Multicancer Early Detection Test Usage at Different National Comprehensive Cancer Network and National Cancer Institute-Designated Cancer Centers.
Maria Powers, Smit Patel, Samuel Kitchens, Mrithika Pavan, Amarinthia E Curtis
Abstract
Open AccessBackground Multicancer early detection (MCED) tests assess for DNA or protein fragments in the blood that could detect cancer earlier than other current methods. This could improve mortality and morbidity rates in cancer patients. There have been many methods used to create a useful test, but there is only one commercially available MCED test currently, which uses whole-genome methylation. There are many limitations to MCED tests, including, but not limited to, a lack of reliability due to the variability of tumors, false positives, false negatives, financial barriers, and more. This study researched MCED tests at different National Comprehensive Cancer Network (NCCN) and National Cancer Institutes (NCI)-designated cancer centers. This study aimed to assess the level of use of MCED tests at various NCCN and NCI-designated cancer centers. Considering the novelty and limited commercially available products, it was postulated that MCED tests would not be used at NCCN and NCI cancer centers. Methodology The public-facing website of every NCCN and NCI-designated cancer center institution was queried regarding MCED test information and clinical use. The descriptions for each NCI-designated cancer center were screened for the following keywords: MCED, multi-cancer early detection, Galleri, cell-free DNA, and multi-cancer detection. After accessing each website, the same keywords were searched for on each website using the search engines found directly on their website. Specific information on the mention of benefits, the mention of cautions, the mention of types of tests, and the mention of dedicated MCED clinics was collected. Results This study found that 15 out of the 74 NCI-designated cancer centers, or the 15 positive centers, mentioned MCED tests on their public website. Overall, 12 of these positive centers are NCCN centers. Of the 15 positive centers, two centers (Dana-Farber Cancer Center, in Boston, Massachusetts, and the Knight Cancer Institute, in Portland, Oregon) have MCED clinics (one of which, Dana-Farber, is an NCCN center). Two centers (Rogel Cancer Center in Ann Arbor, Michigan, and Huntsman Cancer Institute in Salt Lake City, Utah) caution patients on MCED test use due to the risks of MCED tests (both of which are NCCN centers). Overall, MCED tests are being researched in multiple places, but few centers are using MCED tests in clinics. Moreover, most of the 74 NCI-designated cancer centers do not have any public information mentioning the MCED tests. Conclusions This study is limited by what is available on public-facing websites, which may hamper the research and clinical implementation at each center. Nonetheless, this suggests that despite research interest, clinical adoption of MCED tests is still limited.