Multi-Cancer Early Detection Testing May Be Effective in a Routine Clinical Setting in ASIA
The 2026 ASCO Breakthrough conference in Singapore (June 25–27) highlighted a significant increase in young-onset cancers, particularly within the Asia-Pacific region. Experts emphasized the necessity of adapting screening protocols to address unique Asian cancer profiles and presented large-scale, blood-based early detection tests for tumors that previously lacked screening options.
Key Early-Onset Cancer Insights
During the ASCO Breakthrough Program, leading oncologists analyzed the factors contributing to the rise in young-onset cancers and discussed strategies for adapting regional cancer care.
- Epidemiologic Shift: Sessions looked at the worldwide rise in cancers starting at a young age, exploring why there are more cases of digestive system and other tumors in younger people in Asia and around the world.
- Regional Biology: Unlike Western countries, Asian nations have many cases of liver, stomach, and nasopharyngeal cancers, and most of these do not have regular screening programs in place.
Breakthrough Screening Innovations
To address the lack of early screening, researchers shared strong real-world data from blood tests that can detect many types of cancer early, tested in Asian populations.
- The SPOT-MAS Study: A large study tested over 80,000 people without symptoms across six Asian countries (Vietnam, Thailand, Indonesia, the Philippines, Malaysia, and Singapore) using a blood test called SPOT-MAS that detects free-floating DNA.
- High Accuracy: The test correctly identified cancer in 79% of cases and ruled it out in 99.9% of cases, and accurately indicated which organ the cancer originated from.
- Detecting Hidden Cancers: The test found 20 cases of stomach, liver, and nasopharyngeal cancers, for which there are currently no recommended regular screening tests.
Future Directions
- FDA Designation: In May 2026, the SPOT-MAS 10 test was designated by the U.S. FDA as a Breakthrough Device, indicating it could be useful as an additional cancer screening tool.
- Global Health Equity: Experts highlighted the need to include Asian groups in important cancer studies and to grow supportive care and treatments designed for the specific types of cancer found in the region.
Further research could examine the specific risk factors for cancer in young people or explain in detail how blood tests that detect free DNA detect cancer.
In 2026, early-onset cancers (diagnosed under age 50) are rising across Asia. The most common and fastest-growing early-occurrence cancers include colorectal (bowel) cancer, breast cancer, and stomach (gastric) cancer. Additionally, blood cancers (such as leukemia and multiple myeloma) are increasingly diagnosed in teens and young adults. Medical experts link this “youngening” of cancer to lifestyle changes, including a shift toward Western diets, rising obesity rates, physical inactivity, and environmental pollutants.
Here is the breakdown of the specific early-onset cancers driving these trends in the region:
1. Colorectal Cancer
- The Trend: Bowel and rectal cancers are surging in young adults under 50 across Asia.
- Details: Studies in countries like Singapore show a long-term increase in young-onset cases, particularly rectal cancers among men. Experts note that the biology of the disease in young adults looks similar to that in older patients, but it is disproportionately being found at more advanced stages.
2. Breast Cancer
- The Trend: Breast cancer remains the fastest-growing cancer by incidence in the Asia-Pacific region, heavily affecting women in their 30s and 40s.
- Details: Studies tracking Asian American populations also show a rapid rise in early-onset breast cancers. Aggressive subtypes like triple-negative breast cancer are increasing by more than 6% annually in some younger Asian communities.
3. Gastric (Stomach) Cancer
- The Trend: Gastric cancer risk is emerging earlier in many Asian populations compared to Western populations.
- Details: Rates remain very high in East and Southeast Asia, driven heavily by regional risk factors such as Helicobacter pylori (H. pylori) infections and specific dietary habits.
4. Hematological (Blood) Cancers
- The Trend: Blood-related malignancies constitute a major portion of cancers in adolescents and young adults (AYAs).
- Details: Cancers like leukemia, lymphoma, and multiple myeloma are seeing increased incidence rates among younger demographics in countries such as China and Singapore.
Why is this happening?
According to the WTW Asia Pacific Medical Trends Report, over 50% of insurers in the region report cancer as their fastest-growing condition. Researchers point to:
- Metabolic Changes: Rising rates of obesity and high body mass index.
- Lifestyle: Sedentary behavior and a shift toward “Westernized” diets.
- Environmental Factors: Air pollution and previously unidentified, region-specific risk factors: 1)Cancer led to nearly 10 million deaths worldwide in 2020.Seventy percent of those deaths occurred in low- and middle-income countries. 2) Many low- and middle-income countries lack nationwide screening efforts, or their programs are limited by high costs and other barriers to access. 3)In most of the 6 countries where this study took place, screening programs are largely restricted to breast and cervical cancers.
- MCED tests use blood samples to screen for multiple cancer types by examining fragments of DNA, RNA, or proteins released into the bloodstream by cancer cells.
- SPOT-MAS is an MCED test that can detect 10 cancer types, including the 5 most common in the Asia-Pacific region and 5 aggressive ones.
Key Findings
At the February 2026 data cutoff, 22,597 people with at least 12 months of follow-up met the current analysis criteria:
- Ninety-four people (0.4%) received a positive test result from SPOT-MAS, and diagnostic tests confirmed precancerous or cancerous growths in 64 people. Diagnostic tests did not find precancer or cancer in the remaining 30 people (0.1%), meaning they had false-positive test results from SPOT-MAS.
- Among the 64 people with confirmed precancer or cancer, SPOT-MAS correctly predicted the tissue or organ where the cancer was growing in 79.7% of those people, which helped guide appropriate follow-up diagnostic tests.
- Twenty of those people had cancers (stomach, liver, and nasopharyngeal) that do not have routine screening tests.
- The remaining 22,503 people (99.58%) who underwent SPOT-MAS testing received a negative test result.
- Follow-up confirmed 99.51% of those as true negatives, meaning these people truly did not have precancer or cancer.
- 17 (0.08%) of those were subsequently found to have precancer or cancer, meaning they received a false-negative test result.
- SPOT-MAS had a sensitivity of 79.0% and a specificity of 99.9%.
- The positive predictive value, which reflects the likelihood that someone with a positive test result does have precancer or cancer, was 68.1%.
- The negative predictive value, which represents the likelihood that someone with a negative test result does not have precancer or cancer, was 99.9%.
- These results are consistent with those observed in the K-DETEK trial, demonstrating that the test is applicable in routine clinical practice outside a In an earlier prospective clinical trial called K-DETEK, researchers validated SPOT-MAS in more than 9,000 people in Vietnam. The goal of the current study was to build on the results of K-DETEK by testing SPOT-MAS on a larger scale in routine clinical settings across multiple countries.
Screening for the Presence of Tumor by Methylation and Size (SPOT-MAS), an MCED test, was accurate for detecting 10 cancer types on a large scale in routine clinical practice across 6 Asian countries.
Screening for the Presence of Tumor by Methylation and Size (SPOT-MAS), an MCED test, was accurate for detecting 10 cancer types on a large scale in routine clinical practice across 6 Asian countries.