NDLI: A systems based qualitative analysis exploring the potential to implement risk stratified bowel cancer screening in England

Content Provider	Springer Nature : BioMed Central
Author	Moorthie, Sowmiya Taylor, Lily Dennison, Rebecca Usher-Smith, Juliet
Abstract	Background Improving bowel cancer screening programmes through the introduction of risk stratification has been discussed, but not widely implemented in many countries. This study aimed to gain an understanding of system and programmatic aspects that need to be addressed to enable a move towards implementation. Methods The Engineering Better Care Framework was used to support exploration and thematic analysis of the views of stakeholders involved in delivery of bowel cancer screening in England. Semi-structured interviews (n = 11) were conducted to gain a better understanding of the problem, and to identify elements that would contribute to a well-designed programme and anticipate barriers to delivery. Results There is enthusiasm for introducing risk stratification and it is considered to be beneficial to improving the current screening programme. A major barrier impacting implementation is a lack of consensus on the best approach for risk stratified screening. Many interviewees recognised this as a bottle-neck and were in favour of processes that would enable more joined up decision-making to enable balanced consideration of the differing, and often nuanced potential of different strategies for risk stratification. Several key considerations and design elements were identified: evidence demonstrating benefit of a particular strategy, feasibility of programme delivery (data availability, workforce capacity, public and patient acceptability, impact on equity), as well as changes to design of patient communication materials, the bowel cancer screening system, consent and follow-up services. Conclusions System level issues and clarification of remaining uncertainties require resolution in order to move towards implementation. Moving this agenda forward requires consensus across different stakeholders in the first instance on the best use of risk. This will enable outlining key outstanding evidence gaps and establishing evidence thresholds for implementation. There are opportunities to design an optimal system based on harnessing existing infrastructure and learnings from other screening programmes.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-025-12381-w.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-025-12381-w
Journal	BMC Health Services Research
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-02-11
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Bowel cancer Cancer screening Risk stratification Health policy Risk prediction
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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