Table 3.

Perceived fulfilment of screening principles within the disease/condition and program/system domains (Dobrow et al., 2018).

Domain	Screening principle	2000–2010	2010–2022	What is needed
Disease/condition principles	1. Epidemiology of the disease or condition	+/−	+/−	•Identification of a population for whom screening is relevant
	2. Natural history of disease or condition and detectable preclinical stage	–	+/−	•Understanding the natural history of BE and dysplasia in BE
	3. Target population for screening	–	+/−	•Accessible and complete documentation of personal risk information •Determining the target age range •Discriminative, validated, and accepted risk algorithms (including determination of risk-threshold value)
Program/system principles	7. Screening infrastructure*	–	+/−	•Technology to replace human efforts •High-volume test facilities •Strategy for handling downstream burden on endoscopic surveillance and treatment
	8. Screening coordination and integration	–	–	•Ownership of selecting, counselling, and testing screening participants
	9. Screening acceptability and ethics	+/−	+/−	•Information access for the public •Evaluation of stigmatizing effect of risk-based screening (sex, ethnicity, obesity, smoking and alcohol consumption are all socially sensitive) •Evaluation of the psychological impact of EAC screening
	10. Screening benefits and harms	–	–	•RCT level evidence on benefits and harms
	11. Economic evaluation	+/−	+	•Financial resources
	12. Quality and performance management	–	–	•Monitoring system (in the case of a screening program)

BE, Barrett’s esophagus; EAC, esophageal adenocarcinoma; RCT, randomized controlled trial.

* The test/intervention principles (4, 5 and 6) are shown in Table 4.