Healthcare Delivery
Research Blog

July 2015


The International Screening Network met in Rotterdam, Netherlands this year and has been gathering regularly since the late 1980s.  It was started by Sam Shapiro, the father of cancer screening. He developed and ran the Health Insurance Plan (HIP) randomized trial that created the evidence used to argue for and about mammography for 40 years.  Pretty important data. He thought we could merge breast cancer data from organized programs across Europe and the US.  I attended my first meeting with him 20 years ago in Florence where we realized that merging data was not happening quickly. We could, however, identify common questions, and 20 years later a group of 20 people has grown into a more than 200 researchers whose collaboration has directly resulted in nearly 500 publications.  The meeting this year included workshops on overdiagnosis, primary care's role in cancer... Read more


In May I spent a few days with primary care researchers thinking about cancer at the Ca-PRI meeting. This network has been growing and gathering since 2008. Nearly 200 people attended this year and almost a quarter of them were PhD students, post-docs or young investigators. They reflected a growing cohort of people taking advantage of the many years of healthcare delivery data from countries with organized care systems. It was a peak into our potential future. It felt hopeful and exciting that it was possible to learn from routinely collected data. It was also intriguing because they see the cancer challenge a bit differently. For them, improving symptomatic detection is a big issue, since screening is handled by organized programs outside their realm.  But there was also some common ground; care of comorbid conditions, palliative care, and care at the end of life were all discussion topics and challenges to their care.  What issues do you think... Read more