# The hardest cancers are found late

Source: https://onco.cc/bottlenecks/b-early-detection/  
OnCo record `b-early-detection` (Bottleneck). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Screening exists for only a few cancers. Pancreatic, ovarian, liver, oesophageal and most lung cancers are found when cure is unlikely.

## Summary

Stage at diagnosis is the largest single determinant of survival: localised pancreatic cancer has a five-year relative survival around 44% in SEER data, distant disease about 3%. Organised population screening exists only for breast, cervical and colorectal cancer, low-dose CT for heavy smokers, and prostate in some systems, and uptake is incomplete even where it exists. The cancers that kill most people at a late stage (pancreas, ovary, liver, oesophagus, stomach, most lung cancers in never-smokers) have no screening test, and the largest randomised trial of ovarian screening (UKCTOCS) found no mortality benefit despite a stage shift. Multi-cancer early detection blood tests (Galleri, Shield, fragmentomics) can detect signals from dozens of cancers but have modest sensitivity for stage I disease and have not yet shown reduced mortality; the NHS-Galleri trial is the first randomised test of the concept. Risk-stratified surveillance (new-onset diabetes for pancreas, cirrhosis for liver, Barrett's for oesophagus) is the intermediate strategy.

## Fields

- Kind: Bottleneck
- Last checked: 2026-09-08
- Stage: prevention-detection
- Severity: critical
- Metrics: Five-year relative survival for pancreatic cancer diagnosed at localised vs distant stage (SEER, US): ~44% vs ~3% (NCI SEER Cancer Stat Facts: Pancreatic Cancer); Reduction in lung cancer mortality with low-dose CT screening vs chest X-ray in heavy smokers (NLST): 20% (National Lung Screening Trial Research Team, NEJM 2011); Ovarian cancer deaths prevented by annual multimodal screening over 16 years of follow-up (UKCTOCS): No significant reduction despite stage shift (Menon et al., Lancet 2021); New cancer cases and cancer deaths worldwide, 2022: ~20 million cases, 9.7 million deaths (Bray et al., CA 2024 (GLOBOCAN 2022))
- Causes: Most cancers that prove fatal arise in deep organs without symptoms until they are locally advanced or metastatic.; Screening tests for low-prevalence cancers need very high specificity to avoid harm, which few biomarkers achieve.; A stage shift does not guarantee a mortality reduction, so each test needs a long randomised trial that few sponsors fund.; Screening uptake is incomplete and unequal even for tests that work, because of access, cost and awareness.; Health systems lack the diagnostic capacity (imaging, endoscopy, pathology) to work up the positives a population test would generate.

## Sources

- Crosby et al., Early detection of cancer (Science 2022): https://doi.org/10.1126/science.aay9040
- Menon et al., UKCTOCS ovarian screening mortality results (Lancet 2021): https://doi.org/10.1016/S0140-6736(21)00731-5
- NLST, Reduced lung-cancer mortality with low-dose CT screening (NEJM 2011): https://doi.org/10.1056/NEJMoa1102873
- NCI SEER Cancer Stat Facts: https://seer.cancer.gov/statfacts/

## Connected records

- roadmaps: [Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation](https://onco.cc/roadmaps/colorectal-roadmap/), [Early detection roadmap: organ screening → blood tests for many cancers](https://onco.cc/roadmaps/early-detection-roadmap/), [Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials](https://onco.cc/roadmaps/gallbladder-cancer-roadmap/), [Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch](https://onco.cc/roadmaps/lung-cancer-evidence-roadmap/), [Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question](https://onco.cc/roadmaps/pancreatic-roadmap/), [Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch](https://onco.cc/roadmaps/prostate-roadmap/)
