Evaluation On The Surveillance Systems Related To The Risk Factors Of Major Cancers In China

Objective To establish an index system for evaluation the surveillance systems related to the risk factors of major cancers in China(Chronic diseases and related risk factors Surveillance,Death Surveillance and Cancer Registry),based on the evaluation results to provide advises for establishment a surveillance system on the risk factors of major cancers or improvement the existing and relevant surveillance systems.Methods Using the literature search to search guidelines or frameworks published by international official organizations about surveillance system evaluation.Taking the guidelines of the United States CDC and WHO as reference,combined with the purpose of evaluation and the actual work status of the surveillance systems to be evaluated,the improved Delphi method was used to construct the evaluation index system for this study.Through four methods of data collection,such as field assessment method,data retrieval method,high-level information collection method and questionnaire survey method,each index of each surveillance system was evaluated.The TOPSIS method was used to comprehensively evaluate the three surveillance systems.Results According to the literature search,some guidelines for the evaluation of surveillance systems published by international official organizations have been obtained.Two rounds of Delphi method were carried out in this study.The active coefficients of experts in the two rounds were 85.00% and 94.74%,respectively,and the average authority degree of experts was 0.835.The coordination coefficient of experts on the importance and feasibility scores in the second round were0.578(P<0.01)and 0.589(P<0.01),respectively.The final evaluation index system was established including 3 items of primary indexed,10 items of secondary indexes and 25 items of tertiary indexes.Through four data collection methods,the evaluationresults of the three systems were showed.The chronic diseases and related risk factors surveillance system covers more information on the influence factors of cancers,and uploads data more timely by electronic surveillance technique.The cancer registry system has a relatively coding standard and more complete pathogenesis information of cancer.The death surveillance system has a longer operating time,more complete information on cancer deaths,a wider coverage in monitoring areas,and more research outputs.The common deficiencies are that the information on cancer risk factors and cancer treatment is not yet comprehensive,monitoring methods still need to be improved,the system lacks of legal system protection and so on.After excluding timeliness indicators,the TOPSIS method ranking result shows that the first is the death surveillance system,the second is the cancer registry system,and the third is the chronic diseases and related risk factors surveillance system.However,due to the subjectivity of the evaluation index system and the limitations of TOPSIS method,the ranking result does not represent the actual value of the three systems.Based on the evaluation results,it is recommended that efforts be made to improve surveillance system of cancer in China in terms of complete monitoring content,development of monitoring tools,expansion of monitoring scope,emphasis on team building,improvement of data quality,and strengthening of government guarantees.Conclusions The evaluation index system by improved Delphi method,based on international guidelines combined with actual conditions,high enthusiasm of experts,good degree of authority and coordination,and reasonable calculation of index weights,is suitable to evaluate the relevant surveillance systems.The respective advantages of the three related surveillance systems discovered through the evaluation results should continue to be maintained,and the common deficiencies need to be further improved.We look forward to establishing a sound cancer surveillance system to provide strong support for the prevention and control of cancer as soon as possible in China.