Deputy director and professor of medicine, Oregon Health & Science University Knight Cancer Institute, Portland, OR; Chief Medical Officer of the OHSU Knight Cancer Institute's Cancer Early Detection Advance Research Center (CEDAR). Email:
Am J Manag Care. 2020 Nov;26(14 Suppl):S292-S299. doi: 10.37765/ajmc.2020.88533.
Cancer affects millions of Americans, and the number of cases is steadily rising. The increase in diagnosis of cancer cases comes with an associated increase in personal and economic burden. Earlier detection can improve treatment outcomes and may reduce the burden of cancer. Screening for cervical cancer is a good example of the potential of effective screening methods to dramatically reduce the morbidity and mortality associated with cancer. However, many current screening methods have high false-positive rates, increasing the concern for overdiagnosis and overtreatment. Blood-based tests capable of detecting multiple types of cancer represent an emerging approach to early cancer detection. Although there are several single-cancer detection tests in development, multicancer screening tests have greater potential to allow for widespread screening in the general population. Three multicancer screening tests are being validated in ongoing clinical trials, including the CancerSEEK assay, the Galleri test, and the PanSeer assay, all of which show high specificity in preliminary findings. Further validation is required before multicancer detection tests are incorporated into general population cancer screening.
癌症影响着数以百万计的美国人，且病例数量还在稳步上升。癌症诊断病例的增加伴随着个人和经济负担的相应增加。早期发现可以改善治疗效果，并可能降低癌症的负担。宫颈癌筛查就是一个很好的例子，说明有效的筛查方法具有显著降低与癌症相关的发病率和死亡率的潜力。然而，许多当前的筛查方法存在高假阳性率，这增加了过度诊断和过度治疗的担忧。能够检测多种类型癌症的基于血液的检测代表了早期癌症检测的一种新兴方法。虽然正在开发几种单癌检测测试，但多癌筛查测试具有更大的潜力，可以在普通人群中进行广泛筛查。正在进行的临床试验中正在验证三种多癌筛查测试，包括 CancerSEEK 检测、Galleri 检测和 PanSeer 检测，所有这些测试在初步发现中都显示出很高的特异性。在将多癌检测测试纳入普通人群癌症筛查之前，还需要进一步验证。
