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7. Increasing power in screening trials by testing control-arm specimens: application to multicancer detection screening.

Author

Katki, Hormuzd A, Prorok, Philip C, Castle, Philip E, Minasian, Lori M, and Pinsky, Paul F

Subjects
EARLY detection of cancer, MEDICAL screening, COLON cancer, CANCER-related mortality, SAMPLE size (Statistics)
Abstract

Background Cancer screening trials have required large sample sizes and long time-horizons to demonstrate cancer mortality reductions, the primary goal of cancer screening. We examine assumptions and potential power gains from exploiting information from testing control-arm specimens, which we call the "intended effect" (IE) analysis that we explain in detail herein. The IE analysis is particularly suited to tests that can be conducted on stored specimens in the control arm, such as stored blood for multicancer detection (MCD) tests. Methods We simulated hypothetical MCD screening trials to compare power and sample size for the standard vs IE analysis. Under two assumptions that we detail herein, we projected the IE analysis for 3 existing screening trials (National Lung Screening Trial [NLST], Minnesota Colon Cancer Control Study [MINN-FOBT-A], and Prostate, Lung, Colorectal, Ovarian Cancer Screening Trial—colorectal component [PLCO-CRC]). Results Compared with the standard analysis for the 3 existing trials, the IE design could have reduced cancer-specific mortality P values 6-fold (NLST), 33-fold (MINN-FOBT-A), or 260 000-fold (PLCO-CRC) or, alternately, reduced sample size (90% power) by 25% (NLST), 47% (MINN-FOBT-A), or 63% (PLCO-CRC). For potential MCD trial designs requiring 100 000 subjects per arm to achieve 90% power for multicancer mortality for the standard analysis, the IE analysis achieves 90% power for only 37 500-50 000 per arm, depending on assumptions concerning control-arm test-positives. Conclusions Testing stored specimens in the control arm of screening trials to conduct the IE analysis could substantially increase power to reduce sample size or accelerate trials and could provide particularly strong power gains for MCD tests. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Cancer screening with multicancer detection tests: A translational science review.

Author

Rubinstein, Wendy S., Patriotis, Christos, Dickherber, Anthony, Han, Paul K. J., Katki, Hormuzd A., LeeVan, Elyse, Pinsky, Paul F., Prorok, Philip C., Skarlupka, Amanda L., Temkin, Sarah M., Castle, Philip E., and Minasian, Lori M.

Subjects
TUMOR diagnosis, EARLY detection of cancer, RESEARCH evaluation, DIAGNOSTIC errors, COLLECTION & preservation of biological specimens, TUMOR classification, SENSITIVITY & specificity (Statistics)
Abstract

Multicancer detection (MCD) tests use a single, easily obtainable biospecimen, such as blood, to screen for more than one cancer concurrently. MCD tests can potentially be used to improve early cancer detection, including cancers that currently lack effective screening methods. However, these tests have unknown and unquantified benefits and harms. MCD tests differ from conventional cancer screening tests in that the organ responsible for a positive test is unknown, and a broad diagnostic workup may be necessary to confirm the location and type of underlying cancer. Among two prospective studies involving greater than 16,000 individuals, MCD tests identified those who had some cancers without currently recommended screening tests, including pancreas, ovary, liver, uterus, small intestine, oropharyngeal, bone, thyroid, and hematologic malignancies, at early stages. Reported MCD test sensitivities range from 27% to 95% but differ by organ and are lower for early stage cancers, for which treatment toxicity would be lowest and the potential for cure might be highest. False reassurance from a negative MCD result may reduce screening adherence, risking a loss in proven public health benefits from standard‐of‐care screening. Prospective clinical trials are needed to address uncertainties about MCD accuracy to detect different cancers in asymptomatic individuals, whether these tests can detect cancer sufficiently early for effective treatment and mortality reduction, the degree to which these tests may contribute to cancer overdiagnosis and overtreatment, whether MCD tests work equally well across all populations, and the appropriate diagnostic evaluation and follow‐up for patients with a positive test. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Effectiveness of Colonoscopy Screening vs Sigmoidoscopy Screening in Colorectal Cancer

