Modelled impact of a multi-cancer early detection screening program on the demand for diagnostics in England

People with a cancer signal detected via multi-cancer early detection (MCED) screening need timely access to confirmatory testing. A modelling study estimated the likely change in demand for diagnostic testing in England in MCED screening were introduced. Diagnostic demand was modelled based on estimates of the volume of people aged 50-79 years who would be referred for diagnostic investigation following detection of a cancer signal and on MCED test performance metrics. In an established MCED screening program, assuming 70% of the total eligible population is screened annually (approximately 13 million), the relative change in diagnostic demans was greatest for colonoscopy (+2.09%) whereas the greatest absolute change was for computed tomography (+ 0.76%). This equates to + 1040 colonoscopies and + 4720 CT scans for every million screened. The authors conclude that the predicted increase in diagnostic testing generated by MCED screening is small. Cancer diagnoses brought forward in time through screening should reduce diagnostic use for symptomatic presentations in the future.