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Performance of a targeted methylation-based multi-cancer early detection test by race and ethnicity

Tang, WHW; Yimer, H; Tummala, M; Shao, S; Chung, G; Clement, J; Chu, BC; ... Roberts, LR; + view all (2023) Performance of a targeted methylation-based multi-cancer early detection test by race and ethnicity. Preventive Medicine , 167 , Article 107384. 10.1016/j.ypmed.2022.107384. Green open access

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Abstract

Disparities in cancer screening and outcomes based on factors such as sex, socioeconomic status, and race and ethnicity in the United States are well documented. A blood-based multi-cancer early detection (MCED) test that detects a shared cancer signal across multiple cancer types and also predicts the cancer signal origin was developed and validated in the Circulating Cell-free Genome Atlas study (CCGA; NCT02889978). CCGA is a prospective, multicenter, case-control, observational study with longitudinal follow-up (overall N = 15,254). In this pre-specified, exploratory, descriptive analysis, test performance was evaluated among racial and ethnic groups. Overall, 4077 participants comprised the independent validation set with confirmed cancer status (cancer: n = 2823; non-cancer: n = 1254). Participants were stratified into the following racial/ethnic groups: Black (non-Hispanic), Hispanic (all races), Other (non-Hispanic), Other/unknown and White (non-Hispanic). Cancer and non-cancer participants were predominantly White (n = 2316, 82.0% and n = 996, 79.4%, respectively). Across groups, specificity for cancer signal detection ranged from 98.1% [n = 103; 95% CI: 93.2–99.5%] to 100% [n = 85; 95% CI: 95.7–100.0%]. The sensitivity for cancer signal detection across groups ranged from 43.9% [n = 57; 95% CI: 31.8–56.7%] to 63.0% [n = 192; 95% CI: 56.0–69.5%] and generally increased with clinical stage. The MCED test had consistently high specificity and similar sensitivity across racial and ethnic groups, though results are limited by sample size for some groups. Results support the broad applicability of this MCED test and clinical implementation on a population scale as a complement to standard screening.

Type: Article
Title: Performance of a targeted methylation-based multi-cancer early detection test by race and ethnicity
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ypmed.2022.107384
Publisher version: https://doi.org/10.1016/j.ypmed.2022.107384
Language: English
Additional information: © 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Keywords: Cancer disparities, Cancer screening, Clinical validation, MCED test, Multi-cancer early detection, Performance
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/10163648
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