A Socio-Ecological Analysis of Factors Influencing Perceived Value of Multi-Cancer Early Detection Testing in the United States

Background: Multi-Cancer Early Detection (MCED) tests represent a novel advancement in cancer diagnostics, detecting multiple cancer types through a single blood draw. Understanding factors shaping individual receptivity is crucial for equitable implementation. Methods: Using a socio-ecological framework, we analyzed nationally representative data from the 2024 Health Information National Trends Survey to examine predictors of perceived MCED value across proximal, intermediate and distal levels. Survey-weighted logistic regressions estimated adjusted odds ratios (aOR) with 95% confidence intervals. Results:A total of 7,208 adults were included; 73.6% rated MCED testing as moderately/highly valuable. Adults aged 40-44 years (aOR = 2.23, 95% CI = 1.33-3.75, p = 0.003) and ≥ 45 years (aOR = 2.56, 95% CI = 1.80-3.65) had over twice the odds of valuing MCED testing versus those aged 18-34 years. Hispanic (aOR = 2.00, 95% CI = 1.34-3.00) and Non-Hispanic Black respondents (aOR = 1.86, 95% CI = 1.22-2.84) reported significantly greater receptivity than Non-Hispanic Whites. Greater trust in the health care system (aOR = 1.55, 95% CI = 1.16-2.06), reported health care discrimination (aOR = 1.63, 95% CI = 1.04-2.54) and longer wait times for test results (aOR = 1.44, 95% CI = 1.05-1.98) were associated with higher perceived MCED value. Conclusions: MCED testing receptivity appears to be influenced by sociodemographic, psychosocial and structural factors. Greater receptivity among Black/Hispanic individuals and those reporting discrimination may reflect “protective vigilance” against systemic barriers. Impact: Our findings highlight opportunities for targeted interventions promoting equitable MCED uptake through trust-building and follow-up across populations.