Modelled impact of a multi-cancer early detection screening programme on cancer treatment in England

Background Cancer screening can reduce late-stage diagnoses, expand treatment options, and improve cancer outcomes. We modelled how introducing a multi-cancer early detection (MCED) screening programme in England could impact cancer treatment patterns.

Methods The proportions of cancers (19 types, diagnosed 2014–2019) treated with resection, radiotherapy, and systemic anti-cancer therapy (SACT) were applied to modelled stage-specific cancer incidence data with and without addition of MCED screening to existing screening. We modelled an initial screening round (first screen for individuals aged 50–79 years) and a steady-state programme (annual screening from age 50–79 years).

Results Assuming test parameters are accurate, if MCED screening is introduced in England, more cancers would require resection compared with current annual usage (steady-state: +8900, +10.0%). The number of cancers receiving radiotherapy would decrease overall (–1200; –2.0%) due to a decrease in palliative radiotherapy (–2100; –23.0%); the number of cancers treated with curative radiotherapy would increase slightly (+932; +2.1%). Fewer cancers would receive cytotoxic chemotherapy (–5300, –9.8%) and non-cytotoxic SACT (–530, –12.2%). Increased use of curative treatment combinations is also predicted.

Conclusions Changes to future service delivery and workforce planning will be needed for the full benefits of an MCED screening programme to be realised.