How do you test for cancer
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Methods for Testing Cancer: A Comprehensive Overview
Blood-Based Cancer Detection Tests
Multi-Analyte Blood Tests: CancerSEEK
CancerSEEK is a noninvasive blood test designed to detect eight common types of cancer by assessing circulating protein biomarkers and tumor-specific mutations in cell-free DNA. In a study involving 1000 cancer patients and 850 healthy controls, CancerSEEK demonstrated a sensitivity range of 69% to 98% and a specificity of 99%. This test is particularly effective for cancers such as ovary, liver, stomach, pancreas, and esophagus, for which no standard screening tests exist.
Feasibility of Blood Testing Combined with PET-CT
A study evaluated the feasibility of integrating a multicancer blood test with PET-CT imaging in routine clinical care. The blood test detected 26 cancers among 10,000 women with no prior cancer history, and PET-CT imaging confirmed and localized these cancers. This combination led to surgical removal of nine cancers, demonstrating the potential for early detection and intervention.
Harbinger Health's Genomic and Epigenomic Blood Test
Harbinger Health has developed a blood-based test that uses genomic and epigenomic markers combined with artificial intelligence to detect early-stage cancers. In a study of 1,046 subjects, the test showed an overall sensitivity of 82% and a specificity of 95%. The test was particularly effective for detecting breast, prostate, lung, and colorectal cancers.
Serum-Based Diagnostic Test for Colorectal Cancer
A novel serum-based test for colorectal cancer (CRC) measures biomarkers such as circulating tumor cells (CTCs), microRNAs, ctDNA, and methylated DNA markers. This test demonstrated high sensitivity (78.8% to 96.72%) and accuracy (83.76% to 94.83%), making it a promising tool for early CRC detection.
Cell-Free DNA (cfDNA) Based Multi-Cancer Early Detection (MCED) Tests
Predictive Performance of cfDNA-Based MCED Tests
MCED tests that detect cell-free tumor DNA (cfDNA) in the blood have shown high specificity (95% or higher) and a median sensitivity of 73% across various cancer types. These tests are particularly useful for detecting cancers at different stages, with sensitivity generally increasing with the stage of cancer.
Accuracy of Tumor Origin Detection
The ability to determine the tumor's origin is crucial for guiding treatment. A systematic review found that cfDNA-based MCED tests accurately identified the primary site of cancers in 79% of cases. The accuracy varied across cancer types, with colorectal cancers showing the highest accuracy.
Specific Cancer Detection Tests
Breast Cancer Detection via Circulating Tumor Cells
A blood-based test for breast cancer detection identifies circulating tumor cells (CTCs) using multiplexed fluorescence immunocytochemistry. This test demonstrated high specificity (93.1%) and sensitivity (94.64%) in differentiating breast cancer cases from benign conditions, making it a reliable tool for early breast cancer screening.
SPOT-MAS for Multi-Cancer Detection in Vietnam
The SPOT-MAS assay, designed to detect liver, breast, colorectal, gastric, and lung cancers, showed a positive predictive value of 60% and an accuracy of 83.3% in detecting tumor location in a study involving 2,795 participants. This test is particularly valuable in low- and middle-income countries where comprehensive cancer screening programs are lacking.
Conclusion
Advancements in blood-based cancer detection tests, including multi-analyte tests like CancerSEEK, genomic and epigenomic assays, and cfDNA-based MCED tests, offer promising tools for early cancer detection. These tests demonstrate high sensitivity and specificity, making them valuable for screening various cancer types and guiding early intervention. As research continues, these methods hold the potential to significantly improve cancer outcomes and reduce mortality.
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