Understanding Bladder Cancer Screening Limits Through Comparative Modeling: The Maximum Clinical Incidence Reduction (MCLIR) Methodology

In a standardized CISNET stress test, three bladder cancer microsimulation models imply a relatively short detectable preclinical phase, placing a modest upper bound on the effectiveness of one-time screening in the general population. Differences in MCLIR/RCLIR magnitude and persistence are explained by differences in implied sojourn time and detectable reservoir size. These findings motivate evaluation of risk-targeted and repeated early-detection strategies and highlight key empirical priorities for improving inference on bladder cancer natural history.