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Projecting the impact of multicancer early detection tests on stage at diagnosis: a modeling approach

Principal Investigator

Name
JANE LANGE

Degrees
Ph.D.

Institution
OREGON HEALTH AND SCIENCES UNIVERSITY

Position Title
Staff Scientist

Email
langeja@ohsu.edu

About this CDAS Project

Study
NLST (Learn more about this study)

Project ID
NLST-1012

Initial CDAS Request Approval
Jan 30, 2023

Title
Projecting the impact of multicancer early detection tests on stage at diagnosis: a modeling approach

Summary
Multi Cancer screening tests offer the promise of detecting multiple types of cancer with a single
blood sample. At least one test is now widely available, with several others in the pipeline. However, the
promise of these tests is tempered by a lack of knowledge of their benefit and harms in the population.
In absence of a rigorous clinical trial, modeling has the potential to provide clues about multicancer
tests’ impact on population mortality. The mortality benefit of screening is broadly conceptualized as
occurring through a reduction in advance stage disease at diagnosis. We develop a general framework for
projecting the reduction in advanced stage disease for a given cancer site with known mean sojourn time
based on a screening test with a given sensitivity. We evaluate the performance of the model on the
National Lung Screen trial and discuss its limitations and potential extensions.

Aims

* Develop a model of reduction in advanced stage disease (stage shift) that is applicable to cancer sites without existing screenig
* Validate the model against the observed stage shift in the NLST
-at the end of the trial
-by screen/followup year.

Collaborators

Ruth Etzioni, Kemal Gogebakan

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