A MODELING STUDY INVESTIGATING THE POTENTIAL OF MULTI-CANCER EARLY DETECTION SCREENING IN REDUCING CANCER INCIDENCE AND MORTALITY IN HIGH-RISK GROUPS
Author(s)
Jag Chhatwal, PhD1, Jade Xiao, PhD2, Andrew ElHabr, PhD2, Christopher Tyson, PhD3, Xiting Cao, PhD3, Ashish A. Deshmukh, PhD4, Sana Raoof, MD-PhD5, A Mark Fendrick, MD6, Andrew Briggs, DPhil7, Burak Ozbay, PhD3, Paul Limburg, MD3, Tomasz M. Beer, MD3;
1Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, 2Value Analytics Labs, Boston, MA, USA, 3Exact Sciences Corporation, Madison, WI, USA, 4Medical University of South Carolina, Charleston, SC, USA, 5Memorial Sloan Kettering Cancer Center, New York, NY, USA, 6School of Public Health, University of Michigan, Ann Arbor, MI, USA, 7London School of Hygiene & Tropical Medicine, London, United Kingdom
1Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, 2Value Analytics Labs, Boston, MA, USA, 3Exact Sciences Corporation, Madison, WI, USA, 4Medical University of South Carolina, Charleston, SC, USA, 5Memorial Sloan Kettering Cancer Center, New York, NY, USA, 6School of Public Health, University of Michigan, Ann Arbor, MI, USA, 7London School of Hygiene & Tropical Medicine, London, United Kingdom
OBJECTIVES: Multi-cancer early detection (MCED) tests can simultaneously detect several cancer types and are intended to be used alongside standard-of-care screening (SoC). Using a simulation model, we estimated the impact of MCED screening on stage IV cancer incidence and mortality in high-risk groups.
METHODS: We developed Simulation Model for MCED (SiMCED), a microsimulation model of 14 solid tumor cancers. MCED test performance (V2) was derived from the ASCEND-2 case-control study. We simulated the life course of 5 million adults aged 50-84 years representing the U.S. general population, as well as three high-risk groups: smokers (S), heavy alcohol users (HAU), and individuals with a family history of cancer (FHC). Cancer diagnosis could arise from SoC screening (with real-world adherence) or annual MCED screening. After a cancer diagnosis, individuals followed SEER survival curves to determine the time and cause of death.
RESULTS: In the general population, SoC+MCED screening resulted in a 51% reduction in stage IV incidence and 23% reduction in cancer mortality, compared to SoC screening only. Among S, SoC+MCED screening resulted in lung, colorectal, and pancreatic stage IV incidence reductions of 46%, 62%, and 63%, with mortality reductions of 16% (2,462 versus 2,070 per 100,000), 39% (336 versus 205), and 18% (386 versus 317), respectively. For HAU, SoC+MCED screening resulted in lung, colorectal, and head and neck stage IV incidence reductions of 47%, 63%, and 58%, respectively, with mortality reductions of 17% (994 versus 829), 39% (375 versus 228), and 31% (217 versus 149), respectively. In the FHC cohort, SoC+MCED screening resulted in lung, colorectal, and pancreatic stage IV incidence reductions of 47%, 63%, and 64%, with mortality reductions of 17% (1,014 versus 846), 39% (338 versus 206), and 18% (376 versus 309), respectively.
CONCLUSIONS: SoC+MCED screening may reduce stage IV cancer incidence and mortality in the general population and high-risk groups.
METHODS: We developed Simulation Model for MCED (SiMCED), a microsimulation model of 14 solid tumor cancers. MCED test performance (V2) was derived from the ASCEND-2 case-control study. We simulated the life course of 5 million adults aged 50-84 years representing the U.S. general population, as well as three high-risk groups: smokers (S), heavy alcohol users (HAU), and individuals with a family history of cancer (FHC). Cancer diagnosis could arise from SoC screening (with real-world adherence) or annual MCED screening. After a cancer diagnosis, individuals followed SEER survival curves to determine the time and cause of death.
RESULTS: In the general population, SoC+MCED screening resulted in a 51% reduction in stage IV incidence and 23% reduction in cancer mortality, compared to SoC screening only. Among S, SoC+MCED screening resulted in lung, colorectal, and pancreatic stage IV incidence reductions of 46%, 62%, and 63%, with mortality reductions of 16% (2,462 versus 2,070 per 100,000), 39% (336 versus 205), and 18% (386 versus 317), respectively. For HAU, SoC+MCED screening resulted in lung, colorectal, and head and neck stage IV incidence reductions of 47%, 63%, and 58%, respectively, with mortality reductions of 17% (994 versus 829), 39% (375 versus 228), and 31% (217 versus 149), respectively. In the FHC cohort, SoC+MCED screening resulted in lung, colorectal, and pancreatic stage IV incidence reductions of 47%, 63%, and 64%, with mortality reductions of 17% (1,014 versus 846), 39% (338 versus 206), and 18% (376 versus 309), respectively.
CONCLUSIONS: SoC+MCED screening may reduce stage IV cancer incidence and mortality in the general population and high-risk groups.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HTA9
Topic
Health Technology Assessment
Disease
SDC: Oncology