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Staging patterns and early cancer detection.

C R Smart1, K C Chu

  • 1Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, Maryland 20892.

Seminars in Surgical Oncology
|March 1, 1992
PubMed
Summary
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Early detection of diseases, through increased screening, leads to more early-stage diagnoses and better patient outcomes. However, interpreting these benefits requires careful consideration of potential biases and generalizability.

Area of Science:

  • Oncology
  • Preventive Medicine
  • Biostatistics

Background:

  • Indirect evidence suggests earlier disease detection correlates with improved patient outcomes.
  • Increased early detection activities can shift diagnostic stage patterns.
  • Interpretation of these changes must account for biases and generalizability.

Purpose of the Study:

  • To review indirect evidence supporting the benefits of early disease detection.
  • To identify intermediate markers indicating the effectiveness of early detection.
  • To differentiate early detection effects from other factors influencing mortality.

Main Methods:

  • Review of nonexperimental, indirect evidence.
  • Analysis of changes in case detection numbers and stage at diagnosis.

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  • Evaluation of survival rates and case fatality rates.

    • Main Results:

    • Early detection activities are associated with detecting more cases, predominantly at earlier stages.
    • An increase in site-specific survival rates and a decrease in case fatality rates are observed.
    • Favorable intermediate markers are crucial for early detection to reduce mortality.

    Conclusions:

    • Early detection shows promise for improving cancer outcomes, evidenced by shifts to earlier stages and better survival rates.
    • The effectiveness of early detection in reducing mortality hinges on achieving favorable intermediate markers.
    • Reduced mortality should be carefully attributed, distinguishing early detection benefits from changes in disease incidence or treatment.