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Short-term Endpoints for Cancer Screening Trials: Does Tumor Subtype Matter?

Owens, Lukas; Gogebakan, Kemal Caglar; Menon, Usha; Gulati, Roman; Weiss, Noel S; Etzioni, Ruth; (2023) Short-term Endpoints for Cancer Screening Trials: Does Tumor Subtype Matter? Cancer Epidemiology, Biomarkers and Prevention , 32 (6) pp. 741-743. 10.1158/1055-9965.EPI-22-1307.

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Abstract

Multicancer early detection tests are precipitating a reexamination of potential short-term endpoints for cancer screening trials. A reduction in advanced stage incidence is a prime candidate, and stage-shift models that substitute early-stage for late-stage survival have been used to predict mortality reduction due to screening. However, standard stage-shift models often ignore prognostic subtypes, effectively implying that cancers detected early also have an associated subtype shift. To illustrate the differences between mortality predictions from stage-shift models that ignore versus preserve prognostic subtype, we use ovarian cancer partitioned by histologic subtype and prostate cancer partitioned by grade. We infer general conditions under which stage-shift models that preserve prognostic subtype are likely to predict mortality reductions that differ from those that ignore subtype and examine the implications for short-term endpoints based on stage in cancer screening trials.

Type: Article
Title: Short-term Endpoints for Cancer Screening Trials: Does Tumor Subtype Matter?
Location: United States
DOI: 10.1158/1055-9965.EPI-22-1307
Publisher version: https://doi.org/10.1158/1055-9965.EPI-22-1307
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Early Detection of Cancer, Female, Humans, Incidence, Male, Ovarian Neoplasms, Prognosis, Prostatic Neoplasms
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 Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10173568
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