Systems Modeling to Determine the Societal Benefit of Multi-Cancer Early Detection in the Community

Recently, the development and validation of multicancer blood tests, known as multi-cancer early detection (MCED) blood tests in emerged as an exciting and potentially ground-breaking technology for relatively early detection or diagnosis of cancer in a minimally invasive manner. Early results are suggesting a reasonable validity can be achieved for selected cancers, potentially also at early stages of disease. This allows earlier detection and thus (curative) treatment with the aim to reduce overall cancer mortality. However, the best way of using these MCED tests and concerns about false-positive rates require further investigation. In particular, we know there is an enormous gap between what we know can optimize health and what gets implemented in everyday practice. For instance, use of MCEDs for population screening is quite different from the use as a diagnostic test in primary care for patients suspected to have cancer. Further, there is evidence for heterogeneity between countries and regions (such as availaibility of treatments) that create disparities in access and thus in differences in cancer outcomes over time. An evaluation of the impact of MCED testing from a health systems perspective is therefore needed to project impact on health outcomes, disparities, and costs over time, including healthcare and economic costs. Considering this broad, complex, interrelated environment in which the testing decision takes place and its far-reaching consequences, complex systems model of evidence for public health is an approach to which this impact could be evaluated. The seed fund project will focus on building the consortium of academic and societal partners for proposal writing to develop such a complex systems model. This will be done through the organization of several site-visits and a workshop.