Author

Juul, Frederik E., primary, Cross, Amanda J., additional, Schoen, Robert E., additional, Senore, Carlo, additional, Pinsky, Paul F., additional, Miller, Eric A., additional, Segnan, Nereo, additional, Wooldrage, Kate, additional, Wieszczy-Szczepanik, Paulina, additional, Armaroli, Paola, additional, Garborg, Kjetil K., additional, Adami, Hans-Olov, additional, Hoff, Geir, additional, Kalager, Mette, additional, Bretthauer, Michael, additional, Holme, Øyvind, additional, and Løberg, Magnus, additional

Published
2024
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31. Perspectives on This Article from Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens

Author

Cramer, Daniel W., primary, Bast, Robert C., primary, Berg, Christine D., primary, Diamandis, Eleftherios P., primary, Godwin, Andrew K., primary, Hartge, Patricia, primary, Lokshin, Anna E., primary, Lu, Karen H., primary, McIntosh, Martin W., primary, Mor, Gil, primary, Patriotis, Christos, primary, Pinsky, Paul F., primary, Thornquist, Mark D., primary, Scholler, Nathalie, primary, Skates, Steven J., primary, Sluss, Patrick M., primary, Srivastava, Sudhir, primary, Ward, David C., primary, Zhang, Zhen, primary, Zhu, Claire S., primary, and Urban, Nicole, primary

Published
2023
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32. Data from A Framework for Evaluating Biomarkers for Early Detection: Validation of Biomarker Panels for Ovarian Cancer

Author

Zhu, Claire S., primary, Pinsky, Paul F., primary, Cramer, Daniel W., primary, Ransohoff, David F., primary, Hartge, Patricia, primary, Pfeiffer, Ruth M., primary, Urban, Nicole, primary, Mor, Gil, primary, Bast, Robert C., primary, Moore, Lee E., primary, Lokshin, Anna E., primary, McIntosh, Martin W., primary, Skates, Steven J., primary, Vitonis, Allison, primary, Zhang, Zhen, primary, Ward, David C., primary, Symanowski, James T., primary, Lomakin, Aleksey, primary, Fung, Eric T., primary, Sluss, Patrick M., primary, Scholler, Nathalie, primary, Lu, Karen H., primary, Marrangoni, Adele M., primary, Patriotis, Christos, primary, Srivastava, Sudhir, primary, Buys, Saundra S., primary, and Berg, Christine D., primary

Published
2023
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33. Supplementary Materials from A Framework for Evaluating Biomarkers for Early Detection: Validation of Biomarker Panels for Ovarian Cancer

Author

Zhu, Claire S., primary, Pinsky, Paul F., primary, Cramer, Daniel W., primary, Ransohoff, David F., primary, Hartge, Patricia, primary, Pfeiffer, Ruth M., primary, Urban, Nicole, primary, Mor, Gil, primary, Bast, Robert C., primary, Moore, Lee E., primary, Lokshin, Anna E., primary, McIntosh, Martin W., primary, Skates, Steven J., primary, Vitonis, Allison, primary, Zhang, Zhen, primary, Ward, David C., primary, Symanowski, James T., primary, Lomakin, Aleksey, primary, Fung, Eric T., primary, Sluss, Patrick M., primary, Scholler, Nathalie, primary, Lu, Karen H., primary, Marrangoni, Adele M., primary, Patriotis, Christos, primary, Srivastava, Sudhir, primary, Buys, Saundra S., primary, and Berg, Christine D., primary

Published
2023
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35. Perspectives on This Article from A Framework for Evaluating Biomarkers for Early Detection: Validation of Biomarker Panels for Ovarian Cancer

