Impact of early detection on cancer curability: A modified Delphi panel study

Abstract

Expert consensus on the potential benefits of early cancer detection does not exist for most cancer types. We convened 10 practicing oncologists using a RAND/UCLA modified Delphi panel to evaluate which of 20 solid tumors, representing >40 American Joint Committee on Cancer (AJCC)-identified cancer types and 80% of total cancer incidence, would receive potential clinical benefits from early detection. Pre-meeting, experts estimated how long cancers take to progress and rated the current curability and benefit (improvement in curability) of an annual hypothetical multi-cancer screening blood test. Post-meeting, experts rerated all questions. Cancers had varying estimates of the potential benefit of early cancer detection depending on estimates of their curability and progression by stage. Cancers rated as progressing quickly and being curable in earlier stages (stomach, esophagus, lung, urothelial tract, melanoma, ovary, sarcoma, bladder, cervix, breast, colon/rectum, kidney, uterus, anus, head and neck) were estimated to be most likely to benefit from a hypothetical screening blood test. Cancer types rated as progressing quickly but having comparatively lower cure rates in earlier stages (liver/intrahepatic bile duct, gallbladder, pancreas) were estimated to have medium likelihood of benefit from a hypothetical screening blood test. Cancer types rated as progressing more slowly and having higher curability regardless of stage (prostate, thyroid) were estimated to have limited likelihood of benefit from a hypothetical screening blood test. The panel concluded most solid tumors have a likelihood of benefit from early detection. Even among difficult-to-treat cancers (e.g., pancreas, liver/intrahepatic bile duct, gallbladder), early-stage detection was believed to be beneficial. Based on the panel consensus, broad coverage of cancers by screening blood tests would deliver the greatest potential benefits to patients.

The National Health Service urgent cancer referral pathway for suspected urological cancers: early economic evaluation of a risk prediction test

“…stage-shift or reduction in absolute incidence of late-stage cancer) is appropriate ( 16 ; 17 ). Given the difficulties in estimating the potential benefits of early cancer diagnosis, Schwartzberg ( 18 ) conducted a modified Delphi panel with expert oncologists to estimate how long different cancers would take to progress from the beginning of one stage to the beginning of the next. For prostate cancer, the median number of years for each stage to progress ranged from 3 to 7 years.…”

Current unmet needs in locally advanced (unresectable) or metastatic dedifferentiated liposarcoma, the relevance of progression-free survival as clinical endpoint, and expectations for future clinical trial design: an international Delphi consensus report

“…The effectiveness of the Delphi technique hinges on the collection and synthesis of diverse opinions from experts possessing relevant insights regarding the clinical issue at hand. Since there is no universally agreed-upon optimal panel size, 32 this was based on recently published oncology Delphi studies 37 , 38 , 39 , 40 and available resources. A panel of 12 experts from seven countries, encompassing the United States and Europe (France, Germany, Italy, Spain, the UK, and Belgium), was recruited.…”

Advancing Colorectal Cancer Diagnosis with AI-Powered Breathomics: Navigating Challenges and Future Directions

“…It ranks as a leading cause of death and a profound barrier to increasing life expectancy worldwide [1]. Detection of cancer in early stages along with timely and appropriate treatment is a critical component of reducing cancer-related mortality and morbidity [2]. Currently, there is a lack of reliable screening modalities for highly fatal cancers like pancreatic and gastric cancer [3].…”