Screening for cancer is the most effective intervention to detect cancer at early stages and leads to improved health outcomes for patients. As a result, the National Institutes of Health (NIH) have started the Cancer Screening Research Network (CSRN), a new clinical trials network to evaluate emerging cancer screening technologies. This network supports the Biden-Harris administration’s Cancer Moonshot and aims to identify cancers at earlier stages, when they are more treatable. The CSRN plans to investigate the efficacy of multi-cancer detection (MCD) tests to screen for several types of cancer through a blood test; if implemented, GlobalData epidemiologists expect that the new screening methods will likely drive an increase in the diagnosed incident cases of several types of cancer.
MCDs have the potential to increase access to screening and increase the detection of cancer at an early stage. MCDs work by testing blood and other body fluids for biological substances that cancer cells may shed, such as circulating tumour cells, tumour DNA, or other materials, which can indicate the presence of cancer in the body. However, they have not yet been evaluated to determine if they detect cancer early in a manner that will translate to reduced deaths. The NIH Vanguard Study aims to address this. The feasibility of MCDs will be evaluated in the Vanguard Study, which aims to enrol up to 24,000 people and will inform the design for a larger randomised controlled study. This study also aims to recruit from groups that have been historically underrepresented in clinical trials, and thus make the findings as representative as possible to benefit all Americans.
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This network comes at a crucial time. According to the Centers for Disease Control and Prevention (CDC), screening rates in the US for breast, cervical, and colorectal cancers remain below national screening targets and vary notably by age and race. Rates of screening may remain low due to previously identified barriers, such as poor insurance coverage, low access to healthcare services, and lingering impacts of Covid-19, which have delayed screenings. According to GlobalData epidemiologists, the most commonly diagnosed cancer, breast cancer, will increase from nearly 283,000 diagnosed incident cases in 2024 to 305,000 diagnosed incident cases by 2030 in women. Further, non-small cell lung cancer (NSCLC), a leading cause of death by cancer, is expected to increase from 199,000 diagnosed incident cases in 2024 to 220,000 diagnosed incident cases by 2029 in both sexes. However, if the new screening tests are implemented, the number of diagnosed incident cases of all cancers, including breast cancer and NSCLC, will likely surpass the current forecast estimates due to increased case identification and diagnosis. Optimistically, these cases will be early stage and thus more susceptible to treatment. This increased case-finding will lead to reduced burden on healthcare services by avoiding late-stage cancer diagnoses, and overall improved outcomes for patients.
