{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:42:56Z","timestamp":1792348976548,"version":"4.4.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C8162\/A27047"],"award-info":[{"award-number":["C8162\/A27047"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["CTUQQR-Dec22\/100005"],"award-info":[{"award-number":["CTUQQR-Dec22\/100005"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["EDDCPGM\\100002"],"award-info":[{"award-number":["EDDCPGM\\100002"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["EDDCTR-2022\/100001"],"award-info":[{"award-number":["EDDCTR-2022\/100001"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR302434"],"award-info":[{"award-number":["NIHR302434"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Med Screen"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer-specific mortality traditionally has been used to evaluate the effectiveness of cancer screening, and reduction of late-stage disease has been found to correlate with reduction of cancer-specific mortality, but measurement requires long follow-up. Increased detection of early-stage cancer has been proposed as a potential early indicator of beneficial interventions. Our systematic review and meta-analysis evaluated trial-level correlations between early-stage outcomes (early-stage cancer incidence, proportion of screen-detected cancers, diagnostic yield of screening) and cancer-specific mortality from all available cancer screening randomised controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Weighted Pearson correlation coefficients were estimated for early-stage diagnosis outcomes (log relative risk for early-stage cancer incidence; proportion otherwise) and cancer-specific mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 213 publications from 58 trials (62 trial-arm comparisons) covering 10 cancer types, but only 15 trials reported cancer stage at a timepoint prior to mortality. The correlation between early-stage cancer incidence and cancer mortality was \u22120.25 (95% CI: \u22120.49 to 0.07; 43 trials). This was similar by cancer type (e.g., lung [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200914]: \u22120.36 [95% CI: \u22120.69 to 0.15]; breast [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200913]: \u22120.21 [95% CI: \u22120.61 to 0.42]). The correlation for the proportion of screen-detected cancers was \u22120.16 (95% CI: \u22120.50 to 0.29; 44 trials). Correlation between the diagnostic yield and cancer mortality was \u22120.02 (95% CI: \u22120.72 to 0.45) for bowel (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200911) and \u22120.32 (95% CI: \u22120.83 to 0.19) for breast cancer (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200911).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For cancer screening RCTs, neither early-stage cancer incidence, the proportion of screen-detected cancers nor diagnostic yield of screening demonstrated a reliable correlation with cancer mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09691413261498649","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:40:13Z","timestamp":1792071613000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between the impact of cancer screening on early-stage cancers and on cancer mortality: A systematic review and meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6446-6094","authenticated-orcid":false,"given":"Julia","family":"Geppert","sequence":"first","affiliation":[{"name":"University of Warwick","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nefeli","family":"Kouppa","sequence":"additional","affiliation":[{"name":"Queen Mary University of London","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2419-7688","authenticated-orcid":false,"given":"Chris","family":"Stinton","sequence":"additional","affiliation":[{"name":"University of Warwick","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9963-2918","authenticated-orcid":false,"given":"Karoline","family":"Freeman","sequence":"additional","affiliation":[{"name":"University of Warwick","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Randell","sequence":"additional","affiliation":[{"name":"University of Warwick","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Warwick Library","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Smith","sequence":"additional","affiliation":[{"name":"American Cancer Society","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1509-8744","authenticated-orcid":false,"given":"Peter","family":"Sasieni","sequence":"additional","affiliation":[{"name":"Queen Mary University of London","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4901-7922","authenticated-orcid":false,"given":"Stephen","family":"Duffy","sequence":"additional","affiliation":[{"name":"Queen Mary University of London","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam M","family":"Janes","sequence":"additional","affiliation":[{"name":"University College London","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5350-1018","authenticated-orcid":false,"given":"Bethany","family":"Shinkins","sequence":"additional","affiliation":[{"name":"University of Warwick","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-4357","authenticated-orcid":false,"given":"Adam","family":"Brentnall","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Population Health","place":["UK"]},{"name":"Queen Mary University of London","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-645X","authenticated-orcid":false,"given":"Matejka","family":"Rebolj","sequence":"additional","affiliation":[{"name":"Queen Mary University of London","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1841-4346","authenticated-orcid":false,"given":"Sian","family":"Taylor-Phillips","sequence":"additional","affiliation":[{"name":"University of Warwick","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2026-629407"},{"key":"e_1_3_3_3_2","unstructured":"NHS England. 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