{"entity":{"id":"idea-moon-population-interception","kind":"idea","name":"A whole-population cancer interception programme: risk-stratify every adult, detect and intercept early","aka":[],"tldr":"Instead of separate screening programmes for a few cancers, assess every adult's overall cancer risk and offer blood tests, imaging and preventive treatment tuned to that risk, all inside one system that learns.","summary":"Screening today covers a handful of cancers with organ-specific programmes and reaches a fraction of eligible people. Multi-cancer early detection blood tests (NHS-Galleri, PATHFINDER 2) and polygenic, exposure and imaging-based risk models make a unified approach conceivable: every adult over 40 receives a risk profile, a personalised detection schedule, and where indicated interception (chemoprevention, vaccines, risk-reducing procedures), with all results feeding a national learning system that recalibrates the models. Overdiagnosis is controlled through molecular indolence classifiers and surveillance-first protocols.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022)","url":"https://doi.org/10.1126/science.aay9040"}],"tags":[],"related":["idea-mced-plus-fapi"],"cancers":[],"sections":[],"technologies":["mced","liquid-biopsy","chemoprevention","whole-body-mri"],"targets":[],"drugs":["galleri"],"companies":[],"institutions":[],"pathways":[],"terms":["stage-shift","ppv"],"trials":["nhs-galleri","pathfinder-2"],"people":[],"bottlenecks":["b-early-detection","b-prevention-adoption","b-overdiagnosis"],"keyPapers":["paper-crosby-science"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A unified risk-stratified programme reduces late-stage (III/IV) cancer incidence across all cancers by at least 20% within a decade at acceptable cost per life-year, without increasing overtreatment of indolent disease.","rationale":"Stage at diagnosis is the strongest determinant of survival, most cancers have no screening, and organ-by-organ programmes cannot scale to thirty diseases. Risk models and blood-based detection convert the problem into a systems problem.","test":"A regional cluster-randomised implementation of the programme versus standard screening with stage-shift, cancer-specific mortality and overdiagnosis metrics at five years, building on the NHS-Galleri infrastructure.","maturity":"speculative","actor":"policy","cost":"large","horizonYears":10},"route":"/ideas/idea-moon-population-interception/","neighbours":{"idea":[{"id":"idea-mced-plus-fapi","kind":"idea","name":"FAPI PET as the workup for MCED positives","route":"/ideas/idea-mced-plus-fapi/"}],"technology":[{"id":"chemoprevention","kind":"technology","name":"Chemoprevention & risk-reducing surgery","route":"/technologies/chemoprevention/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"},{"id":"whole-body-mri","kind":"technology","name":"Whole-body MRI","route":"/technologies/whole-body-mri/"}],"drug":[{"id":"galleri","kind":"drug","name":"Galleri","route":"/drugs/galleri/"}],"term":[{"id":"ppv","kind":"term","name":"Positive predictive value (PPV)","route":"/terms/ppv/"},{"id":"stage-shift","kind":"term","name":"Stage shift","route":"/terms/stage-shift/"}],"trial":[{"id":"nhs-galleri","kind":"trial","name":"NHS-Galleri","route":"/trials/nhs-galleri/"},{"id":"pathfinder-2","kind":"trial","name":"PATHFINDER 2","route":"/trials/pathfinder-2/"}],"bottleneck":[{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"},{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"paper":[{"id":"paper-crosby-science","kind":"paper","name":"Early detection of cancer","route":"/key-papers/paper-crosby-science/"}]}}