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Strong association between reduction of late-stage cancers and reduction of cancer-specific mortality in meta-regression of randomized screening trials across multiple cancer types.
Dai, James Y; Georg Luebeck, E; Chang, Ellen T; Clarke, Christina A; Hubbell, Earl A; Zhang, Nan; Duffy, Stephen W.
Afiliación
  • Dai JY; GRAIL, LLC, Menlo Park, CA, USA.
  • Georg Luebeck E; Fred Hutchinson Cancer Center, Seattle, WA, USA.
  • Chang ET; GRAIL, LLC, Menlo Park, CA, USA.
  • Clarke CA; GRAIL, LLC, Menlo Park, CA, USA.
  • Hubbell EA; GRAIL, LLC, Menlo Park, CA, USA.
  • Zhang N; GRAIL, LLC, Menlo Park, CA, USA.
  • Duffy SW; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
J Med Screen ; 31(4): 211-222, 2024 Dec.
Article en En | MEDLINE | ID: mdl-38797981
ABSTRACT

BACKGROUND:

Late-stage cancer incidence has been proposed as an early surrogate for mortality in randomized controlled trials (RCTs) of cancer screening; however, its validity has not been systematically evaluated across screening RCTs of different cancers.

METHODS:

We conducted a meta-regression analysis of cancer screening RCTs that reported both late-stage cancer incidence and cancer mortality. Based on a systematic literature review, we included 33 RCTs of screening programs targeting seven cancer types, including lung (n = 12), colorectal (n = 8), breast (n = 5), and prostate (n = 4), among others. We regressed the relative reduction of cancer mortality on the relative reduction of late-stage cancer incidence, inversely weighted for each RCT by the variance of estimated mortality reduction.

RESULTS:

Across cancer types, the relative reduction of late-stage cancer incidence was linearly associated with the relative reduction of cancer mortality. Specifically, we observed this association for lung (R2 = 0.79 and 0.996 in three recent large trials), breast (R2 = 0.94), prostate (R2 = 0.98), and colorectal cancer (R2 = 0.75 for stage III/IV cancers and 0.93 for stage IV cancers). Trials with a 20% or greater reduction in late-stage cancers were more likely to achieve a significant reduction in cancer mortality. Our results also showed that no reduction of late-stage cancer incidence was associated with no or minimal reduction in cancer mortality.

CONCLUSIONS:

Meta-regression of historical screening RCTs showed a strong linear association between reductions in late-stage cancer incidence and cancer mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ensayos Clínicos Controlados Aleatorios como Asunto / Detección Precoz del Cáncer / Neoplasias Límite: Female / Humans / Male Idioma: En Revista: J Med Screen Asunto de la revista: EPIDEMIOLOGIA / SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ensayos Clínicos Controlados Aleatorios como Asunto / Detección Precoz del Cáncer / Neoplasias Límite: Female / Humans / Male Idioma: En Revista: J Med Screen Asunto de la revista: EPIDEMIOLOGIA / SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido