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Current cancer screening reduces mortality for individual cancers but detects only a minority of cases and increases false positives because of a sensitivity-specificity tradeoff. Blood-based multicancer early detection tests using next-generation sequencing and related technologies could expand detectable cancer types. Advancing clinical adoption requires novel, carefully designed trial designs to improve population-level efficiency while addressing these evidence gaps.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/dying-to-find-out-the-cost-of-time-at-the-dawn-of-the-multicancer-early-detection-era/379094/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/dying-to-find-out-the-cost-of-time-at-the-dawn-of-the-multicancer-early-detection-era/379094.png","ImageObject",300,407,{"name":92,"@type":93},"Riley West","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why do current cancer screening tests have limited population impact?","Question",{"text":113,"@type":114},"They detect only a minority of all cancers and require a sensitivity-for-specificity tradeoff, which leads to a high cumulative rate of false positives. Consequently, current tests address only a subset of cancer deaths among screened populations.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is the potential role of blood-based multicancer early detection (MCED) tests?",{"text":118,"@type":114},"MCED tests based on next-generation sequencing and other technologies may broaden the range of cancer types detected in screened individuals. They also aim to reduce cancer mortality by improving detection and screening efficiency at the population level.",{"name":120,"@type":111,"acceptedAnswer":121},"What major limitation beyond test performance affects screening today?",{"text":122,"@type":114},"Screening adherence is suboptimal. The text notes declines across screening rounds and explains that missed appointments and factors such as anxiety after false positives or perceived reassurance after negative results can reduce uptake.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},379094,1790542803,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Dying To Find Out: The Cost of Time at the Dawn of the Multicancer Early Detection Era  \nEric A. Klein1, Sarina Madhavan2, Tomasz M. Beer3, Chetan Bettegowda4, Minetta C. Liu5, Anne-Renee Hartman6, and Allan Hackshaw7  \n◥  \nCancer is a significant burden worldwide that adversely impacts life expectancy, quality of life, health care costs, and workforce productivity. Although currently recommended screening tests for individual cancers reduce mortality, they detect only a minority of all cancers and sacrifice specificity for high sensitivity, resulting in a high cumulative rate of false positives. Blood-based multicancer early detection tests (MCED) based on next-generation sequencing  \n(NGS) and other technologies hold promise for broadening the number of cancer types detected in screened populations and hope for reducing cancer mortality. The promise of this new technology to improve cancer detection ratesand make screening more efficientat the population level demands the development of novel trial designs that accelerate clinical adoption. Carefully designed clinical trials are needed to address these issues.  \nThe Public Health Burden of Cancer  \nCancer is a leading cause of death globally and the most common cause of death in high-income countries. Cancer incidence is expected to rise by almost50%(to 􀀁 28million new cases annually)over the next 20 years because of population growth, aging, and increased environmental exposures due to climate change (1) . The American Cancer Society (ACS) estimates 1.9 million new cancer cases and more than 600,000 deaths in the United States in 2022 (2) . Most cancers that result in death are diagnosed at a late stage, often requiring aggressive treatments and, in an era of molecular profiling and targeted therapies, expensive drugs. In 2017, estimated U.S. cancer healthcare spending reached $161.2 billion; productivity loss from morbidity $30.3 billion; and premature mortality, $150.7 billion, totaling 1.8% of gross domestic product ([https://canceratlas.cancer.org/taking-action/economic](https://canceratlas.cancer.org/taking-action/economic)burden/). More effective methods of screening could have a significant impact in ameliorating these trends.  \nLimitations of Current Approaches to Early Detection  \nDespite several decades of research and significant financial investments, only four cancers have screening tests that have been shown to reduce mortality in a cost-effective fashion (breast, colon, lung,  \n1GRAIL, Inc, and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. 2Harvard Medical and Business School, Boston Massachusetts. 3Exact Sciences Corporation and OHSU Knight Cancer Institute, Portland, Oregon. 4Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. 5Natera. Inc and Mayo Clinic, Austin, Texas. 6Adela, Inc, Foster City, California. 7Cancer Research UK and UCL Cancer Trials Centre, University College London, London, United Kingdom.  \nCorresponding Author: Eric A. Klein, Glickman Urological and Kidney Institute, Desk Q10, 9500 Euclid Avenue, Cleveland, OH 44122 . Phone: 216-849-7415;  \nE-mail: [kleine@ccf.org](kleine@ccf.org)  \nCancer Epidemiol Biomarkers Prev 2023;32:1003–10  \ndoi: 10.1158/1055-9965 . EPI-22-1275  \nThis open access article is distributed under the Creative Commons AttributionNonCommercial-NoDerivatives 4 . 0 International (CC BY-NC-ND 4 . 0) license.  \n􀀁2023The Authors;Published by the American Association for Cancer Research  \nand cervical; [https://canceratlas.cancer.org/taking-action/economic](https://canceratlas.cancer.org/taking-action/economic)burden/; [https://uspreventiveservicestaskforce.org](https://uspreventiveservicestaskforce.org).) Their use highlights the power of screening to detect and treat precancerous lesions (cervical carcinoma in situ and colonic adenomas) and nonmetastatic cancers that are amenable to curable interventions. However, these four cancers account for only 25% to 30%","cbCaielayOuFzUyg","https://ap.wps.com/l/cbCaielayOuFzUyg","pdf",1733052,"English","# The Public Health Burden of Cancer\n## Limitations of Current Approaches to Early Detection\n## Clinical Need for New Trial Designs\n## Promise and Challenges of Blood-Based MCED Tests","[{\"question\":\"Why do current cancer screening tests have limited population impact?\",\"answer\":\"They detect only a minority of all cancers and require a sensitivity-for-specificity tradeoff, which leads to a high cumulative rate of false positives. Consequently, current tests address only a subset of cancer deaths among screened populations.\"},{\"question\":\"What is the potential role of blood-based multicancer early detection (MCED) tests?\",\"answer\":\"MCED tests based on next-generation sequencing and other technologies may broaden the range of cancer types detected in screened individuals. They also aim to reduce cancer mortality by improving detection and screening efficiency at the population level.\"},{\"question\":\"What major limitation beyond test performance affects screening today?\",\"answer\":\"Screening adherence is suboptimal. The text notes declines across screening rounds and explains that missed appointments and factors such as anxiety after false positives or perceived reassurance after negative results can reduce uptake.\"}]","Dying To Find Out: The Cost of Time at the Dawn of the Multicancer Early Detection Era | PDF",1790234083]