Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2016.50 Figure 2 A framework for ongoing improvement of cancer-screening programmes Figure 2 | A framework for ongoing improvement of cancer-screening programmes. We present a modified version of the screening cascade proposed by the High-Value Care Task Force of American College of Physicians109. Our recommendations for cancer-screening programmes focus on incorporation of key clinical questions at each step of the cascade, as well as components of the 'feedback loop' (areas to refine) — aspects of screening decision-making that can be actively improved using outcomes from the corresponding step on the cascade. IDLE, indolent lesions of epithelial origin. Shieh, Y. et al. (2016) Population-based screening for cancer: hope and hype Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2016.50