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Updated: Jun 1, 2026

Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients
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Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients

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Cancer Diagnostic Delay Rates Associated With a Population-Based Screening Trial Evaluating a Cell-Free DNA

Sean Mann1, Pedro Nascimento de Lima1, Joshua Eagan1

  • 1RAND, Arlington, Virginia.

JAMA
|May 30, 2026
PubMed
Summary
This summary is machine-generated.

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Participation in a multicancer early detection (MCED) screening trial was linked to a slight rise in diagnostic delays for certain cancers. This effect was modest and unlikely to impact the trial’s main findings on early cancer detection.

Area of Science:

  • Oncology
  • Public Health
  • Health Services Research

Background:

  • Population-based screening trials can have unintended consequences on healthcare systems.
  • Spillover effects, like impacts on access to services, are often not evaluated in clinical trials.
  • Understanding these effects is crucial for real-world implementation of new screening technologies.

Purpose of the Study:

  • To assess if regional participation in the NHS-Galleri multicancer early detection (MCED) screening trial influenced cancer diagnostic delay rates.
  • To investigate potential system-level spillover effects of a population-based screening intervention.

Main Methods:

  • A cross-sectional study design was used across 21 cancer alliance regions in England.
  • An event study with a difference-in-differences analysis compared regions participating in the MCED trial versus non-participating regions.

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Last Updated: Jun 1, 2026

Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients
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Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients

Published on: September 9, 2020

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids
06:53

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids

Published on: June 8, 2019

  • Diagnostic delay rates and patient referral rates for specific cancer types were analyzed before and after the trial's initiation.

    • Main Results:

    • Participating regions showed a modest increase in diagnostic delay rates for head and neck, lung, and upper gastrointestinal cancers in the initial 6-12 months of the trial.
    • An adjusted difference-in-differences estimate indicated a 3.4 percentage point increase in delays (P < .001) during the first 6 months.
    • Patient referral rates for these cancers were also higher in participating regions during the first 6 months (P = .04).

    Conclusions:

    • Regional participation in the MCED screening trial was associated with a small increase in diagnostic delays for specific cancers.
    • These spillover effects were unlikely to significantly alter the primary findings of the MCED screening trial.
    • Future large-scale screening trials should incorporate monitoring for system-level spillover effects on healthcare resources.