Cancer Stage Compared with Mortality as End Points in Randomized Clinical Trials of Cancer Screening. A Systematic Review and Meta-Analysis
One of the white hopes for cancer prevention is population screening. It is hoped that cancer can be avoided or detected early in those who have a genetic predisposition.
The NHS in the UK have commenced a large clinical trial called Galleri. In this trial 140,000 people have been tested using the multi cancer early detection (MCED) test, with a similar control group who are not tested.
The purpose of the trial is to determine whether cancer survival can be improved. Unfortunately, the design of the trial is flawed with the endpoints being diagnosis of stage III/IV cancer, instead of the normal endpoints of progress-free or overall survival.
This retrospective review sought to compare the mortality of several cancers with staging. A close correlation was found for ovarian cancer (0.95), moderate for breast cancer (0.6) and low for colorectal cancer (0.4).
From this study it appears that true understanding of any benefit of MCED will be delayed.
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