{"entity":{"id":"idea-prev-open-stage-shift-microsimulation","kind":"idea","name":"Open-source models that translate stage shift into lives saved, for every cancer","aka":[],"tldr":"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.","asOf":"2026-09-08","links":[{"label":"CISNET","url":"https://cisnet.cancer.gov"}],"tags":[],"related":[],"cancers":[],"sections":["early-detection"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["stage-shift"],"trials":["nhs-galleri"],"people":[],"bottlenecks":["b-early-detection","b-trial-design"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","test":"Fund the library; register predictions for NHS-Galleri and the NCI Vanguard study before their readouts.","maturity":"speculative","actor":"research","cost":"small","horizonYears":3},"route":"/ideas/idea-prev-open-stage-shift-microsimulation/","neighbours":{"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"term":[{"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/"}],"bottleneck":[{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}]}}