Modelled mortality benefits of multi-cancer early detection screening in England
Menée en Angleterre à partir d'une modélisation utilisant des données d'incidence et de survie issues du "National Cancer Registration and Analysis Service", cette étude estime le bénéfice, en termes de réduction de la mortalité et du taux de cancers détectés à un stade tardif, de programmes de dépistage utilisant des tests sanguins de détection multicancer et ciblant les personnes âgées de 50 à 79 ans
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.
British Journal of Cancer , article en libre accès, 2023