Patient, community, and clinician beliefs about multi-cancer detection tests: implications for the evidence needed to recommend routine use

BACKGROUND: Multi-cancer detection tests (MCDs) have the potential to reduce cancer-related deaths by identifying cancers early when they can be more effectively treated. While initial studies show promise in detecting multiple cancer types, there is a lack of large-scale, prospective trials evaluating their clinical utility and real-world impact. METHODS: We conducted 23 focus groups with 158 participants to identify and describe key stakeholders' perspectives on the benefits and risks of MCD tests. Participants included clinicians (n = 58), patients (n = 17), and community members recruited from partner community advisory boards (n = 83). RESULTS: Participants recognized the benefits of early cancer detection and the convenience of a single blood test in reducing barriers to cancer screening. However, they shared concerns about insufficient clinical validation for MCD tests and the potential physical and psychological harm that false positives, overdiagnosis, and overtreatment may cause. They also expressed concerns about the financial costs and time burden associated with follow-up care, as well as potential inequities in access and outcomes in underserved communities. CONCLUSIONS: Patients and clinicians want better evidence before routine use of MCD testing for cancer screening. Future research should prioritize rigorous randomized controlled trials that evaluate cancer-mortality, quality of life, diagnostic workup, and potential harms.