- ideas: [A 28-day national pathway for people with a positive multi-cancer blood test](https://onco.cc/ideas/idea-prev-mced-positive-resolution-pathway/), [A breath test to rule out cancer in people with vague symptoms](https://onco.cc/ideas/idea-prev-breath-voc-symptomatic-ruleout/), [A cancer blood test for older people arriving at A&E with unexplained symptoms](https://onco.cc/ideas/idea-prev-emergency-department-cancer-test/), [A fast-track pathway from suspicion to treatment for pancreatic cancer in the NHS, measured from first scan to first treatment](https://onco.cc/ideas/idea-pdac-uk-fast-track-diagnosis-to-treatment-pathway/), [A legislated, publicly reported 28-day standard from urgent referral to diagnosis](https://onco.cc/ideas/idea-acc-28-day-diagnosis-standard/), [A live national dashboard of stage at diagnosis as the scorecard for early detection](https://onco.cc/ideas/idea-prev-live-stage-dashboard/), [A single 'cancer check at 60' appointment bundling all screening tests](https://onco.cc/ideas/idea-prev-bundled-cancer-check-at-60/), [A swallowable sponge test for reflux patients, offered in pharmacies](https://onco.cc/ideas/idea-prev-capsule-sponge-pharmacy/), [A ten-dollar blood test for the five cancers that kill most people in poorer countries](https://onco.cc/ideas/idea-prev-lmic-five-cancer-methylation-test/), [A urine DNA test to decide who with blood in the urine needs a camera test](https://onco.cc/ideas/idea-prev-urine-dna-haematuria-triage/), [A whole-population cancer interception programme: risk-stratify every adult, detect and intercept early](https://onco.cc/ideas/idea-moon-population-interception/), [AI clears the normal lung screening scans so radiologists read only the suspicious ones](https://onco.cc/ideas/idea-prev-ldct-ai-negative-triage/), [AI that spots pancreatic cancer on scans taken a year before diagnosis](https://onco.cc/ideas/idea-prev-pancreas-ai-prediagnostic-ct/), [Ask whether survivorship screening saves lives, using registry-based randomisation](https://onco.cc/ideas/idea-rejuv-registry-randomised-screening-in-survivors/), [Bank yearly blood from cancer survivors so future tests can be validated](https://onco.cc/ideas/idea-bio2-survivor-plasma-biobank/), [Blood EBV DNA screening for nasopharyngeal cancer across southern China and Southeast Asia](https://onco.cc/ideas/idea-prev-ebv-dna-npc-screening-scaleup/), [Blood-based HCC surveillance to replace six-monthly ultrasound](https://onco.cc/ideas/idea-hcc-blood-surveillance/), [Blood-based pancreatic cancer detection in new-onset diabetes](https://onco.cc/ideas/idea-mced-new-onset-diabetes/), [Cancer risk scores running automatically in GP records to prompt urgent referral](https://onco.cc/ideas/idea-prev-ehr-symptom-signature-prompts/), [Cheap DNA fragment-pattern blood test as a first sieve before expensive cancer tests](https://onco.cc/ideas/idea-prev-fragmentomics-first-tier/), [Community health workers with smartphone AI screen for mouth 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signal](https://onco.cc/ideas/idea-prev-cgm-glycaemic-drift-pancreas/), [Judge a prostate screening programme on metastatic presentation, not on incidence or mortality](https://onco.cc/ideas/idea-prostate-metastatic-presentation-as-the-screening-endpoint/), [Let MCED trials read out on late-stage incidence, with mortality follow-up mandated](https://onco.cc/ideas/idea-prev-mced-stage-endpoint-surrogate/), [Lung screening eligibility by risk score, not pack-years, including high-risk never-smokers](https://onco.cc/ideas/idea-prev-lung-screening-risk-model-eligibility/), [Make a two-minute mouth cancer check part of every dental visit](https://onco.cc/ideas/idea-prev-dental-oral-exam-standard/), [Mandatory interval-cancer audit for every blood-based screening test](https://onco.cc/ideas/idea-prev-interval-cancer-audit-blood-tests/), [Mobile diagnostic units that biopsy, scan and treat on the same visit](https://onco.cc/ideas/idea-acc-mobile-see-and-treat-units/), [Molecular indolence classifiers bundled with every screening programme](https://onco.cc/ideas/idea-moon-indolence-classifiers-with-screening/), [MRI-first prostate screening with genetic pre-selection](https://onco.cc/ideas/idea-prev-mri-first-prostate-screening-prs/), [Multi-cancer blood test as the first step for patients with non-specific symptoms](https://onco.cc/ideas/idea-prev-mced-non-specific-symptom-triage/), [New