Cancer screening with multicancer detection tests: A translational science review

Area of Science:

• Oncology
• Genomics
• Biomarker Discovery

Background:

• Multicancer detection (MCD) tests offer concurrent screening for multiple cancers using a single biospecimen.
• These tests hold potential for improving early detection, especially for cancers lacking current screening methods.
• Significant uncertainties exist regarding the benefits and harms of MCD tests.

Purpose of the Study:

• To evaluate the performance of MCD tests in detecting various cancers.
• To assess the potential impact of MCD tests on early cancer diagnosis and patient outcomes.
• To identify key areas for future research concerning MCD test accuracy and clinical utility.

Main Methods:

• Analysis of two prospective studies involving over 16,000 individuals.
• Evaluation of reported sensitivities for MCD tests across different cancer types and stages.
• Review of potential implications for cancer screening adherence and diagnostic workups.

Main Results:

• MCD tests identified early-stage cancers, including pancreas, ovary, liver, and hematologic malignancies, particularly those without standard screening.
• Reported sensitivities ranged from 27% to 95%, varying by cancer type and generally lower for early-stage disease.
• A negative MCD result could lead to false reassurance, potentially reducing adherence to standard screening protocols.

Conclusions:

• MCD tests show potential for early detection of various cancers but require further validation.
• Prospective clinical trials are crucial to address uncertainties in accuracy, clinical utility, and population-specific performance.
• Clarifying diagnostic pathways and follow-up for positive MCD tests is necessary for safe and effective implementation.