Multicancer detection (MCD) tests use a single, easily obtainable biospecimen, such as blood, to screen for more than one cancer concurrently. MCD tests can potentially be used to improve early cancer detection, including cancers that currently lack effective screening methods. However, these tests have unknown and unquantified benefits and harms. MCD tests differ from conventional cancer screening tests in that the organ responsible for a positive test is unknown, and a broad diagnostic workup may be necessary to confirm the location and type of underlying cancer. Among two prospective studies involving greater than 16,000 individuals, MCD tests identified those who had some cancers without currently recommended screening tests, including pancreas, ovary, liver, uterus, small intestine, oropharyngeal, bone, thyroid, and hematologic malignancies, at early stages. Reported MCD test sensitivities range from 27% to 95% but differ by organ and are lower for early stage cancers, for which treatment toxicity would be lowest and the potential for cure might be highest. False reassurance from a negative MCD result may reduce screening adherence, risking a loss in proven public health benefits from standard-of-care screening. Prospective clinical trials are needed to address uncertainties about MCD accuracy to detect different cancers in asymptomatic individuals, whether these tests can detect cancer sufficiently early for effective treatment and mortality reduction, the degree to which these tests may contribute to cancer overdiagnosis and overtreatment, whether MCD tests work equally well across all populations, and the appropriate diagnostic evaluation and follow-up for patients with a positive test.

中文翻译：

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使用多种癌症检测测试进行癌症筛查：转化科学综述


多癌检测 (MCD) 测试使用单一且易于获得的生物样本（例如血液）来同时筛查多种癌症。 MCD 检测有可能用于改善早期癌症检测，包括目前缺乏有效筛查方法的癌症。然而，这些测试具有未知且未量化的益处和危害。 MCD 测试与传统癌症筛查测试的不同之处在于，导致阳性测试的器官未知，并且可能需要进行广泛的诊断检查以确认潜在癌症的位置和类型。在两项涉及超过 16,000 人的前瞻性研究中，MCD 测试发现了那些未接受目前推荐的筛查测试的癌症患者，包括早期胰腺癌、卵巢癌、肝癌、子宫癌、小肠癌、口咽癌、骨癌、甲状腺癌和血液恶性肿瘤。报道的 MCD 测试灵敏度范围为 27% 至 95%，但因器官而异，并且对于早期癌症较低，治疗毒性最低，治愈潜力可能最高。 MCD 阴​​性结果带来的错误保证可能会降低筛查依从性，从而可能导致标准护理筛查带来的已证实的公共健康益处丧失。需要进行前瞻性临床试验来解决 MCD 准确性的不确定性，以在无症状个体中检测不同的癌症，这些测试是否能够足够早地检测出癌症以进行有效治疗和降低死亡率，这些测试可能在多大程度上导致癌症过度诊断和过度治疗，MCD 是否测试对所有人群都同样有效，并且对测试呈阳性的患者进行适当的诊断评估和随访。