diabetes after 50 plus weight loss triggers a pancreatic cancer check](https://onco.cc/ideas/idea-prev-new-onset-diabetes-pancreas-pathway/), [Non-endoscopic screening for Barrett's oesophagus and early adenocarcinoma](https://onco.cc/ideas/idea-non-endoscopic-barretts-screening/), [Offer the blood test for bowel cancer only to people who refuse stool tests or colonoscopy](https://onco.cc/ideas/idea-prev-blood-crc-test-for-non-responders/), [One-stop breast clinics: imaging, biopsy and a preliminary answer in a single visit](https://onco.cc/ideas/idea-acc-one-stop-breast-diagnostic-clinic/), [Open-source models that translate stage shift into lives saved, for every cancer](https://onco.cc/ideas/idea-prev-open-stage-shift-microsimulation/), [Personalised stool-test cut-offs by age, sex and prior results](https://onco.cc/ideas/idea-prev-fit-risk-adapted-thresholds/), [Pre-agreed update rules so an MCED test is not obsolete when its trial reads out](https://onco.cc/ideas/idea-prev-mced-change-control-plan/), [Publish the four numbers the NHS lung cancer pathway does not currently measure: reflex testing rate, genomic turnaround, surgical access and a lung-specific waiting time in every nation](https://onco.cc/ideas/idea-lung-uk-screening-testing-and-access-gaps/), [Push residual disease detection a hundredfold deeper with whole-genome methods](https://onco.cc/ideas/idea-bio2-whole-genome-mrd-depth/), [Rapid diagnostic centres for people with vague but worrying symptoms](https://onco.cc/ideas/idea-acc-rapid-diagnostic-centres-vague-symptoms/), [Record and publish the symptom-to-diagnosis interval for every cancer, by hospital](https://onco.cc/ideas/idea-acc-diagnostic-interval-public-registry/), [Registry-based randomised MCED trial: a million people, no study visits](https://onco.cc/ideas/idea-prev-mced-registry-randomised/), [Replace six-monthly ultrasound with a blood test for liver cancer in cirrhosis](https://onco.cc/ideas/idea-prev-hcc-blood-surveillance-cirrhosis/), [Require stage-shift or interval-cancer endpoints for AI in cancer screening](https://onco.cc/ideas/idea-data-ai-screening-endpoints/), [Risk-targeted ultrasound screening in high-incidence regions, tested against usual care](https://onco.cc/ideas/idea-gbc-risk-targeted-ultrasound-in-high-incidence-regions/), [Roll out AI-supported mammography nationally as a stepped-wedge trial](https://onco.cc/ideas/idea-prev-mammography-ai-stepped-wedge/), [Run the ENDPAC score on every new diabetes diagnosis after 50 and scan the high scorers](https://onco.cc/ideas/idea-pdac-new-onset-diabetes-risk-score-pathway/), [Set each woman's mammogram interval from her last mammogram, using AI risk](https://onco.cc/ideas/idea-prev-ai-mammogram-risk-intervals/), [Smart scales and health records flag unexplained weight loss for a cancer check](https://onco.cc/ideas/idea-prev-weight-loss-auto-alert/), [Stomach cancer serology screening for high-risk migrant communities in low-incidence countries](https://onco.cc/ideas/idea-prev-gastric-serology-migrant-screening/), [Surveillance for every germline carrier found by universal testing, inside a registry rather than a research exception](https://onco.cc/ideas/idea-pdac-surveillance-for-every-germline-carrier/), [Tailored screening for second cancers in survivors with known high-risk exposures](https://onco.cc/ideas/idea-acc-tailored-second-cancer-screening/), [Take lung screening scanners to supermarket car parks in the poorest areas](https://onco.cc/ideas/idea-prev-mobile-lung-screening-deprived-areas/), [Treat lung cancer in never-smokers as its own disease, with its own detection programme](https://onco.cc/ideas/idea-lung-never-smoker-disease-its-own-programme/), [Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a model](https://onco.cc/ideas/idea-crc-screening-uptake-and-age-extension/), [UK gap: match endoscopy capacity and quality to the faecal immunochemical test thresholds the NHS has already set](https://onco.cc/ideas/idea-crc-uk-colonoscopy-capacity-and-fit-threshold/), [UK gap: shorten the route to diagnosis for patients below the screening age, where the rise in incidence is](https://onco.cc/ideas/idea-crc-uk-young-patient-referral-and-diagnostic-interval/), [Use a polygenic risk score to set when screening starts](https://onco.cc/ideas/idea-prev-prs-screening-start-age/), [Use the trend in routine blood counts, not a single threshold, to spot cancer](https://onco.cc/ideas/idea-prev-blood-count-trend-flags/), [Whole-body MRI plus blood DNA surveillance for people with Li-Fraumeni syndrome](https://onco.cc/ideas/idea-prev-li-fraumeni-mri-plus-cfdna/)
