DESC-1, a prospective study on epidemiologic factors influencing general population to engage with liquid biopsy based cancer screening.
Authors: Kossler Thibaud , Vitale Marta , Dubos Richard , Pennacchio Francesco , Baysson Helene , Stringhini Silvia , Dietrich Pierre-Yves 
Published: June 2022

e13630

Background: Liquid biopsy technology has delivered promising results for therapy monitoring and disease relapse detection. The simplicity of the procedure makes it attractive for early cancer detection despite its clinical value in this setting being as yet unknown. The objective of the study is to evaluate the acceptance of this new screening technology by the general population. Methods: Participants in a digital health study originally selected randomly from the general population of the canton of Geneva (Switzerland) were invited to participate in a survey investigating (1) their motivation and (2) what factors might affect their decision regarding whether to proceed to a liquid biopsy test for cancer screening. Results: 2’898 participants responded to the survey (participation rate: 35%), 1’568 are > 50yo. Two thirds are female, 7.6% have a history of cancer, 80.8% have a family relative with a history of cancer. In the whole population: 97.7% are ready to use liquid biopsy as a cancer screening test. In the > 50yo, 97.3% of women and 98.5% of men would do the test. In the < 50yo, 97.2% of women and 98.6% of men would take it with X² = 0.018 (p = 0.89) for independence with sex. Age category, education level, income band, professional status, self-rated health, tobacco status, chronic disease, personal or familial history of cancer and COVID pandemic have no statistical impact on the incentive to do a liquid biopsy test. In the whole population, 94.6% would take the test knowing that there is a risk of a false positive. The median accepted false positive percentage error rate is 10% with interquartile rate (IQR) Q1: 5% and Q3: 15%. Ninety-six percent of respondents would take the test knowing that there is a risk of a false negative, accepting a median false negative percentage error rate of 10% with IQR Q1: 5% and Q3 : 20%. Most respondents (97.6%) will do the test knowing that additional tests or procedures could be required in case of positivity and 58.8% would take it yearly, while 24.6% only every two years. Fifty-nine percent believe that taking the test could influence their lifestyle, regardless of the result. Conclusions: This study shows that the surveyed population is ready to engage with liquid biopsy as a cancer screening tool despite its limitations and drawbacks. Willingness to take the test might depend on sex only in the < 50yo population. Knowing the lack of demonstrated benefit, it is urgent to conduct trials assessing the clinical value, psychological impact and financial burden of liquid biopsy tests before incorporating this technology into cancer screening programs. Due to the very high level of interest demonstrated in our study, the possibility of direct-to-consumer availability should prompt health authorities and accreditation bodies to carefully weigh the impact of authorizing market access to liquid biopsy technologies for this purpose.