Background: The World Health Organization (WHO) has recently established global initiatives for childhood (2018), cervical (2020), and breast (2021) cancers, outlining key population-based targets for their prevention and control. Recognizing that cancers represent a complex and heterogeneous group of conditions, we sought to develop a comprehensive set of evidence-informed indicators to be included within a global cancer monitoring and evaluation framework.

Objectives: We conducted a rapid review to identify and synthesize indicators related to global cancer monitoring and evaluation from the scientific literature. The pool of literature-derived indicators would undergo selection and prioritization by an international expert panel for ultimate inclusion in the global framework.

Methods: In consultation with WHO cancer experts, we developed the global framework structure and domains a priori, considering the Donabedian model for healthcare quality, the WHO health systems building blocks, the cancer control continuum, and existing WHO monitoring frameworks for primary health care, noncommunicable diseases, and priority cancers (childhood, cervical, and breast). We systematically searched MEDLINE, CINAHL, PsycINFO, the Cochrane Systematic Reviews Database, and the WHO Global Index Medicus for peer-reviewed literature reviews, guidelines, and expert consensus statements published between 2000 and 2024. Two reviewers performed two-step relevance screening of the references. References were included if they had a formal literature review component as part of their methodology and if they focused on developing or defining monitoring and evaluation indicators specific to cancers. Indicators extracted through the systematic search were supplemented by indicators from the existing WHO monitoring frameworks. Indicators were then categorized according to the global framework domains. During the synthesis process, indicators with similar definitions were iteratively combined until a set of measurable indicators with distinct definitions was achieved.

Results: After screening 10,224 references, 126 references representing 120 studies were included. Most studies were expert panel consensus reports, including Delphi panels (n = 69, 58%), followed by systematic reviews (n = 31, 26%), scoping reviews (n = 10, 8%), narrative or non-systematic reviews (n = 9, 8%), and guideline statements (n = 1, 1%). Most studies focused on high-income countries (n = 100, 83%), followed by studies with mixed or undefined country resource levels (n = 16, 13%), and studies focusing on low and middle-income countries (n = 4, 3%). A total of 3,545 indicators was extracted. Following the indicator synthesis process, 155 unique indicators were derived. Among these, 30 (19%) were classified as input-type indicators, covering structural domains like governance, health workforce, medicines and technology, health information, and financing; 84 (54%) as process-type indicators, covering primary prevention, screening and early detection, diagnosis, appropriate management (treatment and survivorship), palliative and supportive care, healthcare utilization, quality, and safety, and patient-reported outcomes and experience; and 41 (26%) as outcome-type indicators, covering physiological risk factors, infectious risk factors, lifestyle and behavioural risk factors, quality of life, morbidity, and mortality.

Conclusions/Implications: Monitoring and evaluation of major conditions is an essential function of public health systems. We have identified comprehensive, evidence-informed indicators that can be used to assess and compare country cancer burden and prevention and control efforts.