- collections: [GLOBOCAN / Global Cancer Observatory](https://onco.cc/collections/globocan/), [SEER (Surveillance, Epidemiology, and End Results)](https://onco.cc/collections/seer/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Ovarian cancer](https://onco.cc/cancers/ovarian/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Small intestine cancer (small bowel adenocarcinoma)](https://onco.cc/cancers/small-bowel/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- technologies: [AI in radiology](https://onco.cc/technologies/radiology-ai-screening/), [Breast cancer after chest radiotherapy in childhood, and the screening that follows](https://onco.cc/technologies/rejuv-paed-breast-after-chest-radiotherapy/), [cfDNA fragmentomics](https://onco.cc/technologies/fragmentomics/), [Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)](https://onco.cc/technologies/colorectal-screening/), [DNA methylation profiling](https://onco.cc/technologies/methylation-profiling/), [HCC surveillance in cirrhosis (ultrasound + AFP)](https://onco.cc/technologies/hcc-surveillance/), [High-risk pancreatic surveillance (CAPS / PRECEDE)](https://onco.cc/technologies/pancreatic-surveillance/), [How long it takes to diagnose cancer in a young person, and what the evidence actually says](https://onco.cc/technologies/rejuv-ayac-diagnostic-delay/), [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [Low-dose CT lung screening](https://onco.cc/technologies/low-dose-ct-screening/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- drugs: [Galleri](https://onco.cc/drugs/galleri/), [Shield](https://onco.cc/drugs/shield/)
- companies: [DELFI Diagnostics](https://onco.cc/companies/delfi-diagnostics/), [Exact Sciences (Abbott)](https://onco.cc/companies/exact-sciences/), [Freenome](https://onco.cc/companies/freenome/), [GRAIL](https://onco.cc/companies/grail/), [Guardant Health](https://onco.cc/companies/guardant-health/), [Harbinger Health](https://onco.cc/companies/harbinger-health/)
- institutions: [Advanced Research Projects Agency for Health](https://onco.cc/institutions/arpa-h/), [Bowelbabe Fund for Cancer Research UK](https://onco.cc/institutions/bowelbabe-fund/), [Cancer Research UK](https://onco.cc/institutions/cruk/), [Cancer Research UK Cambridge Centre / CRUK Cambridge Institute](https://onco.cc/institutions/cruk-cambridge-centre/), [David H. Koch Institute for Integrative Cancer Research at MIT](https://onco.cc/institutions/mit-koch/), [Fred & Pamela Buffett Cancer Center](https://onco.cc/institutions/nebraska-buffett/), [ICMR-National Institute of Cancer Prevention and Research](https://onco.cc/institutions/icmr-nicpr/), [Institut National du Cancer](https://onco.cc/institutions/inca/), [International Agency for Research on Cancer (IARC / WHO)](https://onco.cc/institutions/iarc/), [Lustgarten Foundation](https://onco.cc/institutions/lustgarten-foundation/), [National Cancer Center of China](https://onco.cc/institutions/ncc-china/), [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/), [National Cancer Registry Programme (ICMR-NINE, Bengaluru)](https://onco.cc/institutions/icmr-ncrp/), [Tata Trusts](https://onco.cc/institutions/tata-trusts/)
