Table 1

Criteria for setting a threshold for the key benefit of cancer screening in the trade-off between benefits versus harms and burdens and in cost-effectiveness evaluation in cancer screening guidelines*

Questions	Criteria or examples for judging ‘yes’
Key steps for setting a threshold for the key benefit of screening given harms and burdens
1. Does the guideline specify cancer mortality and/or incidence as the only key benefit of screening?	Specifying by a statement that cancer mortality and/or incidence is the ‘key’, ‘crucial’, ‘most important’ (or using synonyms) benefit. Specifying by another statement reflecting that cancer mortality and/or incidence is the only/main benefit considered by the guideline panel. Specifying by grading the importance of outcomes.
2. Does the guideline have an explicit statement of key harms and burdens of screening?	Specifying by a statement that certain outcomes are ‘key’, ‘crucial’ or ‘most important’ (or using synonyms) harms or burdens considered by the guideline panel. Specifying by a statement reflecting that certain outcomes are the main harms and burdens considered by the guideline panel. Specifying by grading the importance of outcomes.
3. Does the guideline specify the magnitude of effect of the key harms and burdens of screening?	Yes, specifies in absolute term or relative term. No, not specified.
4. Does the guideline specify the magnitude of effect of the key benefit (ie, reduction in cancer mortality or cancer incidence) that would be required for recommending screening, given the evidence of key harms and burdens?	That is, specifying a threshold for the key benefit that would be required for recommending screening (vs no screening) or a particular screening option (vs other options), given the evidence of harms and burdens.
Key steps for setting a threshold for the key benefit of screening in cost-effectiveness evaluation
1. Does the guideline consider cost-effectiveness evaluation?	The guideline panel performed cost-effectiveness evaluation. The guideline panel identified cost-effectiveness evidence performed by other researchers.
2. Does the guideline identify the key benefit of screening in cost-effectiveness evaluation?	Specifying by a statement of ‘key’, ‘crucial’ or ‘most important outcome’ (or using synonyms). Specifying by other statement reflecting that a certain outcome is the only benefit considered by the guideline panel in cost-effectiveness evaluation. Specifying by grading the importance of outcomes.
3. Does the guideline specify the measurement of the cost-effectiveness ratio for the key benefit?	For example, the incremental cost-effectiveness ratio (ICER).
4. Does the guideline set a cost-effectiveness threshold that would be required for recommending screening (vs no screening) or a particular screening option (vs other options)?	For example, a threshold for ICER that would be required for recommending screening.

*Guidelines that performed each of the key steps meet the criteria of setting a threshold for the key benefit of screening in the trade-off between benefits versus harms and burdens or in cost-effectiveness evaluation.