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258 The validity of instruments measuring knowledge in cancer screening programmes: a systematic review
  1. Rikke Nicoline Stokholm1,2,
  2. Louise Stenholt3,
  3. Henrik Hein Lauridsen4,
  4. Adrian Edwards1,5,
  5. Berit Andersen1,2,
  6. Mette Bach Larsen1,2
  1. 1Department of Public Health Programmes and University Research Clinic in Cancer Screening, Randers Regional Hospital, Randers, Denmark
  2. 2Department of Clinical Medicine, Aarhus University, Denmark
  3. 3Medical Library, Regional Hospital Central Jutland, Denmark
  4. 4Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
  5. 5Division of Population Medicine, School of Medicine, Cardiff University, UK


Introduction Relevant knowledge forms the basis of an informed choice about (non)participation in population-based cancer screening. Many instruments have been proposed to assess residents’ knowledge about participation in cancer screening programmes but their measurement properties are unknown. This systematic review aims to identify and critically appraise the measurement properties of instruments to measure knowledge about cancer screening in individuals eligible for population-based screening.

Methods A literature search was undertaken in PubMed, PsycINFO, Embase, CINAHL, Scopus and Web of Science in August 2023. The review included any study reporting instrument development and one or more measurement properties of the instrument or sub-scale used measuring knowledge of cancer screening including breast, colorectal and/or cervical cancer screening. Studies including males aged 45 or older and females aged 20 or older were included. Two independent reviewers screened the articles and assessed the included articles using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist for patient-reported outcome measures.

Results We included 31 studies (29 instruments). The included instruments varied in number and characteristics of items. None of the included instruments met initial COSMIN assessment criteria for adequate development, owing to inadequate content validity including the instrument development.

Discussion The validity of existing instruments is limited by the lack of a clear and common definition of what constitutes relevant knowledge about cancer screening. Despite inadequate instrument design and development, the existing instruments may serve as a strong inspiration in the conceptualization and design of novel validated measurement instruments.

Conclusion Studies were assessed to have inadequate development stages according to the COSMIN Risk of Bias Checklist. The results indicate an unmet need for a well-developed and validated instrument to measure knowledge about cancer screening focusing on the development process and content validity.

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