{"doi":"10.7326/m23-0067","title":"Multi-cancer Early Detection Tests, Primary Care, and Shared Decision Making","abstract":"What to do you think, doc, should I get one of these tests?\"I am seeing Mr. Y, a 55-yearold business school teacher with a penchant for new technologies.He is in good health, has not smoked for 20 years, and takes 1 medication for benign prostatic hypertrophy.Mr. Y shows a direct-to-consumer advertisement for a multi-cancer early detection, or MCED, test.\"What if you found cancer early enough to make a difference?Seventy-one percent of cancer deaths are caused by cancers not commonly screened for\" (1).The logic is compelling: Despite recommended screening, Mr. Y might benefit from additional testing for multiple cancers.I pause.This situation, with more than one reasonable choice and considerable uncertainty due to poor-quality evidence (2), is perhaps suited for shared decision making with the 3-talk model (3).I begin with the \"team talk\": \"This is new to me actually, so let's work together and try to decide what makes sense for you.\"The MCED tests represent a significant shift in cancer screening and may arrive before most clinicians know about them.Also called \"liquid biopsies,\" they search for very small quantities of cell-free DNA and protein biomarkers released from early-stage cancer cells into the blood, before symptoms or signs occur.Paired with machine learning, these assays use proprietary algorithms to suggest a likely tumor origin for the DNA and proteins.Some MCED tests are already commercially available as laboratory-developed tests through the Clinical Laboratory Improvement Act (CLIA), but none are currently approved by the U.S. Food and Drug Administration (FDA).","journal":"Annals of Internal Medicine","year":2023,"id":358367,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9562,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":278538,"name":"Glyn Elwyn","orcid":"0000-0002-0917-6286","position":1,"is_corresponding":false},{"id":278531,"name":"Robert J. Volk","orcid":"0000-0001-8811-5854","position":2,"is_corresponding":false},{"id":539635,"name":"Kevin Selby","orcid":"0000-0002-9096-0720","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":null,"created_at":"2026-07-19T01:13:43.629667Z","pmid":"37037037","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}