What are multi-cancer early detection (MCED) tests, and should you get one?

In the ever-evolving landscape of medical technology, an innovation that could revolutionize cancer screening has emerged. Multi-cancer early detection (MCED) tests have captured the attention of doctors, researchers and patients due to their potential to detect a range of cancers through a simple blood test.

But are these tests reliable?

MCED tests, a type of liquid biopsy, aim to catch early-stage cancer cells long before symptoms appear. By utilizing machine-learning algorithms, these tests identify the likely origin of tumors based on DNA and protein profiles.

"MCED tests hold immense promise for revolutionizing cancer detection," says Ernest Hawk, M.D., vice president, Cancer Prevention and Population Sciences. "However, patients who prioritize early adoption have to be aware of the potential consequences, and health care professionals must provide accurate information and support."

How many types of cancer do multi-cancer early detection tests cover?

Currently, there are around 20 tests in development. They offer screening for anywhere from two to over 50 tumor types in a single test. Some of the cancers the tests can detect include pancreatic, prostate, kidney, lung, breast, skin, ovarian and liver cancer.

What are the benefits of multi-cancer early detection tests?

Early diagnosis enables timely treatment, which may lead to improved survival rates and better patient outcomes.

These tests could also allow for more targeted treatments. Once a doctor has a blood sample, the laboratory uses advanced technologies and tests to study the DNA. If any abnormalities are located, they are analyzed further. Having this genomic information could allow a doctor to administer precise therapies that are potentially more effective.  

Cancer can also come with a big bill. Detecting disease earlier can reduce the need for costly advance-stage treatments, benefiting health care systems and patients alike.

"The world of cancer screening is on the cusp of a transformative shift with the rise of MCED tests," says Robert Volk, Ph.D., professor, Health Services Research. "But we need to have standardized, unbiased patient decision aids in place by the time they are approved."

What are the risks of using multi-cancer early detection tests?

Eager to rule out a cancer diagnosis, patients may focus on the potential benefits of multi-cancer early detection tests while overlooking the risks and limitations.

There are concerns that early-stage tumors won’t provide much DNA. This means the tumors may have to be further along to generate enough DNA to be reliably detected by the blood test.

Mammograms, colonoscopies and other screening approaches for individual cancers are each supported by rigorous studies but MCEDs have yet to be tested in large clinical trials. While some trials are underway in the U.S. and U.K., results are years away. As we await the data, questions linger about whether the tests are effective in reducing cancer mortality and whether there’s potential for overdiagnosis.

“Any positive blood tests require a subsequent diagnostic evaluation,” explains Hawk. “Endoscopy, radiologic imaging and biopsies all take additional time, add costs and may result in additional risks from the procedures themselves.”

Both Hawk and Volk also warn of the possibility of false positives. 

Imagine being told you have cancer when, in fact, you do not. This could cause immense emotional harm to patients.

“Ensuring the accuracy and reliability of these tests to minimize false positives should be a top priority to avoid undue patient stress," Volk emphasizes.

Are multi-cancer early detection tests covered by insurance?

Currently, they are not covered by insurance. Of the tests in development, the price can range between $200 and $1,000. Legislative efforts are underway to get the cost reimbursed by Medicare, once these tests are approved by the Food and Drug Administration (FDA).

While none of the tests are currently approved by the FDA, some are available commercially through the Clinical Laboratory Improvement Act for around $1,000.

Weigh the costs and benefits before using an MCED

Both Volk and Hawk agree that the potential to detect multiple cancer types at an early stage and the promise of personalized, targeted treatments are game-changers.

These innovative screening methods could make a life-or-death difference for millions of prospective cancer patients worldwide. However, they emphasize the need for evidence-based decision-making.

Until then, Hawk says, it’s best to weigh the risks and benefits of MCEDs before spending the money on one.

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