基层医疗中对多癌检测（MCTs）的偏好：英格兰全科医生和普通公众的离散选择实验

Preferences for multi-cancer tests (MCTs) in primary care: discrete choice experiments of general practitioners and the general public in England.

作者信息

Buckell John, Madyiwa Nomalanga, Hayward Gail, Middleton Mark R, Hobbs F D Richard, Buchanan James, Tsiachristas Apostolos, Nicholson Brian D

机构信息

Health Economics Research Centre, Oxford Population Health, University of Oxford, Oxford, England.

Buckinghamshire Healthcare NHS Trust, Ayelsbury, England.

出版信息

Br J Cancer. 2025 Jun 2. doi: 10.1038/s41416-025-03063-9.

DOI:10.1038/s41416-025-03063-9

PMID:40456923

Abstract

BACKGROUND

Multi-Cancer tests (MCTs) hold potential to detect cancer across multiple sites and some predict the origin of the cancer signal. Understanding stakeholder preferences for MCTs could help to develop appealing MCTs, encouraging their adoption.

METHODS

Discrete Choice Experiments (DCEs) conducted online in England.

RESULTS

GPs (n = 251) and the general public (n = 1005) preferred MCTs that maximised negative predictive value, positive predictive value, and could test for a larger number of cancer sites. A reduction of the NPV of 4.0% was balanced by a 12.5% increase in the PPV for people and a 32.5% increase in PPV for GPs. People from ethnic minority backgrounds placed less importance on whether MCTs can detect multiple cancers. People with more knowledge and experience of cancer placed substantial importance on the MCT being able to detect cancer at an early stage. Both GPs and members of the public preferred the MCT reported in the SYMPLIFY study to FIT, PSA, and CA125, and preferred the SYMPLIFY MCT to 91% (GPs) and 95% (people) of 2048 simulated MCTs.

CONCLUSIONS

These findings provide a basis for designing clinical implementation strategies for MCTs, according to their performance characteristics.

摘要

背景

多癌检测（MCTs）有潜力检测多个部位的癌症，并且一些检测能够预测癌症信号的起源。了解利益相关者对MCTs的偏好有助于开发有吸引力的MCTs，促进其应用。

方法

在英国进行了在线离散选择实验（DCEs）。

结果

全科医生（n = 251）和普通公众（n = 1005）更喜欢最大化阴性预测值、阳性预测值且能检测更多癌症部位的MCTs。对于公众而言，阴性预测值降低4.0%可由阳性预测值增加12.5%来平衡，对于全科医生而言，阴性预测值降低4.0%可由阳性预测值增加32.5%来平衡。少数族裔背景的人对MCTs是否能检测多种癌症的重视程度较低。对癌症有更多知识和经验的人非常重视MCTs能够早期检测癌症。全科医生和公众都更喜欢SYMPLIFY研究中报告的MCT，而不是粪便免疫化学检测（FIT）、前列腺特异性抗原（PSA）和糖类抗原125（CA125），并且相对于2048个模拟MCTs中的91%（全科医生）和95%（公众），他们更喜欢SYMPLIFY MCT。