Evidence Insufficient to Determine Benefits of Multicancer Screening Tests
THURSDAY, Sept. 18, 2025 -- No controlled studies report benefits of screening with multicancer detection (MCD) tests, according to a study published online Sept. 16 in the Annals of Internal Medicine.
Leila C. Kahwati, M.D., M.P.H., from RTI-University of North Carolina Evidence-based Practice Center in Research Triangle Park, and colleagues conducted a systematic review of controlled studies on blood-based MCD tests to examine the benefits, accuracy, and harms of screening with these tests in asymptomatic adults.
The researchers found that none of the studies assessed the benefits of screening. Twenty studies, with 109,177 people, reported accuracy for 19 MCD tests. Seven studies reported the accuracy of future cancer detection in asymptomatic persons followed for one year (prediagnostic studies), while the remainder estimated accuracy from high risk-of-bias case-control studies involving clinically confirmed cancer cases and healthy controls (diagnostic studies). Sensitivity varied from 0.095 to 0.998 across tests; specificity varied from 0.657 to 1.0; and the area under the receiver operating characteristic curve (AUC) varied from 0.52 to 1.0. Compared with prediagnostic performance studies, the sensitivity and AUC were higher in diagnostic performance studies. There were no other discernable patterns in accuracy. Harms were reported by one cohort study.
"No controlled studies are completed that report benefits of screening with MCD tests. The evidence was judged insufficient to evaluate harms and accuracy. Accuracy varies by test and study design," the authors write.
One author disclosed ties to the pharmaceutical industry.
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