Estimating the population health impact of a multi-cancer early detection genomic blood test to complement existing screening in the US and UK
Menée à l'aide d'une modélisation simulant deux scenarii (scénario américain, scénario britannique), cette étude analyse l'intérêt, du point de vue du nombre supplémentaire de cancers détectés et du rapport "nombre de résultats réellement positifs/nombre de résultats faussement positifs", d'ajouter aux examens et/ou tests de dépistage actuellement recommandés un test sanguin recherchant la présence de plusieurs cancers
Background : Multi-cancer early detection (MCED) next-generation-sequencing blood tests represent a potential paradigm shift in screening.
Methods : We estimated the impact of screening in the US and UK. We used country-specific parameters for uptake, and test-specific sensitivity and false-positive rates for current screening: breast, colorectal, cervical and lung (US only) cancers. For the MCED test, we used cancer-specific sensitivities by stage. Outcomes included the true-positive:false-positive (TP:FP) ratio; and the cost of diagnostic investigations among screen positives, per cancer detected (Diagcost). Outcomes were estimated for recommended screening only, and then when giving the MCED test to anyone without cancer detected by current screening plus similarly aged adults ineligible for recommended screening.
Results : In the US, current screening detects an estimated 189,498 breast, cervical, colorectal and lung cancers. An MCED test with 25–100% uptake detects an additional 105,526–422,105 cancers (multiple types). The estimated TP:FP (Diagcost) was 1.43 ($89,042) with current screening but only 1:1.8 ($7060) using an MCED test. For the UK the corresponding estimates were 1:18 (£10,452) for current screening, and 1:1.6 (£2175) using an MCED test.
Conclusions : Adding an MCED blood test to recommended screening can potentially be an efficient strategy. Ongoing randomised studies are required for full efficacy and cost-effectiveness evaluations.
British Journal of Cancer , article en libre accès, 2021