Development of Population-Based Cancer Indicators and a Measurement of Cancer Care Continuum Using a Modified Delphi Method

SIMPLE SUMMARY: This study intended to identify the current state of national cancer management and prevention policies and provide a useful framework for policy establishment. The development of population-based cancer indicators project was conducted as part of a Nationwide Population-based Cancer Registration Project and aimed to applying quality of health care system approaches to the cancer care in population-based monitoring system. The literature review and grey literature review were conducted prior to Delphi method. Our findings confirm 26 cancer indicators and classify them into “Primary prevention,” “Secondary prevention,” “Treatment,” “Quality of care,” “Survivor management,” and “End-of-life care.” The Donabedian model used for health services and the Institute of Medicine quality of healthcare domains of six dimensions were applied to the measurement system. The developed cancer indicators and measurements will be able to provide useful information for prioritizing the operational tasks that can be used by health authorities and policymakers from the other countries. ABSTRACT: To identify population-based cancer indicators and construct monitoring systems for the entire lifecycle of cancer patients using a modified Delphi method. A modified Delphi method was used to identify the cancer indicators and measurement by scoping review and gray literature. The final list of cancer indicators was developed by consensus of 11 multidisciplinary experts over multiple rounds and rating scored the importance of each indicator on a 10-point scale. Frequency analysis was performed to rate with median scores ≥7 and finalized the list of indicators according to the priority. Initially, 254 indicators were identified, of which 94 were considered important and feasible. After two rounds of rating by the experts and panel discussions, 26 indicators were finalized in six domains: primary prevention (n = 7), secondary prevention (n = 11), treatment (n = 2), quality of life (n = 4), survivor management (n = 1), and end-of-life care (n = 1). The Donabedian model used for examining health services and the Institute of Medicine quality of healthcare domains were applied to the measurement system. Panel experts identified cancer indicators based on priorities with a high level of consensus, providing a scrupulous foundation for community-based monitoring of cancer patients.