Abstract

Early cancer detection and intervention can significantly improve patient outcomes and reduce mortality rates. Evidence shows that emerging blood-based multi-cancer early detection (MCED) tests can detect a variety of cancer types across stages and provide a predicted cancer signal origin with high specificity. However, little is known about patients’ preferences for MCED tests. This study aimed to quantify preferences for attributes of blood-based MCED tests among the US general population aged 50-80 years. A DCE consisting of five attributes (true positives, false negatives, false positives, likelihood of the cancer type unknown [e.g., inaccurate cancer signal origin], and number of cancers tested for) was administered online to US general population members to elicit preferences to quantitatively pilot test the DCE. Data were analyzed using an error-component multinomial logit model and relative attribute importance (RAI) was obtained. Participants (N=303) were 62.0% male (n=188), mean age 68.2 years (SD=6.4). RAI indicated that the rank order of attribute importance was false negatives (35.7%), true positives (27.6%), false positives (17.3%), number of cancers tested for (16.8%), and cancer type unknown (2.7%). Attributes related to improved test accuracy were important and participants strongly preferred screenings that tested for more cancer types (all p < 0.05). Preferences were non-significant for the likelihood of cancer type unknown attribute levels. Overall, 71.9% of participants reported that they would prefer to receive the MCED test in addition to their currently recommended cancer screenings. Participants’ preferences were strongly driven by the desire for a screening test with fewer false negatives and more true positives, with these 2 attributes comprising 63.3% of the RAI. False positive results and number of types of cancer tested for also impacted preferences but were of lower importance. The majority of participants preferred adding a MCED test to supplement current cancer screenings.

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