The clinical and psychosocial consequences of genomic Multi-Cancer Detection (MCD) tests in underserved populations:
Esther Low1,2, Shritha Gayathri1,3, Alexandra Wicker1
1Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, USA.
Introduction:
Multi-cancer detection (MCD) tests currently being tested in clinical trials may be a scalable, convenient means to improve cancer screening, yet little is known about the potential clinical and psychosocial consequences of doing so in underserved communities.
Objective:
To summarize the current literature examining potential clinical and psychosocial outcomes and consequences for MCD testing in underserved populations.
Methods:
We searched and then reviewed articles from five databases: PubMed, Embase, Scopus, Web of Science, and Cochrane. For inclusion, studies had to primarily focus on MCD testing within underserved populations. Out of 376 articles identified, 29 met inclusion criteria.
Results:
Financial constraints were the most frequently cited barrier (n = 23). 24 articles mentioned clinical consequences and nine mentioned psychosocial consequences, with the most common being lower rates of cancer screening with proven existing recommended tests (n = 10) and emotional stress, worry, and anxiety (n = 11), respectively. Many expressed concerns about underrepresentation in clinical trials.
Conclusions:
The review highlights common potential clinical consequences as well as important factors underserved populations may face if/when MCD testing is implemented in their healthcare. Future prospective studies, experimental and observational, should intentionally include underrepresented patient populations to better understand and address these challenges.
