Multi-cancer early detection tests: A new paradigm in cancer screening
Multi-cancer early detection tests: A new paradigm in cancer screening
Ali Rezaei,1Paria sadat agha seyed mirzaei,2Shirin Farivar,3,*
1. Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran 2. Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran 3. Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
Introduction: Multi-cancer early detection (MCED) tests can detect many different cancers through a single blood test. An example is the Galleri® test, which uses cfDNA methylation patterns, and an extracellular vesicle protein-based blood test. Thus, this type of testing reveals cancers that are at an early, more treatable stage, which then reduces mortality rates, and consequently, enhances patients' outcomes.
Methods: This review presents findings from several MCED tests. The research included a thorough analysis of 10 journal articles, where direct attention was paid to test methodologies, clinical trials, and statistical analyses. The authors of the studies provided key data points and a summary that included information about sensitivity, specificity, and the influence on early-stage cancer detection rates.
Results: The Galleri® test showed an overall sensitivity of 55% through more than 50 cancer types with a false-positive rate of less than 1%. Another test based on an extracellular vesicle protein showed a sensitivity of 71.2% and specificity of 99.5%. This test could detect many cancers at early stages, leading to a reduction of 77 to 100 deaths per 100,000 individuals annually.
These tests would be superior to the current single-cancer screening methods in terms of positive prediction value (PPV), especially when combined with machine learning algorithms. It is shown that this approach led to 95.5% sensitivity and 95% specificity in detecting lung, liver, and colorectal cancers.
Conclusion: MCED testing is not only a new and fascinating way to detect a variety of cancers but also a procedure that would have a positive impact on cancer screening as patients would only need to take a blood test to discover a possible diagnosis. These tests that can detect multiple types of cancer at once would thus contribute to the early detection of cancer and the resulting higher survival rate of the patients. Their use in clinical settings may not only take the place of current methods but might also play a significant role in the reduction of cancer incidence.