According to a recent study, researchers have demonstrated that annual blood-based multicancer early detection screening could significantly reduce both late-stage cancer diagnoses and cancer mortality.
In the study, researchers from Cambridge University Hospitals National Health Service Foundation Trust, GRAIL, and Queen Mary University of London evaluated how different screening intervals could affect cancer detection and mortality outcomes.
The researchers employed a state-transition model to estimate the effect of screening with a multicancer early detection (MCED) test at different intervals on cancer stage at diagnosis and mortality endpoints. They examined screening intervals between 6 months and 3 years, focusing particularly on annual and biennial (every 2 years) screening.
Annual screening under the "fast tumor growth" scenario was associated with 370 more cancer signals detected per year per 100,000 individuals screened, 49% fewer late-stage diagnoses, and 21% fewer deaths within 5 years compared with usual care (current clinical practice with no MCED test). While biennial screening also showed benefits (292 more cancer signals detected and 39% fewer late-stage diagnoses), annual screening prevented more cancer deaths.
"Annual MCED test screening provided more overall benefit than biennial screening," the study authors said. The researchers developed the model using published MCED performance measures from a large case-control study by cancer type and stage at diagnosis and Surveillance, Epidemiology, and End Results data describing stage-specific incidence and cancer-specific survival among individuals aged 50 to 79 years in the United States.
Biennial screening demonstrated some advantages, including a higher positive predictive value (54% vs 43%) and greater efficiency per 100,000 tests in preventing deaths within 5 years (132 vs 84). However, it ultimately prevented fewer deaths per year compared with annual screening.
The researchers modeled different tumor growth scenarios to account for cancer heterogeneity. In the "fast" scenario, the range of mean dwell times across cancer types was 2 to 4 years in stage I, while in the "fast aggressive" scenario, the range was 1 to 2 years in stage I, with decreasing dwell times for successive stages.
This study represented an important step in determining optimal screening intervals for MCED tests, which detect cancer signals from multiple cancer types using a single blood sample. The researchers emphasized that MCED tests are intended to complement, not replace, existing single-cancer screenings.
The study authors noted: "Modelling the sensitivity of outcomes to different MCED screening intervals can inform timescales for investigation in trials." The findings suggested that while any MCED screening interval could improve patient outcomes, annual screening could offer the strongest mortality reduction benefits.
The researchers cautioned that their estimates represented "upper bounds of potential benefits" under ideal assumptions, including 100% screening compliance and diagnostic follow-up. Real-world benefits would likely be less than those estimated in the model.
Disclosures can be found in the study.
Source: BMJ Open