- terms: [Alpha-fetoprotein (AFP)](https://onco.cc/terms/afp/), [Barrett's oesophagus](https://onco.cc/terms/barretts-esophagus/), [Bowel cancer after abdominal and pelvic radiotherapy](https://onco.cc/terms/second-primary-bowel-after-abdominal-radiotherapy/), [Breast cancer after chest radiotherapy given young](https://onco.cc/terms/second-primary-breast-after-chest-radiotherapy/), [CA 19-9](https://onco.cc/terms/ca19-9/), [Faecal immunochemical test (FIT)](https://onco.cc/terms/fit-test/), [Lead time, and lead-time bias](https://onco.cc/terms/lead-time-bias/), [Lung cancer after chest radiotherapy and after alkylating chemotherapy](https://onco.cc/terms/second-primary-lung-after-chest-radiotherapy/), [Metastasis-free survival (MFS)](https://onco.cc/terms/metastasis-free-survival/), [Number needed to screen (and number needed to diagnose)](https://onco.cc/terms/number-needed-to-screen/), [Overtreatment](https://onco.cc/terms/overtreatment/), [PI-RADS (Prostate Imaging Reporting and Data System)](https://onco.cc/terms/pi-rads/), [Polygenic risk score (PRS)](https://onco.cc/terms/polygenic-risk-score/), [Positive predictive value (PPV)](https://onco.cc/terms/ppv/), [Sarcoma in the radiotherapy field, and angiosarcoma of the treated breast](https://onco.cc/terms/second-primary-sarcoma-in-the-treated-field/), [Screening survivors: where the UK, American and European answers differ](https://onco.cc/terms/rejuv-second-screening-after-treatment-compared/), [Second cancers after treatment: what the risk is, and what is done about it](https://onco.cc/terms/rejuv-second-cancers-overview/), [Skin cancer after cancer treatment](https://onco.cc/terms/second-primary-skin-cancer-after-cancer-treatment/), [Stage shift](https://onco.cc/terms/stage-shift/), [Template mapping biopsy (transperineal template prostate mapping)](https://onco.cc/terms/template-mapping-biopsy/), [The UK very high risk breast screening protocol after chest radiotherapy](https://onco.cc/terms/rejuv-second-uk-very-high-risk-breast-screening/), [Thyroid cancer after neck radiotherapy, and whether to look for it](https://onco.cc/terms/second-primary-thyroid-after-neck-radiotherapy/)
- trials: [Kerala oral cancer visual screening trial (Trivandrum)](https://onco.cc/trials/kerala-oral-screening/), [Mumbai VIA cervical screening trial (Tata Memorial)](https://onco.cc/trials/mumbai-via-screening/), [NHS-Galleri](https://onco.cc/trials/nhs-galleri/), [NLST & NELSON (low-dose CT screening)](https://onco.cc/trials/nlst-nelson/), [Osmanabad cervical screening trial (HPV testing vs cytology vs VIA)](https://onco.cc/trials/osmanabad-hpv-screening/), [PATHFINDER 2](https://onco.cc/trials/pathfinder-2/), [UKCTOCS](https://onco.cc/trials/ukctocs/)
- key papers: [Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease](https://onco.cc/key-papers/paper-travis-breast-cancer-after-hodgkin-radiotherapy-jama-2003/), [Cancer genome landscapes: about 140 driver genes, and each tumour needs only a handful](https://onco.cc/key-papers/paper-vogelstein-cancer-genome-landscapes-science-2013/), [Cancer Statistics, 2020: Report from National Cancer Registry Programme, India](https://onco.cc/key-papers/paper-mathur-ncrp-cancer-statistics-2020/), [Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths (National Polyp Study)](https://onco.cc/key-papers/paper-zauber-national-polyp-study-colonoscopic-polypectomy-nejm-2012/), [Colorectal cancer incidence patterns in the United States, 1974-2013](https://onco.cc/key-papers/paper-siegel-colorectal-incidence-birth-cohort-jnci-2017/), [Colorectal cancer statistics, 2023](https://onco.cc/key-papers/paper-siegel-colorectal-cancer-statistics-ca-2023/), [DETECT-A: a blood test plus PET-CT found treatable cancers in 10,000 women with no symptoms](https://onco.cc/key-papers/paper-detect-a-science-2020/), [Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging](https://onco.cc/key-papers/paper-johnson-mpmri-individual-foci-eur-urol-2019/), [Distinct biological subtypes and patterns of genome evolution in lymphoma revealed by circulating tumour DNA](https://onco.cc/key-papers/paper-scherer-ctdna-lymphoma-subtypes-genome-evolution-sci-transl-med-2016/), [Early detection of cancer](https://onco.cc/key-papers/paper-crosby-science/), [Effect of screening on oral cancer mortality in Kerala, India](https://onco.cc/key-papers/paper-sankaranarayanan-oral-screening-lancet-2005/), [ERSPC: screening and prostate cancer mortality in a randomised European study](https://onco.cc/key-papers/paper-schroder-erspc-screening-mortality-nejm-2009/), [Evaluation of USPSTF Lung Cancer Screening Guidelines Among African American Adult