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<https://discovery.ucl.ac.uk/id/eprint/10206230> <http://purl.org/dc/terms/title> "Screening for multiple cancers: evaluation must go beyond aggregate measures"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10206230> <http://purl.org/ontology/bibo/abstract> "Tom Callender and colleagues argue that aggregate outcomes amongst groups of cancers\r\nare insufficient for the evaluation of multi-cancer detection tests for cancer screening and\r\nthat research providing cancer-specific outcomes will be necessary.\r\nMulti-cancer detection tests (MCDs) using blood-based biomarkers for the concurrent\r\nscreening of multiple cancer types in asymptomatic individuals are currently being trialled in\r\nthe UK and elsewhere [1]. This has led to talk of their adoption in early cancer population\r\nscreening programmes.\r\nConsiderable attention has been paid to the potential benefits that MCDs could present by\r\nimproving cancer survival, particularly that of rarer cancers, through early detection.\r\nBalanced against these benefits has been a focus on the possible harms from false\r\npositives; inaccurate predictions of, or indeed inability to, predict the cancer site; and cases\r\nwhere a cancer is detected by an MCD but is too small to be seen on imaging [2,3].\r\nMost discussion has considered the overall – aggregate – benefits and harms of an MCD\r\nprogramme. However, cancers behave remarkably differently both between individuals and\r\ncancer types. Despite this, the benefits and harms accruing to each type of cancer with\r\nstrategies that uses a single multi-cancer screening test has had relatively little emphasis.\r\nIn this analysis, we discuss how differences in disease natural history could affect one\r\npotential harm, overdiagnosis, when screening for multiple cancers simultaneously. We\r\nargue that a focus on aggregate, all-cancer, metrics to evaluate MCDs will obscure\r\ndifferences between cancers that are clinically and policy relevant. Building on this, we\r\ndiscuss the benefits and challenges of approaches that balance the translation of a\r\npromising MCD screening programme against the further research that may be required to\r\ninform robust policy."^^<http://www.w3.org/2001/XMLSchema#string> .
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