Is a ‘cancer check-up’ near for high-risk adults? clinician attitudes and perspectives on multicancer early detection tests.

Abstract

e23008 Background: Current screening guidelines for many cancers are limited and multiple cancer-screening tests are not yet FDA approved. The development and potential use of a pan-tumor or multi-cancer early detection (MCED) test has been met with both enthusiasm and hesitation, despite its potential for early detection and a resultant reduction in cancer-related mortality and morbidity. The lack of knowledge of clinician perceptions of MCED test and the need to educate a multidisciplinary team prompted the design of educational initiatives in 2020 and 2021. Methods: In September 2020 and July 2021; two 1-hour CME activities were launched live-online on OMedLive.com; the 2021 activity remains on-demand until July 2022. The 2020 activity introduced the value proposition and trial designs of MCED tests and reviewed the current cancer screening guidelines. Challenges revealed from the 2020 activity informed the multidisciplinary approach of the 2021 activity presenting epidemiology, oncology, and primary care perspectives. In both activities, participants were assessed at 3 time points (pre-, immediate post-, and 2 mos. post-activity) and McNemar tests compared paired responses with Cohen’s d for effect size. Behavioral impact, perception, and practice pattern questions were also assessed immediately post-activity and year-to-year data analyzed. Results: As of 02/13/22, 1,015 clinicians have participated in the 2020 activity and 3,372 in the 2021 activity. Across the eight CME test questions, seven exhibited improvements in knowledge/competence related to screening modalities, trial data, value of MCED tests, and clinical workflow following results. In the analysis of perception and practice pattern questions, 50% of clinicians were likely to integrate MCED tests into their practice; however, expectation of high costs and access/availability to utilize MCED tests at their practice were the top barriers identified. A lack of consensus in identifying adults at higher risk of cancer was observed in 2020 with improvements seen in 2021. At 2-mos. follow-up for the 2020 and 2021 activity, respectively, clinicians reported practice behavior changes as 89% and 73% related to clinical practice, while 89% and 72% reported improved patient experience/outcomes. Qualitative data including clinician write-in examples of specific practice behavior changes will be analyzed. Conclusions: These data provide real-world insight into clinician perspectives on MCED tests and the clinical, patient-care, and workflow challenges that should be considered before incorporating future approaches on multi-cancer screening. As the primary care setting is most suited for the introduction of novel cancer-screening tools, PCPs and oncologists will require continued education to apply practical strategies for point-of-care decision-making and transitions of care protocols.