A large real-world study conducted across six Asian countries suggests that a blood-based multi-cancer early detection (MCED) test may accurately identify multiple cancer types in routine clinical practice, including cancers for which no standard screening programs currently exist. The research was highlighted in a media briefing ahead of the 2026 ASCO Breakthrough Meeting, taking place June 25 to June 27 in Singapore.
The Screening for the Presence of Tumor by Methylation and Size (SPOT-MAS) test demonstrated high specificity and strong predictive performance among asymptomatic individuals in Vietnam, Thailand, Indonesia, the Philippines, Malaysia, and Singapore. The findings indicate that MCED testing could help address major screening gaps in low- and middle-income countries, particularly for cancers that are prevalent in Asia but lack established population-based screening programs.
Study Details
The retrospective analysis evaluated commercial SPOT-MAS testing performed in routine clinical settings among 84,145 people without cancer-related symptoms. SPOT-MAS uses a multilayered analysis of circulating tumor DNA, incorporating methylomics, fragmentomics, copy number alterations, and end-motif profiling, combined with machine-learning algorithms to identify cancer signals. The assay is designed to detect 10 cancer types, including the five most common cancers in the Asia-Pacific region as well as five aggressive malignancies.
According to lead investigator Dang Luu Hong Nguyen, MD, of the Medical Genetics Institute in Ho Chi Minh City, Vietnam, the study may provide the first large-scale real-world evidence from Asia supporting clinical utility of SPOT-MAS as a complementary screening strategy, particularly in LMICs lacking accessible national screening programs. Researchers noted that the cancer landscape in Asia differs substantially from that of Western populations, with cancers such as liver, gastric, and nasopharyngeal carcinoma occurring at higher rates.
For the current analysis, investigators focused on 22,597 participants who had completed at least 12 months of follow-up and underwent appropriate diagnostic evaluation after testing. Individuals with positive MCED results were referred for physician assessment and confirmatory diagnostic procedures, including imaging studies and tissue biopsies. The study population was predominantly Vietnamese, female, and relatively low risk, with most participants reporting no heavy smoking, alcohol use, hepatitis B or C infection, or family history of cancer. The median age was 46 years.
Key Findings
Among the evaluable participants, 94 individuals (0.4%) received a positive SPOT-MAS result. Diagnostic workup confirmed precancerous or cancerous lesions in 64 of those individuals, yielding a positive predictive value of 68.1%. Thirty participants were ultimately determined to have false-positive results. The assay correctly identified the tissue or organ of origin in nearly 80% of confirmed cases, helping direct subsequent diagnostic investigations. Of the confirmed cancers detected, 20 involved stomach, liver, or nasopharyngeal cancers—tumor types that currently lack routine screening programs.
Of 22,503 individuals who tested negative, follow-up confirmed that 99.51% were true negatives, whereas 17 participants were subsequently found to have precancerous or cancerous lesions, representing false-negative results. Overall, SPOT-MAS achieved a sensitivity of 79.0% and a specificity of 99.9%, with a negative predictive value of 99.9%. Investigators noted that these findings closely mirrored results previously observed in the prospective K-DETEK trial, supporting the reproducibility of the assay outside of a controlled research environment and suggesting it may be practical for routine clinical implementation.
The investigators plan to continue monitoring participants beyond 12 months to determine whether additional cancers emerge after longer follow-up and to further assess the test’s real-world performance.
DISCLOSURE: For full disclosures of the study authors, visit coi.asco.org.
