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Multicancer early detection testing: Guidance for primary care discussions with patients
Journal article   Open access   Peer reviewed

Multicancer early detection testing: Guidance for primary care discussions with patients

Richard M. Hoffman, Andrew M. D. Wolf, Sana Raoof, Carmen E. Guerra, Timothy R. Church, Elena B. Elkin, Ruth D. Etzioni, Ya‐Chen Tina Shih, Steven J. Skates, Deana Manassaram-Baptiste, …
Cancer, Vol.131(7), e35823
04/01/2025
DOI: 10.1002/cncr.35823
PMCID: PMC11962340
PMID: 40170549
url
https://doi.org/10.1002/cncr.35823View
Published (Version of record) Open Access

Abstract

Multicancer early detection (MCED) tests are an emerging technology for cancer screening. MCED tests can detect cancer signals from multiple cancers concurrently in biological samples such as blood, urine, saliva, or other bodily fluids. Some tests can suggest the most likely cancer origin, whereas others report cancer detected somewhere in the body. Although some MCED tests are currently commercially available, none are approved by the Food and Drug Administration or endorsed by any clinical practice guideline or recommendation. Most insurance companies do not currently cover MCED testing. MCED tests have not yet been evaluated for safety and effectiveness in randomized controlled trials. Because patients already are asking for MCED test prescriptions or for interpretation of results from tests acquired elsewhere, clinicians should be prepared to discuss what is known about the benefits, risks, and uncertainties of MCED testing, including performance characteristics in screening populations and preferred follow‐up strategies for positive test results. At this time, clinicians should not feel obligated to initiate discussions about MCED testing with their patients. However, clinicians should engage patients who inquire about getting tested or previous MCED test results in shared decision‐making, and take the opportunity to offer and help patients complete age‐ and sex‐appropriate guideline‐recommended cancer screenings. In this article, the current evidence and issues around MCED testing are summarized, and a framework for shared decision‐making discussions is provided. Clinicians should be aware of the potential benefits, harms, and uncertainties around the use of multicancer early detection (MCED) blood tests for cancer screening to inform discussions with patients who inquire about these tests. Discussions should also note that MCED tests have limited insurance coverage, and are not approved by the Food and Drug Administration or endorsed by professional society guidelines.
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