OBJECTIVES : Earlier detection is a critical step to improving cancer care. This analysis assessed the potential clinical value to patients of expanding current U.S. guideline-recommended cancer screening (ie, breast, cervical, colorectal, and lung cancers) to include a multi-cancer early detection (MCED) test.

METHODS : A health economic model with a lifetime time horizon was developed comparing the clinical outcomes of adding a MCED test to current cancer screening with current screening alone. The model considered a cohort beginning screening at age 50. Current screening practices reflected observed adherence to USPSTF recommended (grade A or B) cancer screening. In the MCED arm, the MCED test was added to current screening annually from ages 50 to 79. The model projected cancer incidence for each arm and, for those diagnosed with cancer, quality of life and survival. Cancer incidence in the current screening arm was derived from SEER data. The effects of the MCED test were represented as shifts in cancer stage and time of diagnosis based on the stage and cancer type-specific sensitivity of an MCED test with an overall sensitivity of 55% (Liu, 2019). Survival following diagnosis of cancer was based on five year stage-specific survival from SEER. Quality of life for patients with cancer was estimated from published literature.

RESULTS : A cohort receiving an annual MCED test was predicted to experience an incremental gain of 0.35 life-years and 0.34 quality-adjusted life-years (QALYs) per person. These clinical gains were primarily due to detection of cancers at earlier stages leading to improved survival outcomes. At willingness-to-pay thresholds of $100,000 to $150,000/QALY, this translates to a benefit of $34,400 to $51,600 per person.

CONCLUSIONS : Adding a multi-cancer early detection test to current USPSTF-recommended cancer screening enables the detection of multiple additional cancer types and offers substantial value to patients.