Impact Of Early Detection On Cancer Curability

Abstract

Consensus among experts regarding the potential advantages of early cancer detection is lacking across many cancer types. To address this gap, we assembled a panel of 10 practicing oncologists using a modified Delphi method based on RAND/UCLA guidelines. This panel evaluated 20 solid tumors, representing over 40 types of cancer identified by the American Joint Committee on Cancer (AJCC) and accounting for 80% of total cancer incidence, to determine which could benefit from early detection.

Before the panel meeting, experts provided estimates on the progression rates of various cancers and assessed the current curability and potential benefits (improvement in curability) of an annual multi-cancer screening blood test. Following the meeting, experts reassessed their initial estimations.

The findings revealed diverse perspectives on the potential benefits of early cancer detection, influenced by factors such as cancer stage progression and curability. Cancers deemed to progress rapidly and have high curability in early stages (e.g., stomach, eso[1]phagus, lung, urothelial tract, melanoma, ovary, sarcoma, bladder, cervix, breast, colon/rectum, kidney, uterus, anus, head and neck) were considered most likely to benefit from a screening blood test. Conversely, cancers with rapid progression but lower curability in early stages (e.g., liver/intrahepatic bile duct, gallbladder, pancreas) were seen as having moderate potential for benefit.

Cancers characterized by slower progression and high curability regardless of stage (e.g., prostate, thyroid) were viewed as having limited potential for benefit from early detection strategies. Nevertheless, the panel concluded that most solid tumors, including challenging-to-treat ones like pancreatic and liver/bile duct cancers, could still benefit from early-stage detection.

The consensus suggests that a comprehensive screening approach covering a wide range of cancers through blood tests holds significant potential to improve patient outcomes.