A single blood test, designed to pick up chemical signals indicative of the presence of many different types of cancer, could potentially thwart progression to advanced disease while the malignancy is still at an early stage and amenable to treatment in up to half of cases, suggests a new study.
Incorporating the test, formally known as a multi-cancer early detection test, or MCED for short, either yearly or biennially, could therefore improve outcomes for patients by intercepting disease progression, suggest the researchers in a modelling study published in the open access journal BMJ Open.
Currently, only a few cancers can be reliably screened for - those of the breast, bowel, cervix (neck of the womb), and lung for those at high risk. While effective at lowering death rates from these diseases, these screens can also result in false positive results and overdiagnosis, say the researchers.
The optimal interval at which screening will pick up the most cancers at an early stage (I and II) while at the same time avoiding unnecessary testing and treatment still isn’t clear.
To inform future clinical trials, the researchers drew on a previously published disease progression model for many different cancers. They used this to predict the impact of regular screening with an MCED test on the time of cancer diagnosis and patient death for different screening schedules among 50–79-year-olds in receipt of usual care.
The screening schedules modelled ranged from six months to three years, but with an emphasis on annual and biennial screening for two sets of cancer growth scenarios. These were ‘fast’, where tumours remain at stage 1 for between 2-4 years before progressing; and ‘fast aggressive’ where tumours remain at stage 1 for between 1-2 years, with decreasing periods of time for progression to successive stages.
Cancer types included were those of the anus; bladder; breast; cervix; bowel/rectum; food pipe (oesophagus); gallbladder; head and neck; kidney; liver/ bile-duct; lung; ovary; pancreas; prostate; sarcoma (soft tissues/bone); stomach; thyroid; urothelial tract, and uterus, as well as leukaemia, lymphoma, melanoma, blood cancers (myeloid neoplasm, immune cell cancers (plasma cell neoplasm).
The researchers drew on MCED test characteristics from a recently published report and patient outcomes from population cancer data from the US Surveillance, Epidemiology and End Results (SEER) programme.
Their analysis showed that all MCED screening intervals had more favourable early-stage diagnostic rates than usual care alone. There was a larger impact on stage shift for tumours with ‘fast’ growth than for tumours with ‘fast aggressive’ growth.
But annual MCED screening under the fast tumour growth scenario was associated with a higher number of diagnoses: 370 more cancer signals were detected per year per 100,000 people screened, with 49% fewer late-stage diagnoses, and 21% fewer deaths within five years than usual care.
While biennial MCED screening was able to shift the stage at diagnosis and avert deaths, it was not as effective as annual screening: 292 more cancer signals were detected/year/100,000 people screened; 39% fewer late-stage diagnoses; and 17% fewer deaths within five years than usual care.
- Rous B, Clarke CA, Hubbell E, et al. Assessment of the impact of multi-cancer early detection test screening intervals on late-stage cancer at diagnosis and mortality using a state-transition model. BMJ Open 2025;15:e086648. doi: 10.1136/bmjopen-2024-086648