title: Evaluation of feedback interventions for improving the quality assurance of cancer screening in Japan: study design and report of the baseline survey.
abstract: OBJECTIVE
  The importance of quality assurance in cancer screening has recently gained increasing attention in Japan. To evaluate and improve quality, checklists and process indicators have been developed. To explore effective methods of enhancing quality in cancer screening, we started a randomized control study of the methods of evaluation and feedback for cancer control from 2009 to 2014.
  
  
  METHODS
  We randomly assigned 1270 municipal governments, equivalent to 71% of all Japanese municipal governments that performed screening programs, into three groups. The high-intensity intervention groups (n = 425) were individually evaluated using both checklist performance and process indicator values, while the low-intensity intervention groups (n= 421) were individually evaluated on the basis of only checklist performance. The control group (n = 424) received only a basic report that included the national average of checklist performance scores. We repeated the survey for each municipality's quality assurance activity performance using checklists and process indicators.
  
  
  RESULTS
  In this paper, we report our study design and the result of the baseline survey. The checklist adherence rates were especially low in the checklist elements related to invitation of individuals, detailed monitoring of process indicators such as cancer detection rates according to screening histories and appropriate selection of screening facilities. Screening rate and percentage of examinees who underwent detailed examination tended to be lower for large cities when compared with smaller cities for all cancer sites.
  
  
  CONCLUSIONS
  The performance of the Japanese cancer screening program in 2009 was identified for the first time.
authors.affiliation: Screening Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Machii
authors.forename: Kumiko
authors.initials: K
authors.lastname: Saika
authors.forename: Takahiro
authors.initials: T
authors.lastname: Higashi
authors.forename: Ayako
authors.initials: A
authors.lastname: Aoki
authors.forename: Chisato
authors.initials: C
authors.lastname: Hamashima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
mesh_terms: D057189:Checklist; D055088:Early Detection of Cancer / Q000592:standards* / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D017064:Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012107:Research Design; D011795:Surveys and Questionnaires