{"entity":{"id":"idea-prev-mced-positive-resolution-pathway","kind":"idea","name":"A 28-day national pathway for people with a positive multi-cancer blood test","aka":[],"tldr":"A positive blood test with no known tumour is frightening and hard to manage. A standard imaging cascade with a time limit, and a registry of what was found, would make these tests usable.","summary":"PATHFINDER showed diagnostic resolution sometimes took months and repeated procedures. Propose a protocolised pathway: tissue-of-origin-directed imaging first, PET-CT second, FAPI PET or whole-body MRI third, explicit stopping rules for unresolved positives (repeat test at six months), and a mandatory registry of investigations, complications, and outcomes per positive.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022)","url":"https://doi.org/10.1126/science.aay9040"}],"tags":[],"related":["idea-mced-plus-fapi"],"cancers":[],"sections":["early-detection"],"technologies":["mced","fapi-pet","pet-ct","whole-body-mri"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["ppv"],"trials":[],"people":[],"bottlenecks":["b-early-detection","b-overdiagnosis"],"keyPapers":["paper-crosby-science"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A protocolised pathway achieves diagnostic resolution within 28 days in at least 80% of positives with two or fewer imaging procedures on average, and halves invasive procedures per false positive relative to unstructured care.","rationale":"NHS Rapid Diagnostic Centres already do this for non-specific symptoms; the MCED positive is a new referral reason for the same machinery.","test":"Compare structured versus usual-care resolution in the NHS-Galleri implementation phase.","maturity":"early-clinical","actor":"clinic","cost":"medium","horizonYears":3},"route":"/ideas/idea-prev-mced-positive-resolution-pathway/","neighbours":{"idea":[{"id":"idea-mced-plus-fapi","kind":"idea","name":"FAPI PET as the workup for MCED positives","route":"/ideas/idea-mced-plus-fapi/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"fapi-pet","kind":"technology","name":"FAPI PET","route":"/technologies/fapi-pet/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"},{"id":"pet-ct","kind":"technology","name":"PET/CT","route":"/technologies/pet-ct/"},{"id":"whole-body-mri","kind":"technology","name":"Whole-body MRI","route":"/technologies/whole-body-mri/"}],"term":[{"id":"ppv","kind":"term","name":"Positive predictive value (PPV)","route":"/terms/ppv/"}],"bottleneck":[{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"paper":[{"id":"paper-crosby-science","kind":"paper","name":"Early detection of cancer","route":"/key-papers/paper-crosby-science/"},{"id":"paper-pathfinder-lancet-2023","kind":"paper","name":"PATHFINDER: the first prospective test of a multi-cancer blood test in people without symptoms","route":"/key-papers/paper-pathfinder-lancet-2023/"}],"roadmap":[{"id":"ctdna-tests","kind":"roadmap","name":"ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment","route":"/roadmaps/ctdna-tests/"}]}}