A novel multi-cancer screening approach based on screening objectives, cancer occurrence mechanism, and cost modeling.

Abstract

e22509 Background: The current cancer screening approach is relatively expensive and unable to cover all general population. Certain amount of information collected is possibly “overkill” at the expense of costs and technology complexity as statistically only 2-3 individuals in very one thousand individuals have cancer. We propose a novel multi-cancer screening for general population which is based on initial screening objectives, new cancer occurrence mechanism, and cost model. Since the step following cancer screening is cancer diagnosis in which significant tests will be carried out, we strongly believe that cancer screening should mainly focus on (1) separating high cancer risk individuals from low risk group, and (2) reduce screening costs and make screening available for everyone. Methods: We analyzed our own large size, multi-year, multi-cancer data as well as other reported studies. We have also studied new cancer occurrence mechanisms developed in recent years which included correlations between immune system and micro- environment change in human body (both of which could occur before the tumor is formed) and cancer occurrence. Finally, we have analyzed cost numbers for the new and traditional approaches. Results: In our extensive multi-year, multi-cancer general population screening of over 200,000 individuals and follow-up study, only 1.4% tested classified as high risk individuals, while this small group accounted for close to 92% of all cancer cases confirmed to date in the follow-up study when enrollment is normalize for all groups. This is very significant because this demonstrates that as long as screening is statistically meaningful and effective, a lot other information is not needed in screening as high risk people will undergo diagnosis anyway. The new screening approach does not require to obtain full information (for example, traceability (cancer location information), as over 98% of people do not likely have cancer) in order to reduce screening costs. The cost analysis results are shown in Table 1. Conclusions: We proposed a new cancer screening approach which is much more cost effective while it is still workable and meets screening objectives. [Table: see text]