Prognostic Significance of Blood-Based Multicancer Detection in Circulating Tumor DNA: Five-Year Outcomes Analysis
Charles Swanton1, Alan Bryce2, Allen L Cohn3
1Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, United Kingdom.
JCO Precision Oncology
|March 12, 2026
Summary
The multicancer early detection (MCED) test identified cancers with survival rates similar to expected outcomes, even in early stages. This suggests the MCED test finds significant cancers without causing overdiagnosis.
Area of Science:
- Oncology
- Genomics
- Biomarker Discovery
Background:
- Multicancer early detection (MCED) tests aim to identify cancer signals in blood.
- Previous studies showed prognostic value of MCED tests.
- The Circulating Cell-free Genome Atlas (CCGA) study validated MCED test performance.
Purpose of the Study:
- To evaluate the prognostic value of a cancer signal detected (CSD) result from an MCED test.
- To analyze 5-year follow-up data from the CCGA3 substudy.
- To assess if CSD cancers have different survival outcomes compared to expected survival.
Main Methods:
- Analysis of 2,513 participants with stageable, invasive cancer from the CCGA3 study.
- Stratification of overall survival by MCED test result (CSD or no CSD).
- Comparison of observed survival with expected survival using SEER data matched for clinical characteristics.
Main Results:
- CSD rates were higher in participants who died during follow-up (85%) versus those alive (34%).
- Observed survival was similar to expected survival for both CSD (43% vs 40%) and NCSD (88% vs 81%) groups.
- MCED test showed favorable hazard ratios for NCSD cancers and for CSD cancers at stages III-IV.
Conclusions:
- MCED test-detected early-stage cancers do not appear to be more lethal than conventionally detected cancers.
- The MCED test is likely to detect clinically significant cancers.
- The MCED test may avoid overdiagnosis of indolent cancers.
