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Mission Early commissioned RAND Europe to develop an evidence-informed policy framework for early cancer care, which has been previously defined as coordinated efforts across education, screening, diagnosis and timely treatment to detect cancers at their most curable stages. Despite advances in cancer detection and therapy, challenges in access to early diagnosis and treatment persist, and policies often operate in isolation.
We set out to identify and achieve expert consensus on the essential policy components and characteristics of an ‘ideal’ policy framework for early cancer care and understand barriers, enablers and other aspects influencing the implementation of these components across diverse health system contexts.
A three-phase expert consensus study was conducted using a mixed-methods approach. Phase 1 involved idea generation with cancer policy experts. Phase 2 consisted of an Expert Consensus Panel through RAND’s ExpertLens™ platform for iterative rating and discussion of policy components across three rounds. Phase 3 comprised validation workshops to refine findings and assess framework applicability. Quantitative consensus ratings and qualitative thematic insights were synthesised across each phase.
The research spanned international cancer policy and health system contexts across high-, middle-, and low-income settings. Experts in cancer policy represented many countries, including Australia, Colombia, Germany, Italy, Japan, Mexico, the Netherlands, Romania, Rwanda, the UK and the United States.
Our research focused on the development and validation of a consensus-based early cancer care policy framework spanning education and engagement, early detection and screening, early diagnosis, early treatment and cross-cutting health system strengthening components.
Experts identified a set of policy strategies across the cancer care pathway, which were categorised and mapped into ten policy components. Each of these components was rated according to importance and feasibility, with experts considering all components valuable: Public Education and Community Empowerment were rated highly important and feasible; Primary Care Capacity, Care Coordination, and Data Infrastructure were considered as important but moderately feasible due to workforce and governance constraints. Detection and Diagnostic Innovation were valued as important, but raised equity and cost considerations. Incentivisation Structures and Real‑world Evidence systems were regarded as beneficial but difficult to implement due to different contexts in specific systems. Experts’ comments and discussions were recorded and thematised throughout, which highlighted key implementation considerations to address common feasibility concerns. The resulting framework emphasised early cancer care as an integrated continuum supported by data systems, workforce capacity and aligned incentives.
Early cancer care requires cohesive, system-wide policy design linking prevention, detection, diagnosis, treatment and health system strengthening. The proposed framework provides a practical foundation to support policymakers and guide policy dialogue, fostering long-term, equitable and patient-centred progress through coordinated action rather than isolated interventions.
Future research should evaluate the framework’s applicability across different contexts, conduct comparative implementation studies and examine the economic and behavioural aspects of early cancer care. It should also develop context-specific measures and benchmarks to assess and refine the policy components identified within the framework.