Author

Zhu, Claire S., primary, Pinsky, Paul F., primary, Cramer, Daniel W., primary, Ransohoff, David F., primary, Hartge, Patricia, primary, Pfeiffer, Ruth M., primary, Urban, Nicole, primary, Mor, Gil, primary, Bast, Robert C., primary, Moore, Lee E., primary, Lokshin, Anna E., primary, McIntosh, Martin W., primary, Skates, Steven J., primary, Vitonis, Allison, primary, Zhang, Zhen, primary, Ward, David C., primary, Symanowski, James T., primary, Lomakin, Aleksey, primary, Fung, Eric T., primary, Sluss, Patrick M., primary, Scholler, Nathalie, primary, Lu, Karen H., primary, Marrangoni, Adele M., primary, Patriotis, Christos, primary, Srivastava, Sudhir, primary, Buys, Saundra S., primary, and Berg, Christine D., primary

Published
2023
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36. Data from Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens

Author

Cramer, Daniel W., primary, Bast, Robert C., primary, Berg, Christine D., primary, Diamandis, Eleftherios P., primary, Godwin, Andrew K., primary, Hartge, Patricia, primary, Lokshin, Anna E., primary, Lu, Karen H., primary, McIntosh, Martin W., primary, Mor, Gil, primary, Patriotis, Christos, primary, Pinsky, Paul F., primary, Thornquist, Mark D., primary, Scholler, Nathalie, primary, Skates, Steven J., primary, Sluss, Patrick M., primary, Srivastava, Sudhir, primary, Ward, David C., primary, Zhang, Zhen, primary, Zhu, Claire S., primary, and Urban, Nicole, primary

Published
2023
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39. Supplemental Table 1 from Sex Steroid Hormone Metabolism in Relation to Risk of Aggressive Prostate Cancer

Author

Black, Amanda, primary, Pinsky, Paul F., primary, Grubb, Robert L., primary, Falk, Roni T., primary, Hsing, Ann W., primary, Chu, Lisa, primary, Meyer, Tamra, primary, Veenstra, Timothy D., primary, Xu, Xia, primary, Yu, Kai, primary, Ziegler, Regina G., primary, Brinton, Louise A., primary, Hoover, Robert N., primary, and Cook, Michael B., primary

Published
2023
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40. Supplemental Table 2 from Sex Steroid Hormone Metabolism in Relation to Risk of Aggressive Prostate Cancer

Author

Black, Amanda, primary, Pinsky, Paul F., primary, Grubb, Robert L., primary, Falk, Roni T., primary, Hsing, Ann W., primary, Chu, Lisa, primary, Meyer, Tamra, primary, Veenstra, Timothy D., primary, Xu, Xia, primary, Yu, Kai, primary, Ziegler, Regina G., primary, Brinton, Louise A., primary, Hoover, Robert N., primary, and Cook, Michael B., primary

Published
2023
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43. Evaluation of Lung Cancer Risk Among Persons Undergoing Screening or Guideline-Concordant Monitoring of Lung Nodules in the Mississippi Delta

Author

Osarogiagbon, Raymond U., primary, Liao, Wei, additional, Faris, Nicholas R., additional, Fehnel, Carrie, additional, Goss, Jordan, additional, Shepherd, Catherine J., additional, Qureshi, Talat, additional, Matthews, Anberitha T., additional, Smeltzer, Matthew P., additional, and Pinsky, Paul F., additional

Published
2023
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47. The efficacy of prostate‐specific antigen screening: Impact of key components in the ERSPC and PLCO trials

Author

de Koning, Harry J., Gulati, Roman, Moss, Sue M., Hugosson, Jonas, Pinsky, Paul F., Berg, Christine D., Auvinen, Anssi, Andriole, Gerald L., Roobol, Monique J., Crawford, E. David, Nelen, Vera, Kwiatkowski, Maciej, Zappa, Marco, Luján, Marcos, Villers, Arnauld, de Carvalho, Tiago M., Feuer, Eric J., Tsodikov, Alex, Mariotto, Angela B., Heijnsdijk, Eveline A. M., and Etzioni, Ruth

Published
2018
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