| Purpose: To estimate the missed detection rates for early-stage cases of common cancers identified through health examinations in China, providing evidence to promote the health benefits of population. Methods：Utilizing publicly available data including existing health examination coverage rates and population-based early-stage cancer proportions, we constructed a model to simulate the missed detection process; applying Bayesian testing theory, the theoretical early-case detection rate was calculated using health examination rates and expected early detection proportion as prior probabilities, while the actual early-case proportion served as the posterior probability to estimate missed detection rates, with equivalent early detection proportion subsequently computed. Results： Under the assumption of a 30% health examination rate with 90% expected early detection proportion, the estimated aggregate missed detection rate for five common cancers was 47.9%, with corresponding missed detection rates for female breast cancer, gastric cancer, colorectal cancer, lung cancer, and esophageal cancer being 15.4%, 49.2%, 55.7%, 56.4%, and 57.4% respectively; when increasing the health examination rate to 40%, the aggregate missed detection rate rose to 59.2%. Through health examination screening for five common cancers, the aggregate equivalent early detection proportion was 41.3%, with female breast cancer, gastric cancer, colorectal cancer, lung cancer, and esophageal cancer demonstrating equivalent early detection proportions of 74.3%, 40.0%, 33.3%, 32.7%, and 31.7% respectively. Conclusion： Nearly half of detectable early-stage cancer patients undergoing health examinations experience missed detection, highlighting the imperative to enhance early detection effectiveness in health examinations; merely increasing health examination rates without improved detection effectiveness would only generate additional missed early detections. |
