Abstract P057: Application of multi-cancer early detection to lung and breast cancer screening populations
Authors: Dennison Jennifer , Irajizad Ehsan , Ostrin Edwin , Godoy Myrna , Weaver Olena , Leung Jessica , Hanash Samir 
Published: January 2023

The Center for Global Early Detection at MD Anderson has initiated two longitudinal early detection studies: LEAP (Lung Cancer Early Detection and Prevention, 2013-2019) for lung cancer screening and MERIT (Mammography Early Detection Risk Assessment and Imaging Technologies, 2017-ongoing) for breast cancer screening. Both cohorts enrolled subjects based on US standard-of-care guidelines at the time of enrollment for low-dose CT screening and mammography, respectively. The cohorts collected detailed health data from questionnaires, imaging data, and blood specimens at the time of screening. In addition to information on the screened-detected cancers, follow-up information was collected on any other types of cancers that are diagnosed after enrollment. Here, we evaluate the incidence of other cancers without available screening to assess the potential impact of multi-cancer early detection studies for these two types of screening populations. The two studies enrolled approximately 9,300 subjects (N = 2853 for LEAP; N = 6,400 for MERIT) with median follow up times of 2.99 years (IQR: 1.09-4.08) for LEAP and 2.05 years (IQR: 0.09-3.01) for MERIT. Currently, there are more than 800,000 aliquots of banked biospecimens from both cohorts. The incidence of lung cancer for the LEAP cohort undergoing low-dose CT screening was 0.91% per year. Cancers other than lung cancer were also diagnosed after enrollment including prostate, breast, bladder, head, and neck, colorectal, lymphoma, endocrine, gynecologic, and kidney cancers. Overall, the incidence of other cancers in LEAP was high for those cancers without available screening - 0.49% per year excluding breast, prostate, and colorectal cancers. The incidence of breast cancer for women in LEAP was lower than expected, 0.17% per year, likely a result of underscreening by mammography. For the MERIT cohort, the incidence of breast cancer was 0.89% per year. Cancers other than breast were diagnosed in MERIT after enrollment including gynecologic, melanoma, lung, colorectal, endocrine, bladder, and gastrointestinal cancers. The incidence of other cancers in MERIT was 0.55% per year, excluding colorectal cancer. We conclude that the incidence of cancers without a current screening modality in LEAP and MERIT is sufficiently high (0.49-0.55% per year) to justify the application of multi-cancer screening. Even for cancers with standard-of-care screening, a multi-cancer blood-based biomarker test could be useful given the possibility of underscreening, as we observed for breast cancer in the LEAP cohort.

Citation Format: Jennifer Dennison, Ehsan Irajizad, Edwin Ostrin, Myrna Godoy, Olena Weaver, Jessica Leung, Samir Hanash. Application of multi-cancer early detection to lung and breast cancer screening populations. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P057.