SynthesisCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2025
Late-Stage Outcomes as Surrogates for Mortality in Cancer Screening Trials: A Systematic Review and Meta-analysis.
Synthesis in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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
4 citing papers in PubMed.
- Overall and Cause-Specific Late Mortality in Long-Term Survivors of Early Onset Solid Cancer After Surgery: A Population-Based Retrospective Cohort Study.Annals of surgical oncology · 2026Article
- UK National Screening Committee position statement on surrogate outcomes in cancer screening trials.BMJ (Clinical research ed.) · 2026Article
- Evaluating the basis for use of advanced stage as a surrogate endpoint for cancer mortality in screening trials: a simulation study of meta-correlation and an alternative framework.EClinicalMedicine · 2026Article
- Measuring and defining screening benefit in a new era of cancer early detection.Journal of the National Cancer Institute · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
Late-stage cancer incidence has been proposed as a surrogate outcome for cancer-specific mortality in future screening trials. Two previous meta-analyses with 33 and 39 trials assessed trial-level surrogacy but provided inconsistent conclusions about the suitability of late-stage cancer endpoints replacing mortality. Our systematic review and meta-analysis (PROSPERO ID, CRD42023369320) investigated the association between the effect of cancer screening on the incidence of late-stage cancer and cancer-specific mortality. From 57 trials with 61 trial arm comparisons, correlation between late-stage incidence and mortality outcomes was 0.69 [95% confidence interval (CI), 0.47-0.84] for all cancers combined. Specifically, correlations were 0.58 (95% CI, 0.27-0.93) for bowel (N = 11 trials), 0.79 (95% CI, 0.49-0.94) for breast (N = 13), and 0.91 (95% CI, 0.84-0.96) for lung cancer (N = 14). Trial point estimates of the screening effect on mortality were within each trial's 95% CI late-stage incidence estimates in 56 of 61 (92%) trial arm comparisons and in 16 of 19 (84%) trial arm comparisons in which the entire 95% CI for screening effect on late-stage incidence was below one. Evidence suggests potential for late-stage cancer incidence as a key outcome in screening trials, but further research is needed to clarify when to measure late-stage outcomes, extrapolation for cancer types without trials, and the conditions when late-stage cancer does not accurately predict mortality.
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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.