{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T20:19:43Z","timestamp":1779135583743,"version":"3.51.4"},"reference-count":35,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Breast cancer survivors are at elevated risk of multiple new primary cancers compared with the general population. The impact of multicancer screening on late-stage cancer diagnosis is under clinical investigation in average-risk individuals, but it is unclear whether findings will generalize to breast cancer survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We adapted an existing multicancer natural history model for the average-risk US population to reflect increased risks of second primary cancers and all-cause mortality among female breast cancer survivors. We modeled 16 cancer types other than breast cancer and specified a range of natural history parameters and screening test sensitivities to reflect uncertainty in disease onset, progression, and detectability of target cancers. We evaluated annual multicancer screening over a lifetime horizon in simulated hormone receptor\u2013positive (HR-positive) and hormone receptor\u2013negative (HR-negative) cohorts of survivors age 50-74 years and in age-matched women without prior cancer (average-risk women). Outcomes included absolute and relative reductions in late-stage diagnoses compared with no multicancer screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Across a range of natural histories and test sensitivities, multicancer screening was projected to reduce 35-99 late-stage diagnoses per 100,000 person-years (PY; 9%-25% reduction) among HR-positive survivors and 39-111 per 100,000 PY (9%-26% reduction) among HR-negative survivors, compared with 30-84 per 100,000 PY (7%-20% reduction) among average-risk women. Lung cancer contributed most to the reduction in late-stage diagnoses (34%-38%), followed by colorectal cancer (14%-16%) in all populations. Ovarian cancer accounted for greater reduction in HR-negative than HR-positive survivors (10%-11%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      6%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Model-based projections suggest that multicancer screening may reduce late-stage diagnoses among breast cancer survivors more than among average-risk women. This suggests a potential role in long-term surveillance for second primary cancers in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-26-00305","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T19:59:14Z","timestamp":1779134354000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Multicancer Screening on Late-Stage Cancer at Diagnosis in Breast Cancer Survivors: A Modeling Study"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8474-4039","authenticated-orcid":true,"given":"Kemal C.","family":"Gogebakan","sequence":"first","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-9679","authenticated-orcid":true,"given":"Jane","family":"Lange","sequence":"additional","affiliation":[{"name":"Cancer Early Detection Advanced Research Center, Knight Cancer Institute, Oregon Health &amp; Science University, Portland, OR"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-6567","authenticated-orcid":true,"given":"Roman","family":"Gulati","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5735-1819","authenticated-orcid":true,"given":"Marianne E.","family":"Dubard-Gault","sequence":"additional","affiliation":[{"name":"Swedish Cancer Institute, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6579-0416","authenticated-orcid":false,"given":"Charles W.","family":"Drescher","sequence":"additional","affiliation":[{"name":"Swedish Cancer Institute, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen E.","family":"Malone","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"Department of Epidemiology, University of Washington, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9164-6370","authenticated-orcid":true,"given":"Ruth","family":"Etzioni","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2007839"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djae135"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-025-06379-5"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-24-0636"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21149"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.14694\/EdBook_AM.2014.34.e57"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21731"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.10.029"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34679"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-24-1009"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-022-00447-5"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.0079"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.aar3247"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-17316-z"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01700-2"},{"key":"e_1_3_7_17_2","article-title":"Multicancer early detection blood test performance in cancer survivors from the PATHFINDER study","author":"Marinac CR","unstructured":"Marinac CR, O'Donnell EK, Clarke CA, et al: Multicancer early detection blood test performance in cancer survivors from the PATHFINDER study. 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