ABSTRACT

Early cancer detection has been a cornerstone of cancer management strategies, primarily aimed at reducing mortality through timely interventions. The concept of stage shift—diagnosing cancer at an earlier, more treatable stage—has been central to this approach. However, recent critiques have questioned the benefits of early detection, often focusing on overall survival without considering the critical roles of surveillance, monitoring, and early intervention. This paper systematically reviews the literature on stage shift in cancer detection, arguing that it serves as a valuable surrogate endpoint for improved outcomes. Evidence from prostate, breast, cervical, and colorectal cancers demonstrates that early detection, when coupled with active surveillance, significantly reduces morbidity and mortality. The failure of some studies to account for the benefits of ongoing monitoring and timely intervention represents a significant oversight in assessing the full impact of early detection. This review highlights the importance of considering stage shift not merely as an endpoint but as a vital component of a comprehensive cancer management strategy.