SynthesisCancer medicine2019
All-cause mortality versus cancer-specific mortality as outcome in cancer screening trials: A review and modeling study.
Synthesis in Cancer medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Developing and validating key performance indicators for breast, cervical, and colorectal cancer screening programs: a literature review and Delphi survey.Frontiers in public health · 2025Pooled it
- Screening for breast cancer: a systematic review update to inform the Canadian Task Force on Preventive Health Care guideline.Systematic reviews · 2024Pooled it
- Cost effectiveness of breast cancer screening and prevention: a systematic review with a focus on risk-adapted strategies.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Pooled it
- Lung Cancer Screening with Low-Dose CT: a Meta-Analysis.Journal of general internal medicine · 2020Pooled it
- All-cause mortality versus cancer-specific mortality as outcome in cancer screening trials: A review and modeling study.Cancer medicine · 2019Pooled it
- Cost-effectiveness analysis of PSA-based mass screening: Evidence from a randomised controlled trial combined with register data.PloS one · 2019Trial
- The Proposed Introduction of a Prostate Cancer Screening Program in Germany: Procedure, Necessary Studies before Implementation, Benefits, and Risks.Deutsches Arzteblatt international · 2026Review
- Quality-adjusted life years in the presence and absence of organized mammographic screening using data from BreastScreen Norway.International journal of cancer · 2026Article
- Breast cancer mortality among women who have attended BreastScreen Norway, 1996-2023.Breast cancer research : BCR · 2026Article
- Impact of Comorbidities on the Mortality Benefits of Lung Cancer Screening: A Post-Hoc Analysis of the PLCO and NLST Trials.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2025Article
- Evaluation of the Slovenian Breast Cancer Screening Programme: Years of Life Gained and Avoided Deaths.Cancers · 2025Article
- Will DANCAVAS be the most important screening trial in the last 50 years?American journal of preventive cardiology · 2024Article
- Avoiding lead-time bias by estimating stage-specific proportions of cancer and non-cancer deaths.Cancer causes & control : CCC · 2024Article
- About cancer screenings and saving lives: measuring the effects of cancer screening programs through meta-analyses-A comment to the meta-analysis "Estimated Lifetime Gained With Cancer Screening Tests" by Bretthauer et al. (2023).Frontiers in public health · 2024Article
- Is radiotherapy after radical prostatectomy associated with higher other-cause mortality?Cancer causes & control : CCC · 2023Article
- Review
- Disparity in Lung Cancer Screening Among Smokers and Nonsmokers in China: Prospective Cohort Study.JMIR public health and surveillance · 2023Article
- Lung Cancer Screening Knowledge Among Internal Medicine Residents in a University Program.Journal of cancer education : the official journal of the American Association for Cancer Education · 2021Article
- Machine-learning model to predict the cause of death using a stacking ensemble method for observational data.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Colorectal Cancer Incidence After Colonoscopy at Ages 45-49 or 50-54 Years.Gastroenterology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundAll-cause mortality has been suggested as an end-point in cancer screening trials in order to avoid biases in attributing the cause of death. The aim of this study was to investigate which sample size and follow-up is needed to find a significant reduction in all-cause mortality.
methodsA literature review was conducted to identify previous studies that modeled the effect of screening on all-cause mortality. Microsimulation modeling was used to simulate breast cancer, lung cancer, and colorectal cancer screening trials. Model outputs were: cancer-specific deaths, all-cause deaths, and life-years gained per year of follow-up.
resultsThere were large differences between the evaluated cancers. For lung cancer, when 40 000 high-risk people are randomized to each arm, a significant reduction in all-cause mortality could be expected between 11 and 13 years of follow-up. For breast cancer, a significant reduction could be found between 16 and 26 years of follow-up for a sample size of over 300 000 women in each arm. For colorectal cancer, 600 000 persons in each arm were required to be followed for 15-20 years. Our systematic literature review identified seven papers, which showed highly similar results to our estimates.
conclusionCancer screening trials are able to demonstrate a significant reduction in all-cause mortality due to screening, but require very large sample sizes. Depending on the cancer, 40 000-600 000 participants per arm are needed to demonstrate a significant reduction. The reduction in all-cause mortality can only be detected between specific years of follow-up, more limited than the timeframe to detect a reduction in cancer-specific mortality.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.