Comprehensive 1-stop screening proves ‘efficient and valuable’ for identifying early-stage cancers
A multidisciplinary center dedicated to early detection of cancer in ostensibly healthy individuals has demonstrated the soundness of its founding concept, cost-effectively catching cancers of many kinds before the onset of symptoms.
Researchers at the Integrated Cancer Prevention Center (ICPC) at Tel Aviv Medical Center in Israel report their findings in the Journal of Clinical Oncology [1].
The ICPC’s clinical model combines risk-factor assessments, personal histories and blood tests with exams performed by various specialty physicians, including imaging exams overseen by radiologists.
The study’s co-lead authors are Ezra Bernstein, MD, MPH, of the ICPC and NYU Langone Health, and Shahar Lev-Ari, PhD, of Tel Aviv University. Senior author is ICPC director Nadir Arber, MD, MSc, MHA.
For the study, approximately 17,000 adults (about evenly split between men and women) self-referred for prospective comprehensive cancer screenings over a 14-year period ending in 2019, according to the study abstract.
Participants’ ages ranged between 20 and 80, averaging 47.11 ± 11.71 years.
Multiple specialists combined to collate clinical, laboratory and epidemiological data.
Additional data were gathered based on symptoms, family histories, individual risk factors and abnormalities observed during appointments.
Among the study’s key results:
- Of 259 cancers detected through the ICPC, 49 (19.8%) were stage 0, 113 (45.6%) stage I, 30 (12.1%) stage II, 25 (10.1%) stage III, and 31(12.5%) stage IV.
- 17 cancers were missed, six of which were within the scope of the ICPC.
- Compared with the Israeli registry, at the ICPC, fewer cancers were diagnosed at a metastatic stage for breast (none vs. 3.7%), lung (6.7% vs. 11.4%), colon (20.0% vs. 46.2%), prostate (5.6% vs. 10.5%), and cervical/uterine (none vs. 8.5%) cancers.
Comparing stage of detection in the ICPC’s cancer-positive patients with average stage of detection in the U.S., the authors found ICPC detection was earlier for breast, lung, prostate and female reproductive cancers.
The study included a patient experience survey. Aggregated responses showed a satisfaction rate of 8.35 ± 1.85 on a scale of 1 to 10.
The study represents a proof of concept for “a one-stop-shop approach to cancer screening in a multidisciplinary outpatient clinic,” the authors comment. “We successfully detected cancers at an early stage, which has the potential to reduce morbidity and mortality as well as offer substantial cost savings.”
To this Iona Cheng, PhD, MPH, of UC-San Francisco, an associate editor of the publishing journal, adds that an integrative multicancer screening program “may serve as an efficient and valuable approach in identifying early-stage cancers.”
Study abstract here, full text behind paywall.