ArticleLancet (London, England)2023
Blood-based tests for multicancer early detection (PATHFINDER): a prospective cohort study.
Article in Lancet (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 257 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The PATHFINDER Study: Assessment of the Implementation of an Investigational Multi-Cancer Early Detection Test Into Clinical Practice
K-ACCELERATE: A Multi-center Prospective Trial to Evaluate Clinical Utility of Multi Cancer Early Detection Test as a Triage Test for Symptomatic Participants
A Prospective Cohort Study Evaluating the Utility of Artificial Intelligence-Assisted Non-Contrast Computed Tomography for Multi-Cancer Screening in Asymptomatic Individuals Undergoing Routine Health Examinations
Smart Measurement of Circulating Tumor DNA: a Tumor-agnostic Computational Tool to Improve Colorectal Cancer Care
Multi-center Prospective Validation of the SPOT-MAS Lung Test Using Circulating Tumor DNA for the Detection of Lung Cancer
Who cites it
257 citing papers in PubMed, 1 synthesis or guideline pooled it, 320 citations in OpenAlex.
- Multi-cancer early detection tests for general population screening: a systematic literature review.Health technology assessment (Winchester, England) · 2025Pooled it
- Effect of Screening with Multicancer Early-Detection Test on Late-Stage Cancer Diagnosis.The New England journal of medicine · 2026Trial
- Performance and safety of a multi-cancer early detection test: the PATHFINDER 2 study.Nature medicine · 2026Trial
- Performance of a multi-cancer early detection test in the randomized controlled NHS-Galleri trial.Nature medicine · 2026Trial
- Non-invasive screening in hereditary cancer: a randomized controlled trial to test cell-free DNA-based early detection in the CHARM consortium.European journal of human genetics : EJHG · 2026Trial
- NHS-Galleri trial: Enriched enrolment approaches and sociodemographic characteristics of enrolled participants.Clinical trials (London, England) · 2025Trial
- The Vanguard Study: Assessing feasibility of conducting randomized trials of novel multi-cancer detection tests.Contemporary clinical trials · 2026Article
- Some answers, more questions for multi-cancer early detection tests.Nature medicine · 2026Article
- Plasma proteomic profiles associated with low-dose computed tomography findings and incident lung cancer: a prospective pilot study.Translational lung cancer research · 2026Article
- Refining Lung Cancer Care: The Emerging Role of Liquid Biopsy in Screening, Diagnosis, and Precision Oncology.Cancers · 2026Review
- Review
- Beyond the Needle: Is Liquid Biopsy the Future of Veterinary Medicine?International journal of molecular sciences · 2026Review
- Liquid biopsy: current applications and future directions.Molecular biomedicine · 2026Review
- Positive predictive value metrics for multicancer detection tests.Journal of medical screening · 2026Article
- Advancing the applications of liquid biopsies in oncology.Nature reviews. Genetics · 2026Review
- The Terminator-A Blood Test for Early Detection of 50 Cancers.Public health challenges · 2026Article
- Beyond Detection Limits: Integrated Biosensors for Molecular Diagnostics, Longitudinal Monitoring, and Clinical Translation.Biosensors · 2026Review
- Mechanism-Driven Diagnostic Development: A Specimen-Aware Framework Illustrated by Colorectal Cancer and Solid Tumours.Cancers · 2026Review
- Plasma biomarkers predicting development of lung cancer 5 years before diagnosis.Journal of hematology & oncology · 2026Article
- Context-aware monitoring: rethinking comprehensive screening in the era of AI.NPJ digital medicine · 2026Article
197 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundMulticancer early detection (MCED) blood tests can detect a cancer signal from circulating cell-free DNA (cfDNA). PATHFINDER was a prospective cohort study investigating the feasibility of MCED testing for cancer screening.
methodsIn this prospective cohort study done in oncology and primary care outpatient clinics at seven US health networks, a convenience sample of adults aged 50 years or older without signs or symptoms of cancer consented to MCED testing. We collected blood, analysed cfDNA, and returned results to participants' doctors. If a methylation signature indicative of cancer was detected, predicted cancer signal origin(s) informed diagnostic assessment. The primary outcome was time to, and extent of, diagnostic testing required to confirm the presence or absence of cancer. This trial is registered at ClinicalTrials.gov, NCT04241796, and is completed.
findingsBetween Dec 12, 2019, and Dec 4, 2020, we recruited 6662 participants. 4204 (63·5%) of 6621 participants with analysable results were women, 2417 (36·5%) were men, and 6071 (91·7%) were White. A cancer signal was detected in 92 (1·4%) of 6621 participants with analysable results. 35 (38%) participants were diagnosed with cancer (true positives) and 57 (62%) had no cancer diagnosis (false positives). Excluding two participants whose diagnostic assessments began before MCED test results were reported, median time to diagnostic resolution was 79 days (IQR 37-219): 57 days (33-143) in true-positive and 162 days (44-248) in false-positive participants. Most participants had both laboratory tests (26 [79%] of 33 with true-positive results and 50 [88%] of 57 with false-positive results) and imaging (30 [91%] of 33 with true-positive results and 53 [93%] of 57 with false-positive results). Fewer procedures were done in participants with false-positive results (17 [30%] of 57) than true-positive results (27 [82%] of 33) and few had surgery (one with a false-positive result and three with a true-positive result).
interpretationThis study supports the feasibility of MCED screening for cancer and underscores the need for further research investigating the test's clinical utility.
fundingGRAIL.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.