Article Text


The characteristics of national health initiatives promoting earlier cancer diagnosis among adult populations: a systematic review protocol


Introduction The increasing burden of cancer morbidity and mortality has led to the development of national health initiatives to promote earlier cancer diagnosis and improve cancer survival. This protocol describes a systematic review aiming to identify the evidence about such initiatives among the adult population. We will describe their components, stakeholders and target populations, and summarise their outcomes.

Methods and analysis We will search databases and websites for peer-reviewed publications and grey literature on national health initiatives in high-income countries as defined by the World Bank. Quantitative, qualitative and mixed-methods studies will be included and assessed for their methodological quality. Study selection, quality assessment and data extraction will be carried out independently by two reviewers. Narrative synthesis will be used to analyse the findings.

Ethics and dissemination This systematic review analyses secondary data and ethical approval is not required. Review findings will be helpful to researchers, policy makers, governments and other key stakeholders developing similar initiatives and assessing cancer outcomes. The results will be submitted to a peer-reviewed journal in order to reach a diverse group of healthcare professionals, researchers and policy makers. This systematic review protocol is registered at PROSPERO (CRD42016047233).

  • government initiatives
  • systematic review
  • early detection of cancer
  • early diagnosis
  • cancer survival

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from


  • Contributors NC, CC and DW developed and refined the systematic review protocol. NC drafted the manuscript, which was then critically assessed by both CC and DW. All authors approved the final version of this manuscript. NC is the guarantor.

  • Funding This review is supported by the Scottish Government (via the Detect Cancer Early Programme) as part of a PhD study investigating the role of health system level initiatives in promoting the earlier diagnosis of cancer. The PhD is also funded by scholarships from the University of Edinburgh. The supporters had no role in the preparation of this review protocol nor in the decision to publish it.

  • Competing interests None declared.

  • Patient consent This systematic review protocol did not require ethical approval as there is no direct contact with research participants, no issues of confidentially or potential harms. Only secondary data from published studies and grey literature will be analysed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Any data related to this protocol and not published are available upon request to the authors (by email or post). These may include final search strategies for all databases, completed data extraction forms, among others. Please contact the corresponding author ( if you would like to obtain these data.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.