Unified Screening for Multiple Diseases

Abstract

Current screening programs that focus on improving patient health while minimizing screening costs are tailored for individual diseases. Designing unified screening programs for multiple diseases requires carefully balancing competing disease risks, which is an open problem. In this work, we address this problem by casting unified screening as a referral problem, in which we choose to activate a subset of screening policies for individual diseases by accounting for competing risks that influence patient outcomes. We introduce a novel optimization framework that incorporates disease risks, budget constraints, and diagnostic error limits and characterize the structural properties of the optimal referral policy. For the unified screening of two diseases, we show that the optimal activation threshold for the screening of one disease depends on the risk of the other, resulting in decision boundaries with distinct risk-dependent profiles. We compare our unified model with independent screening programs that apply isolated activation thresholds for screening of each disease. Our approach optimizes screening decisions collectively, improving overall survival outcomes, particularly for patients with high disease risks.