Smokers](https://onco.cc/key-papers/paper-aldrich-uspstf-screening-african-american-smokers-jama-oncol-2019/), [Gallbladder cancer](https://onco.cc/key-papers/paper-roa-gallbladder-cancer-primer-nat-rev-dis-primers-2022/), [Genetic alterations during colorectal-tumor development](https://onco.cc/key-papers/paper-vogelstein-genetic-alterations-colorectal-tumor-development-nejm-1988/), [Genomic and evolutionary classification of lung cancer in never smokers](https://onco.cc/key-papers/paper-zhang-lung-cancer-never-smokers-nat-genet-2021/), [Geographic and age variations in mutational processes in colorectal cancer](https://onco.cc/key-papers/paper-diaz-gay-colibactin-geographic-age-mutational-processes-nature-2025/), [Hospital-based gallbladder cancer registry from a high-volume referral cancer centre in India: Insights into epidemiology and roadmap for enhancing cancer care](https://onco.cc/key-papers/paper-patkar-tata-memorial-gallbladder-cancer-registry-cancer-epidemiol-2025/), [HPV screening for cervical cancer in rural India (Osmanabad)](https://onco.cc/key-papers/paper-sankaranarayanan-hpv-screening-nejm-2009/), [Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years](https://onco.cc/key-papers/paper-vuik-early-onset-colorectal-europe-gut-2019/), [Jaiswal: clonal haematopoiesis, the pre-leukaemic clones in most people over 70](https://onco.cc/key-papers/paper-jaiswal-chip-nejm-2014/), [Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context](https://onco.cc/key-papers/paper-draisma-lead-time-overdiagnosis-psa-jnci-2009/), [Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection](https://onco.cc/key-papers/paper-fahrmann-ca19-9-lead-time-gastroenterology-2021/), [Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up](https://onco.cc/key-papers/paper-atkin-flexible-sigmoidoscopy-17-year-follow-up-lancet-2017/), [Lung adenocarcinoma promotion by air pollutants](https://onco.cc/key-papers/paper-hill-lung-adenocarcinoma-air-pollutants-nature-2023/), [Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium](https://onco.cc/key-papers/paper-caps-consortium-surveillance-recommendations-gut-2020/), [Martincorena: normal sun-exposed skin is a patchwork of cancer-mutation clones](https://onco.cc/key-papers/paper-martincorena-somatic-mutations-normal-skin-science-2015/), [MASAI: AI-supported mammography screening finds more cancers with half the radiologist workload](https://onco.cc/key-papers/paper-masai-lancet-oncol-2023/), [Measurement of prostate-specific antigen in serum as a screening test for prostate cancer](https://onco.cc/key-papers/paper-catalona-psa-screening-test-nejm-1991/), [Minnesota trial: a yearly stool blood test cuts bowel cancer deaths by a third](https://onco.cc/key-papers/paper-minnesota-fobt-nejm-1993/), [Model to Determine Risk of Pancreatic Cancer in Patients With New-Onset Diabetes](https://onco.cc/key-papers/paper-sharma-endpac-model-new-onset-diabetes-gastroenterology-2018/), [Multitarget stool DNA testing for colorectal-cancer screening](https://onco.cc/key-papers/paper-imperiale-multitarget-stool-dna-screening-nejm-2014/), [NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms](https://onco.cc/key-papers/paper-nelson-nejm-2020/), [NHS-Galleri: design of the largest randomised trial of a multi-cancer blood test](https://onco.cc/key-papers/paper-nhs-galleri-design-cancers-2022/), [NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers](https://onco.cc/key-papers/paper-nlst-nejm-2011/), [NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected](https://onco.cc/key-papers/paper-nordicc-nejm-2022/), [Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial](https://onco.cc/key-papers/paper-atkin-once-only-flexible-sigmoidoscopy-lancet-2010/), [Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial](https://onco.cc/key-papers/paper-menon-lancet/), [Overdiagnosis and overtreatment of prostate cancer](https://onco.cc/key-papers/paper-loeb-overdiagnosis-overtreatment-prostate-eur-urol-2014/), [PATHFINDER: the first prospective test of a multi-cancer blood test in people without symptoms](https://onco.cc/key-papers/paper-pathfinder-lancet-2023/), [Performance