Abstract:
The new generation of cancer early detection tests holds remarkable promise for revolutionizing and changing the paradigm of cancer early detection. Dozens of cancer early detection tests are being developed and evaluated. Some are already commercialized and available for use, most as a complement to and not in place of existing recommended cancer screening tests. This review evaluates existing single- and multi-cancer early detection tests (MCEDs), discussing their performance characteristics including sensitivity, specificity, positive and negative predictive values, and accuracy. It also critically looks at the potential harms that could result from these tests, including false positive and negative results, the risk of overdiagnosis and overtreatment, psychological and economic harms, and the risk of widening cancer inequities. We also review the large-scale, population-based studies that are being launched in the United States and United Kingdom to determine the impact of MCEDs on clinically relevant outcomes and implications for current practice.
摘要:
新一代的癌症早期检测测试对于彻底改变和改变癌症早期检测的范式具有非凡的前景。正在开发和评估数十种癌症早期检测测试。有些已经商业化,可以使用,大多数作为现有推荐的癌症筛查测试的补充,而不是取代。这篇综述评估了现有的单发和多发癌症早期检测测试(MCEDs),讨论它们的性能特征,包括灵敏度,特异性,阳性和阴性预测值,和准确性。它还严格地研究了这些测试可能导致的潜在危害,包括假阳性和阴性结果,过度诊断和过度治疗的风险,心理和经济伤害,以及扩大癌症不平等的风险。我们还回顾了大规模,美国和英国正在开展的基于人群的研究,以确定MCED对临床相关结局的影响以及对当前实践的影响。医学年度回顾的预期最终在线出版日期,第75卷是2024年1月。请参阅http://www。annualreviews.org/page/journal/pubdates的订正估计数。