General population interest in multi-cancer early detection (MCED) testing: Insights from a seven-country survey on drivers of engagement and cross-national differences.

Abstract

e22507 Background: Most cancers lack organized screening programs, and limited access to primary care further hampers early diagnosis. MCED testing may complement available screening programs and expand the reach of screening to more cancer types. This study assessed public perceptions, motivators, and behavioral intent regarding MCED testing across multiple countries. Methods: An online survey was fielded in the US, Canada, UK, France, Germany, Spain, and Italy (N=1100; ages 21–85) between July 21 and August 1, 2025. After being shown a definition, respondents rated their likelihood to request a MCED test and reported demographic, socioeconomic, and health-related factors. Analyses explored cross-country variation and characteristics associated with three MCED engagement segments: Reluctant (1–4/7), Interested (5–6/7), and Eager (7/7). Results: Overall, 55% (95% CI 52-58%) of respondents reported high likelihood (6–7/7) of requesting an MCED test, increasing to 71% (95% CI 68-74%) when framed as physician recommend. Country-level differences at 95% CI were observed in self-reported quality of life (US, CA: 5.4/7, SP:5.2/7 > DE, IT:4.8/7), health-literacy (Need help reading medical information: FR: 2.2/5, IT:2.5/5 < all others 1.5-1.8/5), ease of accessing care (US: 5.6/7, SP:5.4/7 > all others 3.8-4.6/7) and cancer-related worry (SP: 5.7/7, IT:5.5/7 > all others 3.9-4.3/7). Despite these variations, mean likelihood to request testing was consistent across countries (5.2–5.6/7). Analysis revealed clear distinctions among Reluctant (1–4/7), Interested (5–6/7), and Eager (7/7) groups in demographic, experiential, and healthcare-access factors influencing intent. Conclusions: Public interest in MCED testing is substantial in all countries, with physician recommendation a key additional adoption driver. Engagement varies by demographic and experiential factors, highlighting the need for targeted communication strategies to ensure equitable awareness and uptake, particularly among populations less likely to participate in cancer screening. Factors related to likelihood to request MCED test via a doctor. A - Reluctant (n=295) B -Interested (n=418) C -Eager(n=387) Male vs. Female 49% vs. 50% 55% vs. 45% 52% vs. 48% Relationship: married 48% bc 58% a 59% a Employment: full-time / retired 32% BC / 40% B 48% A / 28% A 43% A / 33% Annual household income 5 th bracket 9% bc 15% a 16% a Help reading medical information: Occasionally / Never 15% c / 65% c 15% C / 58% 22% aB / 56% a Accessing healthcare when I need to is easy 4.9/7 C 4.9/7 C 5.3/7 AB Worried about being diagnosed with cancer 3.5/7 BC 4.5/7 A c 4.8/7 Ab Knows someone close to them diagnosed with cancer in the last 5 years 33% bC 41% a 43% A Has not been screened for any type of cancer in the past 34% BC 22% A 17% A Column comparison symbols: a, b, c (p <= 0.05), A, B, C (p <= 0.01).