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Quantifying the duration of the preclinical detectable phase in cancer screening: a systematic review
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Sandra M. E. Geurts
 , Anne M. W. M. Aarts, André L. M. Verbeek, Tony H. H. Chen , Mireille J. M. Broeders, Stephen W. Duffy
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Epidemiol Health. 2022;44:e2022008. Published online January 3, 2022
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DOI: https://doi.org/10.4178/epih.e2022008
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Abstract
OBJECTIVES
The aim of this study was to provide an overview of published mathematical estimation approaches to quantify the duration of the preclinical detectable phase (PCDP) using data from cancer screening programs.
METHODS A systematic search of PubMed and Embase was conducted for original studies presenting mathematical approaches using screening data. The studies were categorized by mathematical approach, data source, and assumptions made. Furthermore, estimates of the duration of the PCDP of breast and colorectal cancer were reported per study population.
RESULTS From 689 publications, 34 estimation methods were included. Five distinct types of mathematical estimation approaches were identified: prevalence-to-incidence ratio (n=8), maximum likelihood estimation (n=16), expectation-maximization algorithm (n=1), regression of observed on expected (n=6) and Bayesian Markov-chain Monte Carlo estimation (n=5). Fourteen studies used data from both screened and unscreened populations, whereas 19 studies included only information from a screened population. Estimates of the duration of the PCDP varied between 2 years and 7 years for breast cancer in the Health Insurance Plan study (annual mammography and clinical breast examinations in women aged 40-64 years) and 2 years and 5 years for colorectal cancer in the Calvados study (a guaiac fecal occult blood test in men and women aged 45-74 years).
CONCLUSIONS Different types of mathematical approaches lead to different estimates of the PCDP duration. We advise researchers to use the method that matches the data available, and to use multiple methods for estimation when possible, since no method is perfect.
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Summary
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Key Message
Quantifying the duration of the preclinical detectable phase is important for the design and evaluation of cancer screening programs. Different types of mathematical estimation approaches lead to different estimates of the preclinical detectable phase duration. We advise researchers to use the method that matches the data available, and to use multiple methods for estimation when possible, since no method is perfect.
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Citations
Citations to this article as recorded by  - Estimating the Length of the Preclinical Detectable Phase for Open-Angle Glaucoma
Johan Aspberg, Anders Heijl, Boel Bengtsson
JAMA Ophthalmology.2023; 141(1): 48. CrossRef
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