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Multi-Cancer Early Detection Tests

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Multi-Cancer Early Detection Tests

Findings from a systematic literature review

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What is a Multi-Cancer Early Detection (MCED) test?

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What is a Multi-Cancer Early Detection (MCED) test?

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Blood sample taken

Analysed using machine learning

Likely "site" returned (e.g., lung, stomach)

Follow-up tests to confirm diagnosis

  • It is a blood test that uses genetic sequencing to detect potential "signals" of cancer
  • These "signals" are sent by cancer cells and can be picked up by a machine-learning based algorithm to identify patterns that might indicate cancer
  • Some tests can predict the likely "site" that the "signal" is coming from (such as breast or lung)
  • Follow-up tests are then carried out to confirm this
  • Many different technologies are currently being evaluated, such as the Galleri® test which is being evaluated in the NHS

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What is a Multi-Cancer Early Detection (MCED) test?

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Test accuracy is not directly comparable because different tests claim to detect different cancersSome cancers may take several years to develop, so a follow-up test may not detect cancer immediately afterwards

Screening healthy people may create anxiety and lead to unnecessary (and often invasive) testsWrong "site" information may delay diagnosis and treatmentSome cancers may be identified at an early stage but never advance enough to require treatmentCancers may be diagnosed where there are no effective treatments

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What is a Multi-Cancer Early Detection (MCED) test?

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We conducted a systematic literature review (see main steps below), where we reviewed all studies published in this area (between 2010-2023) and summarised them in a report.

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Protocol development

We developed a research plan with key stakeholders, to make sure we focus on the right question and decide on the methods that should be used.

Protocol development

We developed a research plan with key stakeholders, to make sure we focus on the right question and decide on the methods that should be used.

Protocol development

We developed a research plan with key stakeholders, to make sure we focus on the right question and decide on the methods that should be used.

Protocol development

We developed a research plan with key stakeholders, to make sure we focus on the right question and decide on the methods that should be used.

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What is a Multi-Cancer Early Detection (MCED) test?

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At the time of the review, we found 6 tests which were available, and 7 tests which were unclear if they had reached the final stages of development. These are shown below, with manufacturer information in brackets, if these were provided.

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OncoSeek (SeekIn)

Galleri (GRAIL)

CDA (AnPac Bio)

Carcimun test (Carcimun Biotech)

Aristotle (StageZero Life Sciences)

CancerSEEK (Exact Sciences)

SeekInCare (SeekIn)

AICS (Ajinomoto Group)

CancerenD24 (Unknown)

SpecGastro test (Unknown)

Trucheck (Datar Cancer Genetics)

OverC (Burning Rock Biotech)

SPOT-MAS (Gene Solutions)

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What is a Multi-Cancer Early Detection (MCED) test?

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We also looked at how well the test performed depending on the stage of the cancer. Click on the numbers to see what each part of the graph means.

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What is a Multi-Cancer Early Detection (MCED) test?

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We also looked at how well the test performed depending on the stage of the cancer. Click on the numbers to see what each part of the graph means.

We looked at how the test performed depending on whether screening programmes for certain cancers were available through the NHS

Screening programmes

Participant demographic

We looked at the accuracy of the test for different ethnic groups and if it differed for male and female participants

We also looked at the impact of these tests on mortality, potential harms, and acceptability and satisfaction among participants

Real-world impact

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What is a Multi-Cancer Early Detection (MCED) test?

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Updating the review

The team is working on updating this review to look for additional evidence published since 2023. We will also provide an update on trials that were ongoing at the time of the previous review, as well as technologies which were still in the early stages of development, but may have progressed since then.

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An update on previously ongoing studies

We found a few ongoing studies in our previous review that we are hoping to pick up in the updated review.

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An update on upcoming technologies

We found some MCED tests which were still in the early stages of development in the previous review, and will look for an update on these.

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MCED tests available

These MCED tests were judged to be available at the time of the review, according to the manufacturer's websites

Participant demographic

  • Many studies did not report on the ethnicity of the participants, or included mostly people with Caucasian ethnicity
  • When reported, the test appeared to be more accurate for people aged 50 years or over, compared to younger participants (<50 years)
  • No differences were found between male and female participants, but this was based on very limited information and an earlier version of the test that has since been updated

OncoSeek (SeekIn)

What did they find?
  • The accuracy of the test across the two studies were 47.4% to 51.7%
  • Accuracy for specific cancer ranged from 37.1% to 77.6%
Included studies

We found two completed study. Both included people already known to have cancer (to see if the test could accurately detect it as well).

Quality of studies

Both studies had a high risk of bias due to how people were selected to take part (as they were already known to have cancer)

Aristotle (StageZero Life Sciences)
What did they find?

The test showed high accuracy for cervical, nasopharynx, and stomach cancer (100%), and loweset for colon cancer (55.6%)

Included studies

We found one completed study, which included people already known to have cancer (to see if the test could accurately detect it as well).

Quality of studies

This study had a high risk of bias due to how people were selected to take part (as they were already known to have cancer)

Screening availability

  • Most tests were more accurate at detecting cancers that do not have screening programmes through the NHS, compared to cancers with available screening programmes (such as breast, cervical, and colorectal)
  • The Galleri test was fairly accurate at detecting lung cancer, although lung cancer screening is only available for people at high risk of developing lung cancer
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Galleri (GRAIL)

What did they find?
Quality of studies
Included studies
  • We found 4 completed studies
  • They all had different age criteria (e.g., 18+, 20+, 50+)
  • Some included people at high-risk of cancer or were referred with possible symptoms
  • One included people who already had cancer (to see if the test could also detect it)
  • The accuracy of the test varied between studies depending on the type of participants and their study design
  • The likelihood of the test identifying cancer correctly ranged from 20.8% to 66.3%
  • The test was quite good at ruling out cancer

All of these studies had a high risk of bias, such as issues with how people were selected to take part in the study, and how they determined whether someone truly had cancer

Carcimun test (Carcimun Biotech)
What did they find?

