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Multicancer Detection Tests for Screening : A Systematic Review
Leila C Kahwati1, Matthew Avenarius2, Leslie Brouwer2
1RTI-University of North Carolina Evidence-based Practice Center, Research Triangle Park and Chapel Hill, North Carolina; and RTI International, Research Triangle Park, North Carolina (L.C.K., R.C.W.).
Multicancer detection (MCD) blood tests show variable accuracy, but evidence on screening benefits and harms in asymptomatic adults is currently insufficient. Further research is needed to establish their clinical utility.
Area of Science:
- Oncology
- Genomics
- Medical Diagnostics
Background:
- Screening for multiple cancers using a single blood test offers transformative potential.
- Blood-based multicancer detection (MCD) tests aim to identify various cancers early.
Purpose of the Study:
- To evaluate the benefits, accuracy, and harms of MCD tests in asymptomatic adults.
- To synthesize evidence on the performance of MCD tests for cancer screening.
Main Methods:
- Systematic review of controlled studies, diagnostic accuracy studies, and harms assessments.
- Searched MEDLINE, Cochrane Library, and trial registries through March 2025.
- Data extraction and risk of bias assessment performed by independent reviewers.
Main Results:
- No controlled studies reported on the benefits of MCD screening.
- Twenty studies assessed the accuracy of 19 MCD tests, with sensitivity ranging from 0.095 to 0.998 and AUC from 0.52 to 1.0.
- Accuracy varied by test and study design; diagnostic performance estimates may not apply to screening.
Conclusions:
- Evidence is insufficient to evaluate the benefits, harms, or definitive accuracy of MCD tests for cancer screening.
- The clinical utility of MCD tests requires further investigation through well-designed controlled studies.
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