Cancer has become a major public health issue in China, seriously affecting population
health, the economy, and social development. In 2022, there were an estimated 4.82
million new cancer cases and 2.57 million cancer-related deaths. Lung cancer, liver
cancer, gastric cancer, colorectal cancer, esophageal cancer, pancreatic cancer, and
breast cancer are the seven leading causes of cancer-related mortality. A successful
earlier detection strategy would allow patients to receive timely interventions, improve
treatment outcomes, enhance overall survival, and reduce the complexity and cost of
treatment.
In this study, we will conduct a large-scale, prospective, multi-center cohort study,
aiming to evaluate the utility of AI-assisted non-contrast CT for multi-cancer screening.
The population consists of individuals who have undergone non-contrast abdominal or chest
CT scans at Meinian Onehealth Health Examination Center or Shanghai Changhai Health
Examination Center, with an expected enrollment of 1 million participants. A multi-cancer
screening model via non-contrast CT, developed by Alibaba DAMO Academy, will be
integrated into the PACS system of health examination centers. The imaging AI model will
be used to automatically detect various cancerous lesions, including lung cancer, liver
cancer, gastric cancer, colorectal cancer, esophageal cancer, pancreatic cancer, and
breast cancer. Subjects identified with positive lesions by the AI model will be required
to be referred to Shanghai Changhai Hospital for further imaging examinations (such as
contrast-enhanced CT, MRI, Endoscopy, etc.) to confirm the final disease status and
formulate a treatment plan. Additionally, the medical team should follow care pathways
developed based on guidelines from NCCN and ACR, and if necessary, patients will be
directed to the multidisciplinary team (MDT) clinic for specific cancer types to
determine the diagnostic procedures. The ultimate goal of this study is to
comprehensively assess the diagnostic performance metrics of the AI model for each of the
seven cancer types individually. These metrics include, but are not limited to,
sensitivity, specificity, and positive/negative predictive value. Particular emphasis
will be placed on evaluating the model's efficacy in detecting early-stage, resectable
tumors. The overarching aim is to determine whether the implementation of this
AI-assisted screening approach could potentially lead to improved overall survival rates
through earlier detection and intervention.