The test showed high accuracy (88.8%) and was quite good at ruling out cancer

Included studies

We found one completed study, which included people already known to have cancer (to see if the test could accurately detect it as well).

Quality of studies

This study had a high risk of bias due to how people were selected to take part (as they were already known to have cancer)

SPOT-MAS (Gene Solutions)

What did they find?
  • The accuracy of the test ranged from 72.4% to 100%
  • The test was quite good at ruling out cancer
Included studies

We found 2 completed studies. One was in people aged 40+ and one was in people already known to have cancer (to see if the test could also detect it)

Quality of studies

All of these studies had a high risk of bias, such as issues with how people were selected to take part in the study, and how they determined whether someone truly had cancer

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Title 1

What is a systematic review?A systematic review is a type of evidence synthesis, which aims to identify, evaluate, and summarise findings from all relevant studies using rigorous and reproducible methods.

MCED tests availability unknown

These MCED tests were at an unclear stage of development and did not seem to be available for use at the time of the review, but are likely to have reached the final stages of development

OverC (Burning Rock Biotech)
What did they find?
  • The accuracy of the test varied between the studies (69.1% and 74.8%)
  • Accuracy was higher for stage 4 compared to stage 1 cancers
Included studies

We found two completed study. Both included people already known to have cancer (to see if the test could accurately detect it as well).

Quality of studies

Both studies had a high risk of bias due to how people were selected to take part (as they were already known to have cancer)

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Hover over the "?" button to find out more!

Trucheck (Datar Cancer Genetics)

What did they find?
  • The test was 90% accurate in detecting cancer in people not known to have cancer, and 93% accurate at correctly detecting cancer in people known to have cancer.
  • The test was quite good at ruling out cancer
Included studies

We found 2 completed studies. One was in adults without any cancer symptoms, and one was in people already known to have cancer (to see if the test could also detect it)

Quality of studies

All of these studies had a high risk of bias, such as issues with how people were selected to take part in the study, and how they determined whether someone truly had cancer

SpecGastro test (Unknown)
What did they find?

The accuracy of this test was 76.6%, and was better at detecting colorectal cancer (87.8%) compared to gastric cancer (69.9%)

Included studies

We found one completed study, which included people already known to have cancer (to see if the test could accurately detect it as well).

Quality of studies

This study had a high risk of bias due to how people were selected to take part (as they were already known to have cancer)

Ongoing studies

These trials were ongoing at the time of the review in 2023 and may have completed since then. We will look for an update on these studies, if evidence is available.

CDA (AnPac Bio)

What did they find?
  • The accuracy of the test was 40% (out of 10 people with cancer, the test detected 4)
  • The test was quite good at ruling out cancer
Included studies

We found one study which included adults aged 40+ with no history of cancer

Quality of studies

This study did not report enough information on how people were selected or how they determined whether someone truly had cancer, therefore the quality of this study is unclear

AICS (Ajinomoto Group)

What did they find?
  • This test is designed to detect individual cancer separately so no overall accuracy was calculated
  • The accuracy was highest for oesophagus cancer (51.7%) and lowest for ovary cancer (16.7%)
Included studies

We found 3 completed studies. Two included adults (no specified age) and one included healthy women (no specified age)

Quality of studies

Both studies with adults had a high risk of bias due to issues with how people were selected to take part in the study, and how they determined whether someone truly had cancer. The study with women did not report enough information to decide the quality.

CancerSEEK (Exact Sciences)

What did they find?
Quality of studies
Included studies
  • In people known to have cancer, the test correctly identified it 62.3% of the time, but in women not known to have cancer, it was only accurate 27.1% of the time
  • The test was quite good at ruling out cancer

We found 2 completed studies. One was a women-only study (aged 65-75), and one was in people already known to have cancer (to see if the test could also detect it)

All of these studies had a high risk of bias, such as issues with how people were selected to take part in the study, and how they determined whether someone truly had cancer

SeekInCare (SeekIn)
What did they find?
  • Test accuracy varied from 68% to 92.3%
  • Accuracy was better for leukaemia (90.9%) compared to breast cancer (45.1%)
  • Accuracy was higher for stage 4 cancers than stage 1
Included studies

We found two completed study. Both included people already known to have cancer (to see if the test could accurately detect it as well), but also tested it in the general population

Quality of studies

Both studies had a high risk of bias due to how people were selected to take part, and how they determined whether someone truly had cancer

Real-world impact

  • Mortality (impact on the number of deaths due to cancer)
  • Potential harms and impact on healthcare systems
  • Acceptability and satisfaction
Upcoming technologies

Here are some upcoming MCED tests that were still in the early stages of development (at the time of the review), but may have progressed since then. Test names are shown below with manufacturer information (if known) shown in brackets.

CancerenD24 (Unknown)
What did they find?

Accuracy of the test varied for different cancers and between different studies, typically between 38% (bladder cancer) to 100% (stomach cancer)

Included studies

We found five completed study, which all included people already known to have cancer (to see if the test could accurately detect it as well)

Quality of studies

All of these studies had a high risk of bias due to how people were selected to take part (as they were already known to have cancer)