Singapore’s National Cancer Centre Singapore (NCCS) will start a clinical study in the second half of 2026 involving 1,000 people at higher risk of cancer due to genetic factors or pre-cancerous conditions to evaluate multi-cancer early detection (MCED) tests [1, 2, 3]. The tests aim to detect tumour DNA and other cancer markers in the bloodstream to screen for multiple cancers from a single blood sample [1, 2, 3].
The study will link participants to the nation’s health database to monitor cancer diagnosis and long-term survival outcomes, providing comprehensive data on the tests’ effectiveness in an Asian population [1, 2, 3]. MCED tests rarely produce false alarms and can often indicate the tissue of origin of detected cancers, but their ability to detect early-stage tumours is limited. NCCS Professor Ravindran Kanesvaran noted, “because with early tumours, you are not going to get a lot of circulating tumour DNA” [1].
Most existing MCED trials were conducted in Western Caucasian populations, raising questions about test performance in Asian populations with distinct cancer epidemiology and genetics. Professor Kanesvaran said, “The performance characteristics of these tests in Asian populations with their distinct cancer epidemiology and genetic architecture cannot simply be assumed to be the same” [1].
Currently, MCED tests cost between $1,000 and $5,000 per test and are not included in Singapore’s national cancer screening program due to limited evidence of cost-effectiveness and health benefit [1, 2, 3]. There is concern that introducing expensive MCED tests nationwide without addressing access and equity could worsen healthcare disparities [1, 2, 3].
The trial is one of two studies launched by NCCS's new Research, Innovation, and Science in Cancer Early detection (RISE) institute to fill research gaps in cancer prevention and early detection specifically for Asian populations [1, 2, 3]. The study is scheduled to start in late 2026 and will monitor participants’ outcomes over time to provide data supporting decisions on MCED test use in Singapore.
