For decades, cancer screening has focused on detecting one cancer at a time through tests such as mammograms, colonoscopies, cervical cancer screenings, and lung cancer screening. While these tests save lives, many cancers still lack recommended screening options and often are not detected until symptoms develop.
One of the greatest challenges in cancer care is that many cancers are discovered after they have progressed to more advanced stages. At that point, treatment can be more intensive and outcomes may be less favorable.
Multi-cancer early detection (MCED) tests represent a new approach that could change that. MCED tests are blood tests designed to look for signals associated with multiple types of cancer at the same time. Rather than focusing on a single disease, these tests analyze fragments of genetic material and other biomarkers that circulate in the bloodstream. If an abnormal pattern is detected, the test may identify a potential cancer signal and, in some cases, suggest where in the body that signal originated.
“MCED testing may help identify certain cancers before symptoms appear, creating opportunities for earlier evaluation and treatment,” said Kevin Oeffinger, MD, director of the Duke Cancer Institute (DCI) Center for Onco-Primary Care and co-director of the Supportive Care and Survivorship Center.
Researchers and clinicians are particularly interested in the potential of MCED tests to help detect cancers that currently have no routine screening recommendations. MCED testing may offer another tool for finding some of these cancers earlier.
Although MCED testing holds considerable promise, experts emphasize that patients and healthcare providers should understand both its advantages and its current limitations.
MCED testing may be most appropriate for adults age 50 and older, as cancer risk increases with age. It may also be considered for younger individuals who have a higher risk of cancer because of factors such as family history, a personal history of cancer, lifestyle factors, or certain medical conditions.
Importantly, MCED tests do not diagnose cancer. A positive result signals the need for additional testing to determine whether cancer is present and, if so, what type of cancer it may be.
Like all screening tools, MCED tests have limitations. False-positive results can occur, meaning a cancer signal is detected when no cancer is present. False-negative results are also possible, as some cancers may not release detectable signals into the bloodstream.
Experts also stress that MCED testing is not a replacement for recommended cancer screenings.
“Patients should continue to receive all age- and risk-appropriate screenings, including mammograms, colonoscopies, cervical cancer screening, prostate cancer screening, and lung cancer screening,” Oeffinger said.
Currently, MCED tests have not received FDA approval and are available as laboratory-developed tests while additional research continues. While many healthcare organizations can order an MCED test, the Duke Center for Onco-Primary Care offers a dedicated MCED clinic that begins with an individualized discussion about a patient's health history, cancer risk factors, and screening goals.
Patients receive education and counseling before testing, assistance with coordinating the test itself, support in understanding results, and guidance through any recommended follow-up evaluations. Rather than leaving patients to interpret complex information on their own, Duke provides coordinated care throughout the testing and diagnostic pathway.
As research continues, Duke's experts believe MCED testing has the potential to become an important addition to cancer screening strategies.
“Duke's approach ensures patients have access to expert guidance, evidence-based recommendations, and coordinated care every step of the way,” Oeffinger said.
To learn more about the MCED Clinic or to make an appointment, visit dukehealth.org/mced-test, or call 919-613-3333.
