November 10, 2025

expert reaction to a modelling study of a multi-cancer early detection test and earlier diagnoses for numerous cancer types

A study published in Wiley Cancer explores the impact of multicancer early detection tests on cancer stage shift.

Prof Paul Pharoah, Professor of Cancer Epidemiology, Cedars-Sinai Medical Center, said:

“This paper reports the results of a simulation study.  This means that the data are not derived from real individuals but from a simulated set of individuals.  Models like these can be useful for evaluating the potential impact of an intervention such as cancer screening using a multi-cancer detection test, however the results cannot be considered reliable enough to replace the gold-standard method for the evaluation of screening tests which is a randomised controlled trial.

“A simulation study such as this is very dependent on the underlying assumptions.  When modelling a cancer screening test a very important assumption is the sensitivity of the test to detect cancer.  This sensitivity will vary for different cancer types and for cancer at different stages.  Cancer stage is a measure of how advanced the cancer is when diagnosed – a stage 1 cancer is a small cancer that has not spread, and a stage 4 cancer is a cancer that has spread to several organs.  The estimates of sensitivity used for the model cannot be considered reliable.  They were taken from a report that has not undergone peer review and is based on fewer than 800 cases that were clinically diagnosed.  The number of specific cancers at different stages of diagnosis will be too small to be reliable.  Furthermore, sensitivity will be lower in the screening setting.

“In short, the study suggests that cancer screening with a blood-based multi-cancer detection test is likely to result in a change in the stage of cancer at diagnosis, but it does not and cannot tell us what we need to know about these tests, i.e. does screening using the test result in lower mortality.”

‘The impact of multicancer early detection tests on cancer stage shift: A 10‐year microsimulation model’ by Jagpreet Chhatwal et al. was published in Wiley Cancer 

DOI: 10.1002/cncr.70075

Declared interests

Prof Paul Pharoah: I have no conflicts of interest to declare.