# Open-source models that translate stage shift into lives saved, for every cancer

Source: https://onco.cc/ideas/idea-prev-open-stage-shift-microsimulation/  
OnCo record `idea-prev-open-stage-shift-microsimulation` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Whether finding cancer earlier saves lives depends on the cancer. Public models, one per cancer, would let trials and payers predict the mortality benefit from a stage shift honestly.

## Summary

CISNET models exist for a few cancers and are not fully open. Propose an open, peer-reviewed microsimulation library covering the 20 commonest cancers, calibrated to registry survival by stage and to the sojourn-time literature, with pre-registration of predicted mortality effects for each MCED trial before readout.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Pre-registered model predictions fall within the 95% confidence interval of observed mortality effects in at least 70% of subsequent screening trial readouts.
- Rationale: Prediction before readout is the only way to test the models and to stop post-hoc rationalisation of stage-shift results.
- Proposed test: Fund the library; register predictions for NHS-Galleri and the NCI Vanguard study before their readouts.
- Maturity: speculative
- Actor: research

## Sources

- CISNET: https://cisnet.cancer.gov

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- terms: [Stage shift](https://onco.cc/terms/stage-shift/)
- trials: [NHS-Galleri](https://onco.cc/trials/nhs-galleri/)
- bottlenecks: [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/), [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/)

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