Calls for Ukraine
Calls for Europe
Calls for USA
X
Calls for Ukraine
Calls for Europe
Calls for USA
Eng
Blood tests for many cancers can prevent progression in half of cases
A single blood test designed to detect chemical signals that indicate the presence of many different types of cancer could prevent disease progression while the malignancy is still at an early stage and treatable half the time, according to a modeling study published in the journal BMJ Open.
According to the researchers, annual or biannual inclusion of the test, formally known as the Multiple Cancer Early Detection Test, or MCED for short, could improve patient outcomes by preventing disease progression.
Currently, only a few cancers – breast, colon, cervical and lung – are reliably screened in high-risk individuals. While effective in reducing mortality from these diseases, screenings can also lead to false positives and overdiagnosis, the researchers said.
The optimal interval at which screening will detect the most cancers at early stages (I and II) while avoiding unnecessary tests and treatments is still unclear.
To inform future clinical trials, the researchers used a previously published disease progression model for many cancers. They used it to predict the effect of regular screening with the MCED test on the time to cancer diagnosis and patient death for different screening schedules among 50- to 79-year-olds receiving routine medical care.
Screening schedules from six months to three years were modeled, but with an emphasis on annual and biannual screening for two cancer scenarios. These are “rapid,” where tumors remain at stage I for two to four years before progression; and “rapid aggressive,” where tumors remain at stage I for one to two years, with a decreasing time period for progression to subsequent stages.
The cancers included in the study are anus, bladder, breast, cervix, colon/rectum, esophagus, gallbladder, head and neck, kidney, liver, lung, ovary, pancreas, prostate; sarcoma (soft tissue/bone); stomach; thyroid; urothelial and uterine cancers; and leukemia, lymphoma, melanoma, blood cancers (myeloid neoplasms, immune cell cancers (plasma cell neoplasms).
The researchers used MCED test characteristics from a recently published report and patient outcomes from population-based cancer data from the U.S. Surveillance, Epidemiology and End Results (SEER) program.
The analysis showed that all MCED screening intervals had more favorable early stage diagnosis rates than conventional surveillance. The effect on stage change was greater for tumors with “rapid” tumor growth than for tumors with “rapid aggressive” growth.
However, annual MCED screening in the rapid tumor growth scenario was associated with more diagnoses: 370 more cancer signals, 49% fewer late-stage diagnoses, and 21% fewer deaths over five years per 100,000 people screened per year compared with usual care.
Although biannual MCED screening shifted the stage of diagnosis and prevented deaths, it was not as effective as annual screening, with 292 more cancer signals detected per 100,000 screened per year, 39% fewer late-stage diagnoses, and 17% fewer deaths over five years compared with conventional treatment.
Annual MCED screening prevented more deaths over five years than biannual screening in a scenario of rapid tumor growth. However, biannual screening had a higher positive predictive value: 54% versus 43%. In other words, it detected more cancers with each test performed.
Based on the characteristics obtained in the case-control study, both annual and biannual screening with the MCED test can prevent 31-49% of stage I-II cancers that would otherwise be detected at stages III-IV.
The researchers acknowledge that their calculations assume 100 percent adherence to the recommended screening schedule and 100 percent accuracy of confirmatory follow-up tests, and therefore represent an upper bound on the potential benefit of MCED cancer screening.
It is also hypothesized that a reduction in the number of late-stage cancer diagnoses will automatically lead to a reduction in mortality from the disease. In doing so, they note: “The optimal choice of screening interval will depend on real-world estimates of cancer survival and the cost of confirmatory tests after MCED screening.”
However, both annual and biennial MCED screenings have the potential to prevent advanced cancer mortality when used in addition to current guideline-based cancer screening.
Categories:
News
Published:
Updated:
Medical author, Medical editor:
Medical expert:
All categories:
- Diseases (2)
- Interview (17)
- Medical articles (72)
- News (220)
- War (9)
Do you have any questions?
Get a free consultation from our experts
