{"entity":{"id":"idea-prev-mced-registry-randomised","kind":"idea","name":"Registry-based randomised MCED trial: a million people, no study visits","aka":[],"tldr":"Randomise people through the national health system, post the blood kit, and read cancer deaths off the registry. That is ten times cheaper per participant than a classic trial.","summary":"Swedish registry-based RCTs (TASTE, DETO2X) showed pragmatic randomisation at national scale at a fraction of usual cost. Propose an MCED trial that randomises through screening call/recall, draws blood at existing phlebotomy or mobile units, and uses cancer registry and death-certificate linkage for endpoints, with no in-person study visits.","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":[],"cancers":[],"sections":["early-detection"],"technologies":["mced"],"targets":[],"drugs":[],"companies":[],"institutions":["karolinska"],"pathways":[],"terms":["stage-shift"],"trials":[],"people":[],"bottlenecks":["b-early-detection","b-trial-enrolment"],"keyPapers":["paper-crosby-science"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A registry-based RCT of at least one million adults aged 50-79 can detect a 15% relative reduction in cancer mortality within eight years at under $50 per participant-year.","rationale":"MCED effects on all-cancer mortality will be modest and need very large samples; only registry-linked pragmatic designs make that affordable.","test":"Feasibility pilot in a Nordic country or NHS region (100,000 invitations, mailed kits; uptake and linkage completeness as endpoints), then scale.","maturity":"speculative","actor":"research","cost":"large","horizonYears":8},"route":"/ideas/idea-prev-mced-registry-randomised/","neighbours":{"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"}],"institution":[{"id":"karolinska","kind":"institution","name":"Karolinska University Hospital","route":"/institutions/karolinska/"}],"term":[{"id":"stage-shift","kind":"term","name":"Stage shift","route":"/terms/stage-shift/"}],"bottleneck":[{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"},{"id":"b-trial-enrolment","kind":"bottleneck","name":"Trials enrol too few, too slowly","route":"/bottlenecks/b-trial-enrolment/"}],"paper":[{"id":"paper-crosby-science","kind":"paper","name":"Early detection of cancer","route":"/key-papers/paper-crosby-science/"},{"id":"paper-nhs-galleri-design-cancers-2022","kind":"paper","name":"NHS-Galleri: design of the largest randomised trial of a multi-cancer blood test","route":"/key-papers/paper-nhs-galleri-design-cancers-2022/"}],"trial":[{"id":"vanguard-study","kind":"trial","name":"Vanguard Study (NCI Cancer Screening Research Network)","route":"/trials/vanguard-study/"}]}}