Optimal schedules of cancer surveillance and tumor size at detection

The paper explores methodological and mathematical aspects of a new approac h to constructing optimal schedules of cancer screening. This approach cons ists of systematic use of tumor size at detection, combining stochastic mod els of tumor latency, tumor growth and turner detection, and employing a ne w biologically natural screening efficiency criterion defined as the Kantor ovich distance between the tumor size at spontaneous detection in the absen ce of screening and the tumor size at detection when both spontaneous and s creening based mechanisms are in place. An explicit formula. for the effici ency functional is obtained. Sample calculations suggest that in tile case of exponential tumor growth, the optimal screening schedules with a fixed n umber of exams have a trend to uniformity. (C) 2001 Elsevier Science Ltd. A ll rights reserved.