The clinical and psychosocial consequences of genomic Multi-Cancer Detection (MCD) tests in underserved populations: a scoping review

Multi-cancer detection (MCD) tests currently being tested in clinical trials may be a scalable, convenient means to improve cancer screening, yet little is known about the potential clinical and psychosocial consequences of doing so in underserved communities. To summarize the current literature examining potential clinical and psychosocial outcomes and consequences for MCD testing in underserved populations. We searched and then reviewed articles from five databases: PubMed, Embase, Scopus, Web of Science, and Cochrane. For inclusion, studies had to primarily focus on MCD testing within underserved populations. Out of 376 articles identified, 29 met inclusion criteria. Financial constraints were the most frequently cited barrier ( n = 23). 24 articles mentioned clinical consequences and nine mentioned psychosocial consequences, with the most common being lower rates of cancer screening with proven existing recommended tests ( n = 10) and emotional stress, worry, and anxiety ( n = 11), respectively. Many expressed concerns about underrepresentation in clinical trials. The review highlights common potential clinical consequences as well as important factors underserved populations may face if/when MCD testing is implemented in their healthcare. Future prospective studies, experimental and observational, should intentionally include underrepresented patient populations to better understand and address these challenges.