What does this research mean for the field?

Integrating a two-step multi-cancer early detection test with optimized colorectal screening increases detected cancer cases 2.7-fold and reduces the cost per case to $66,637 compared to standard-of-care alone. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the cost-effectiveness of integrating multi-cancer early detection tests with current cancer screening methods in the U.S.

April 5, 2026

Abstract 5104: Cost-effectiveness analysis of integrating multi-cancer early detection into current cancer screenings in the United States

Key Result

Integrating a two-step multi-cancer early detection test with optimized colorectal screening increased detected cases 2.7-fold and reduced the cost per case to $66,637.

Key Points

To assess the cost-effectiveness of integrating multi-cancer early detection tests with current cancer screening methods in the U.S.
Modeling study comparing two strategies: integrating MCED with standard screenings and optimizing colorectal screening.
Analysis based on U.S. SoC screening data from 2021 for multiple cancer types.
Utilized population statistics and real-world screening cohort parameters to inform models.
SoC alone detected 193,554 cancer cases at a cost of $43.2 billion versus 539,909 cases detected with MCED for $57.5 billion.
The cost per detected case dropped from $223,034 for SoC to $106,556 with SeekIn's MCED test.
Optimizing colorectal screening reduced overall costs by $22.1 billion while achieving 531,556 detected cases, further lowering per-case costs.

Structured PICO

Does integrating multi-cancer early detection (MCED) into standard-of-care screenings improve cancer detection and cost-effectiveness in the US screening population?

Population

75.6 million individuals in the U.S. screening population based on 2021 standard-of-care screening data for five common cancers (breast, cervical, colorectal, lung, prostate)

Intervention

Integration of multi-cancer early detection (MCED) testing (SeekIn's two-step MCED or GRAIL's Galleri) into standard-of-care screenings, with or without optimized colorectal cancer screening (FIT followed by colonoscopy)

Comparator

Standard-of-care (SoC) screenings alone

Outcome

Total cost, number of detected cancer cases, and cost per detected case

Integrating cost-effective multi-cancer early detection tests into current standard-of-care screenings can substantially improve cancer detection and lower per-case identification costs.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background: Cancer remains a major global health challenge. While standard-of-care (SoC) screenings (e. g. , colonoscopy, mammography) improve early detection and survival, limitations persist: many cancer types lack screening guidelines, existing methods are single-cancer early detection (SCED) tests, and invasive protocols with low adherence lead to inefficiencies. Multi-cancer early detection (MCED) tests using liquid biopsy technologies provide a potential solution by screening for multiple cancers, including those not targeted by current SoC, within a single test. From a health economic perspective, supplementing SoC with MCED could enhance cost-effectiveness by broadening detection and reducing missed diagnoses. Methods: This modeling study evaluated two strategies: 1) integrating MCED testing into SoC screenings, and 2) optimizing colorectal cancer screening with a two-step process (FIT followed by colonoscopy), further enhanced by MCED. U. S. SoC screening data from 2021 for five common cancers (breast, cervical, colorectal, lung, prostate), U. S. Census 2020 statistics, and real-world screening cohort parameters informed screening population overlap, cancer incidence, and detection rates for both SoC screenings and MCED. Results: Among 75. 6 million individuals screened in 2021, SoC alone detected 193, 554 cancer cases at a total cost of 43. 2 billion (223, 034 per detected case). Integrating SeekIn's two-step MCED test (OnceSeek followed by SeekInCare, 190 per person) raised total cost to 57. 5 billion but increased detected cases to 539, 909, nearly three times SoC alone, while halving the cost per case to 106, 556. In contrast, using GRAIL’s Galleri MCED (949 per person) increased detected cases further, with an additional 297, 141 cases, but escalated total costs to 114. 9 billion. Notably, optimizing the colorectal screening protocol (FIT followed by colonoscopy) reduced SoC spending by 22. 1 billion, covering all participants' TwoStep MCED costs and achieving a surplus of 7. 7 billion. This strategy yielded 531, 556 detected cases (2. 7x SoC) and reduced per-case cost to 66, 637 (29. 9% of SoC). Conclusion: Integrating cost-effective MCED tests, such as TwoStep test, into current SoC screenings can substantially improve cancer detection, lower per-case identification costs, and keep overall expenditures manageable. Targeted optimization, exemplified by a FIT-first colorectal approach, maximizes cost savings and amplifies the benefits of adding MCED tests to established national screening programs, all without requiring an increase in the overall budget. Collectively, these findings highlight a unique opportunity: with thoughtful integration, MCED can reshape population health by delivering timely, accessible, and affordable screening that saves more lives. Citation Format: Mao Mao, Shuaipeng Geng, Shiyong Li, Yinyin Chang, Shujia Hao. Cost-effectiveness analysis of integrating multi-cancer early detection into current cancer screenings in the United States abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts) ; 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86 (7 Suppl): Abstract nr 5104.

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