TY - JOUR
T1 - Evaluating multi-cancer early detection tests
T2 - an argument for the outcome of recurrence-updated stage
AU - Callister, Matthew E.J.
AU - Crosbie, Emma J.
AU - Crosbie, Philip A.J.
AU - Robbins, Hilary A.
N1 - Funding Information:
None specific to this article. EJC is supported by a National Institute for Health and Care Research (NIHR) Advanced Fellowship (NIHR300650). EJC and PAJC are supported by the NIHR Manchester Biomedical Research Centre (IS-BRC-1215-20007). HAR is supported by the US National Cancer Institute (R01CA262164, U19CA203654).
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/10/12
Y1 - 2023/10/12
N2 - The advent of multi-cancer early detection (MCED) tests has the potential to revolutionise the diagnosis of cancer, improving patient outcomes through early diagnosis and increased use of curative therapies. The ongoing NHS-Galleri trial is evaluating an MCED test developed by GRAIL, and is using as its primary endpoint the absolute incidence of late-stage cancer. Proponents of this outcome argue that if the test reduces the number of patients with advanced, incurable cancer, it can be reasonably assumed to be benefitting patients by reducing cancer mortality. Here, we argue that this assumption may not always hold due to the phenomenon of micro-metastatic disease, and propose an adjustment to the trial outcome so that it may better reflect the expected effect of the test on cancer mortality.
AB - The advent of multi-cancer early detection (MCED) tests has the potential to revolutionise the diagnosis of cancer, improving patient outcomes through early diagnosis and increased use of curative therapies. The ongoing NHS-Galleri trial is evaluating an MCED test developed by GRAIL, and is using as its primary endpoint the absolute incidence of late-stage cancer. Proponents of this outcome argue that if the test reduces the number of patients with advanced, incurable cancer, it can be reasonably assumed to be benefitting patients by reducing cancer mortality. Here, we argue that this assumption may not always hold due to the phenomenon of micro-metastatic disease, and propose an adjustment to the trial outcome so that it may better reflect the expected effect of the test on cancer mortality.
KW - Humans
KW - Early Detection of Cancer
KW - Neoplasms/diagnosis
KW - Neoplasms, Second Primary
UR - http://www.scopus.com/inward/record.url?scp=85171563909&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/3f9a2c84-c426-3aa9-a1a0-2c72dd16565b/
U2 - 10.1038/s41416-023-02434-4
DO - 10.1038/s41416-023-02434-4
M3 - Article
C2 - 37726480
AN - SCOPUS:85171563909
SN - 0007-0920
VL - 129
SP - 1209
EP - 1211
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 8
ER -
