A Review of Estimation of Key Parameters and Lead Time in Cancer Screening

Early detection combined with effective treatments are the only ways to fight against cancer, and cancer screening is the primary technique for early detection. Although mass cancer screening has been carried out for decades, there are many unsolved problems, and the statistical theory of cancer screening is still under developed. Screening sensitivity, time duration in the preclinical state, and time duration in the disease free state are the three key parameters, which are critical in cancer screening, since all other estimates are functions of the three key parameters. Lead time is the diagnosis time advanced by screening, and it serves as a measurement of effectiveness of screening programs. In this article, we provide a review for major probability models and statistical methodologies that have been developed on the estimation of the three key parameters and the lead time distributions. These methods can be applied to screening of other chronic diseases after slight modifications.