particularly the current health information system's capacity to support risk-based approaches. The need for evidence-based and internationally validated screening models, comprehensive public communication, provider training, and collaborative discussions involving all relevant parties, including the public, was emphasized.CONCLUSION: The favorable attitude towards RB CCS among stakeholders provides a strong foundation for advancing its development. However, a comprehensive strategy emphasizing the generation of robust evidence, strengthening healthcare infrastructure, prioritizing patient empowerment, and cultivating a collaborative environment built on trust is crucial.
AB - BACKGROUND: The development of risk-based cancer screening programs requires a paradigm shift in existing practices and healthcare policies. Therefore, it is crucial to not only assess the effectiveness of new technologies and risk prediction models but also to analyze the acceptability of such programs among healthcare stakeholders. This study aims to assess the acceptability of risk-based cervical cancer screening (RB CCS) in Estonia from the perspectives of relevant stakeholders.METHODS AND MATERIALS: This qualitative study employed semi-structured interviews with healthcare policy and service level stakeholders in Estonia. The Theoretical Framework of Acceptability guided the interview design, and the findings were charted using framework analysis based on the Consolidated Framework for Implementation Research.RESULTS: 17 interviews were conducted with stakeholders, including healthcare professionals, cancer registry representatives, technology specialists, policymakers, and health insurance providers. While stakeholders generally supported the concept and potential benefits of RB CCS, recognizing its capacity to improve screening outcomes and resource allocation, they raised significant concerns about feasibility, complexity, and ethical challenges. Doubts were expressed about the readiness of the healthcare system and population, particularly the current health information system's capacity to support risk-based approaches. The need for evidence-based and internationally validated screening models, comprehensive public communication, provider training, and collaborative discussions involving all relevant parties, including the public, was emphasized.CONCLUSION: The favorable attitude towards RB CCS among stakeholders provides a strong foundation for advancing its development. However, a comprehensive strategy emphasizing the generation of robust evidence, strengthening healthcare infrastructure, prioritizing patient empowerment, and cultivating a collaborative environment built on trust is crucial.
KW - Humans
KW - Uterine Cervical Neoplasms/diagnosis
KW - Female
KW - Early Detection of Cancer/psychology
KW - Stakeholder Participation
KW - Estonia
KW - Qualitative Research
KW - Mass Screening
KW - Risk Assessment
KW - Health Policy
KW - Health Personnel/psychology
UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/MEDLINE:40043044
UR - https://pubmed.ncbi.nlm.nih.gov/40043044/
UR - http://www.scopus.com/inward/record.url?scp=86000157023&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0317986
DO - 10.1371/journal.pone.0317986
M3 - Article
C2 - 40043044
SN - 1932-6203
VL - 20
JO - PloS one
JF - PloS one
IS - 3
M1 - e0317986
ER -
