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The fundamental challenge of the ONCOSCREEN project is to explore if new technologies can be developed to improve the early diagnosis of colorectal cancer in Europe.  Finding these technologies would allow health systems to have alternatives with greater possibilities of covering more population and having a greater impact on the living conditions of the countries.

For a new technology to be incorporated into the portfolio of healthcare services available to citizens, it is necessary to examine the corresponding evidence. This presupposes that the steps followed by each country in the process of adopting new technologies comply with the criteria that the European Network of Health Technology Assessment (EUnetHTA) has drawn up for the approval of new technologies.

EUnetHTA’s assessment takes place in nine domains that should be considered in the assessment of new technologies. These criteria are as follows: 1) a general description of the characteristics of the technology being evaluated, reflecting what its main advantages are; 2) a description of the health problem and how the new technology will contribute to solving or improving it; 3) the advantage offered by the new technology with respect to the clinical effectiveness care patients receive; 4) the safety in the use of the technology, demonstrating the greatest possible confidence for users; 5) costs and economic evaluation do demonstrate its feasibility; 6) an ethical analysis that guarantees that the technology conforms to the guidelines that exist within the state that it is being developed; 7) the organizational aspects that would be involved in its application; 8) the effect it would have on patients and the social implications of its use; and 9) legal aspects that would affect all processes related to its adoption.

In ONCOSCREEN, it has been decided that while the above criteria would provide for a rigorous analysis of any technology, this process could be broadened with the inclusion of other criteria that might further improve the adoption process of new technologies. As such, the methodology designed in ONCOSCREEN could be seen as an innovative approach to add further weight to the adoption process.

In this benchmark methodology being developed by ONCOSCREEN, several additional criteria have been proposed. The first of these is direct access to the new technologies, especially in relation to their availability in both public and private health services. The second includes citizens’ perception of the advantage the use of this technology may offer them. The third criterion is related to an assessment of the possible impact that the use of the technology may have in participation numbers in colorectal cancer screening programs.

The fourth criterion is an assessment of whether or not citizens, either through health system financing or shared options, have the resources to access the new technologies. The next criterion is the analysis of the viability of integrating the use of the new technology into the health services, with the understanding that it would need to be adequately adapted to the characteristics of the local health system.  The sixth criterion considers whether the health system can feasibly regulate the application of technology. The last criterion is an assessment of the application of the technology by clinicians.

The application of these criteria in the evaluation of the technologies associated with ONCOSCREEN requires multiple sources of information, such as that derived from individuals participating in the clinical study, to patient organizations and clinicians, as well as from information available in the health systems of the countries involved in the project.

“Current standard of care” is a frequently used term when discussing medical technology assessment. The term refers to the most frequently used practice in each health system, relating to different activities, which in this case is CRC screening. The most common standard of care in Europe is the Faecal Immunological Test (FIT). Other countries combine this  with colonoscopy. In ONCOSCREEN, the screening alternatives being developed are compared to those that exist in each country as the standard of care. This article unpacks how ONCOSCREEN’s innovative methodology makes it possible to compare the new technologies that are being developed with those that exist as the current standard of care.


Contribution from URIOJA