多癌早期检测(MCED)试验的出现有潜力彻底改变癌症的诊断，通过早期诊断和更多地使用治愈性治疗来改善患者结果。正在进行的NHS-Galleri试验评估了GRAIL开发的一种MCED检测，并将晚期癌症的绝对发病率作为其主要终点。支持者认为，如果该检测方法减少了晚期、不可治愈癌症患者的数量，可以合理地假设该检测方法通过减少癌症死亡率来使患者受益。在这里，我们认为这种假设可能并不总是成立，这是由于微转移疾病的现象，因此我们提出调整试验结果的建议，以更好地反映该检测方法对癌症死亡率的预期影响。© 2023. 作者。

The advent of multi-cancer early detection (MCED) tests has the potential to revolutionise the diagnosis of cancer, improving patient outcomes through early diagnosis and increased use of curative therapies. The ongoing NHS-Galleri trial is evaluating an MCED test developed by GRAIL, and is using as its primary endpoint the absolute incidence of late-stage cancer. Proponents of this outcome argue that if the test reduces the number of patients with advanced, incurable cancer, it can be reasonably assumed to be benefitting patients by reducing cancer mortality. Here, we argue that this assumption may not always hold due to the phenomenon of micro-metastatic disease, and propose an adjustment to the trial outcome so that it may better reflect the expected effect of the test on cancer mortality.© 2023. The Author(s).