of a multi-cancer early detection test in the randomized controlled NHS-Galleri trial](https://onco.cc/key-papers/paper-nhs-galleri-performance-nat-med-2026/), [Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution](https://onco.cc/key-papers/paper-abbosh-phylogenetic-ctdna-lung-cancer-nature-2017/), [PLCO: mortality results from a randomised prostate cancer screening trial](https://onco.cc/key-papers/paper-andriole-plco-prostate-screening-nejm-2009/), [Probability of pancreatic cancer following diabetes: a population-based study](https://onco.cc/key-papers/paper-chari-pancreatic-cancer-following-diabetes-gastroenterology-2005/), [PROMIS: diagnostic accuracy of multiparametric MRI and TRUS biopsy in prostate cancer](https://onco.cc/key-papers/paper-ahmed-promis-multiparametric-mri-lancet-2017/), [Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005](https://onco.cc/key-papers/paper-welch-albertsen-psa-era-diagnosis-treatment-jnci-2009/), [Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate](https://onco.cc/key-papers/paper-stamey-psa-serum-marker-nejm-1987/), [Quality indicators for colonoscopy and the risk of interval cancer](https://onco.cc/key-papers/paper-kaminski-adenoma-detection-rate-interval-cancer-nejm-2010/), [Randomised controlled trial of faecal-occult-blood screening for colorectal cancer (Nottingham)](https://onco.cc/key-papers/paper-hardcastle-nottingham-faecal-occult-blood-lancet-1996/), [Randomised study of screening for colorectal cancer with faecal-occult-blood test (Funen)](https://onco.cc/key-papers/paper-kronborg-funen-faecal-occult-blood-lancet-1996/), [Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance](https://onco.cc/key-papers/paper-canto-caps-long-term-surveillance-gastroenterology-2018/), [Screening by chest radiograph and lung cancer mortality: the Prostate, Lung, Colorectal, and Ovarian (PLCO) randomized trial](https://onco.cc/key-papers/paper-plco-chest-radiograph-lung-cancer-mortality-jama-2011/), [Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement](https://onco.cc/key-papers/paper-uspstf-lung-cancer-screening-jama-2021/), [Self-collected HPV samples are as accurate as clinician samples and reach women who never attend screening](https://onco.cc/key-papers/paper-hpv-self-sampling-bmj-2018/), [Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women](https://onco.cc/key-papers/paper-hur-sugar-sweetened-beverages-early-onset-colorectal-gut-2021/), [The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival](https://onco.cc/key-papers/paper-dbouk-caps5-stage-survival-jco-2022/), [Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma; a study of 684 proved cases](https://onco.cc/key-papers/paper-wynder-graham-tobacco-bronchiogenic-carcinoma-jama-1950/), [Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction](https://onco.cc/key-papers/paper-conti-trans-ancestry-gwas-prostate-nat-genet-2021/), [USPSTF 2012: screening for prostate cancer, recommendation statement (grade D)](https://onco.cc/key-papers/paper-moyer-uspstf-prostate-screening-ann-intern-med-2012/), [USPSTF 2018: screening for prostate cancer, recommendation statement (grade C at 55 to 69, grade D at 70 and over)](https://onco.cc/key-papers/paper-uspstf-prostate-screening-jama-2018/)
- people: [Betty Ford](https://onco.cc/people/betty-ford/), [Chadwick Boseman](https://onco.cc/people/chadwick-boseman/), [Dame Deborah James](https://onco.cc/people/deborah-james/), [Gilda Radner](https://onco.cc/people/gilda-radner/), [Jade Goody](https://onco.cc/people/jade-goody/), [Katie Couric](https://onco.cc/people/katie-couric/), [Kris Hallenga](https://onco.cc/people/kris-hallenga/), [Marc Lustgarten](https://onco.cc/people/marc-lustgarten/), [Nancy Brinker](https://onco.cc/people/nancy-brinker/), [Phil Knight](https://onco.cc/people/phil-knight/), [Priscilla Chan](https://onco.cc/people/priscilla-chan/), [Ratan Tata](https://onco.cc/people/ratan-tata/), [Sir Chris Hoy](https://onco.cc/people/chris-hoy/), [Stephen Sutton](https://onco.cc/people/stephen-sutton/)

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JSON: https://onco.cc/api/v1/entities/b-early-detection.json