At the request of the Minister of Health, Welfare and Sport, the Health Council has assessed whether and under what conditions risk-based screening could be introduced within the national cancer screening programmes.
Currently, the national cancer screening programmes have a population-based approach. However, some people within the target group are at greater risk than others of developing the disease being screened for. Risk-based screening involves offering screening strategies based on the individual risk of developing the disease. The council describes the potential of risk-based screening and the legal and regulatory requirements. This advice is intended to serve as a framework for future research and implementation of risk-based screening.
Risk-based screening could improve the balance between the benefits and harms of the national cancer screening programmes. An important condition is that the benefits outweigh the harms, also when risk-based screening is implemented as a result of a limited screening capacity.
To implement risk stratification, scientific data are required. Several large randomised studies on risk-based screening are ongoing, but their results are not yet available. For estimating risk scores, the council advises using data already available from the screening programmes, such as previous test results.
Another condition for risk-based screening is that data from different databases must be linked. Additionally, communication is important to ensure that the target group can make an informed choice and that there is sufficient acceptance among the target group and healthcare professionals.