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Modelled mortality benefits of multi-cancer early detection screening in England

Sasieni, P; Smittenaar, R; Hubbell, E; Broggio, J; Neal, RD; Swanton, C; (2023) Modelled mortality benefits of multi-cancer early detection screening in England. British Journal of Cancer , 129 pp. 72-80. 10.1038/s41416-023-02243-9. Green open access

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Abstract

Background: Screening programmes utilising blood-based multi-cancer early detection (MCED) tests, which can detect a shared cancer signal from any site in the body with a single, low false-positive rate, could reduce cancer burden through early diagnosis. Methods: A natural history (‘interception’) model of cancer was previously used to characterise potential benefits of MCED screening (based on published performance of an MCED test). We built upon this using a two-population survival model to account for an increased risk of death from cfDNA-detectable cancers relative to cfDNA-non-detectable cancers. We developed another model allowing some cancers to metastasise directly from stage I, bypassing intermediate tumour stages. We used incidence and survival-by-stage data from the National Cancer Registration and Analysis Service in England to estimate longer-term benefits to a cohort screened between ages 50–79 years. Results: Estimated late-stage and mortality reductions were robust to a range of assumptions. With the least favourable dwell (sojourn) time and cfDNA status hazard ratio assumptions, we estimated, among 100,000 screened individuals, 67 (17%) fewer cancer deaths per year corresponding to 2029 fewer deaths in those screened between ages 50–79 years. Conclusion: Realising the potential benefits of MCED tests could substantially reduce late-stage cancer diagnoses and mortality.

Type: Article
Title: Modelled mortality benefits of multi-cancer early detection screening in England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/s41416-023-02243-9
Publisher version: https://doi.org/10.1038/s41416-023-02243-9
Language: English
Additional information: © 2023 Springer Nature Limited. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Cancer epidemiology, Cancer screening
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/10169806
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