Questions and Answers About the CSRN

NCI created the CSRN to develop and conduct multi-center cancer screening trials. These studies will systematically evaluate emerging technologies for cancer screening – such as multi-cancer detection tests (MCDs) – with the goal of reducing cancer-related illnesses and deaths. The CSRN aligns with President Biden’s Cancer Moonshot^sm goals by investigating how to identify cancer earlier, when it may be easier to treat.

NCI has a long history of running clinical trials to translate emerging technologies into clinical practice. Basic and translational research has informed the understanding of early signals in cancer development. There is a need to understand how these signals inform the development of cancer and how to use these technologies for the purpose of cancer screening.

CSRN is the first large scale network to focus on cancer screening. It will be led by clinicians who perform cancer screening as part of their routine practice. CSRN will engage providers who work with large and diverse populations receiving routine healthcare in a variety of healthcare settings.

Three funding opportunities were released in November 2022.

• RFA-CA-23-020: CSRN Accrual, Enrollment, and Screening Site (ACCESS) Hubs
• RFA-CA-23-021: CSRN Statistics and Data Management Center (SDMC)
• RFA-CA-23-022: CSRN Coordinating and Communication Center (CCC)

Applications went through NIH peer review based on the specific criteria in each Funding Opportunity Announcement.

Yes. The CSRN plans to investigate a variety of emerging technologies for cancer screening. These may include screening methods that involve imaging, biomarkers, procedures, combinations of the above, or tests that have not yet been invented.

MCD tests, also referred to as MCD assays or liquid biopsy tests, measure biological substances that cancer cells may shed in blood and other body fluids – such as circulating tumor cells, tumor DNA, and other analytes – that may suggest the presence of cancer.

MCD tests differ from other cancer screening tests in two main ways. First, they use a single blood test instead of x-rays or imaging tests (such as mammography) or other medical procedures (such as colonoscopy). Second, they check for many types of cancer from different organ sites at the same time—including some cancers that existing screening tests do not check for.

For more information about MCD tests, please refer to Questions and Answers about MCD Tests.

MCD tests are new. They are just beginning to be evaluated to see how well they function as cancer screening tools. It is important to study these tests in clinical trials to better understand important questions including who should get these tests, what should be done after receiving a positive or negative result, and whether these tests can actually save lives.

The first effort for CSRN is a pilot study called the Vanguard study which will inform the design of future large trials to evaluate MCD assays.

CSRN investigators are still designing the Vanguard study. It has not yet started recruiting participants. Stay tuned for more information about recruitment sites near you and the timing of the study launch.

Because CSRN is funded through a cooperative agreement, NCI plays a role in all aspects of CSRN.

View CSRN archived information page to learn more about the steps involved in creating the CSRN such as hosting a virtual workshop to engage MCD assay developers, past presentations, application information/frequently asked questions, and CSRN use of NCI clinical trials infrastructure.

Yes, CSRN will engage large and diverse populations receiving routine healthcare in a variety of healthcare settings. The funded ACCESS Hubs have detailed recruitment plans that include engaging participants from Federally Qualified Health Centers, rural populations, tribal nations, and racially and socioeconomically diverse populations. The goal is to ensure that the results of CSRN trials apply to diverse populations.

NCI has a Questions and Answers about MCD Tests that provides answers to the following questions:

• What are cancer screening tests?
• What kind of tests are used to screen for cancer?
• Does a positive cancer screening test mean I have cancer?
• Does a negative cancer screening test mean I do not have cancer?
• What are multi-cancer detection (MCD) tests?
• How are MCDs and MCEDs different?
• How are MCD tests different from genetic tests?
• Are there FDA-approved MCD tests available in the United States?
• What MCD tests are available to the public in the United States?
• Do health insurance plans pay for MCD tests?
• What kinds of cancers can each MCD test potentially find?
• Does a positive result on an MCD test mean that a person has cancer?
• Will an MCD test say what type of cancer a person has?
• How many follow-up tests might be needed if an MCD test is positive for cancer?
• Does a negative MCD test mean that a person does not have cancer?
• What are the potential benefits of MCD tests for cancer screening?
• What are the potential harms of MCD tests?
• Do MCD tests address health disparities?
• What is not yet known about MCD tests?
• What research and clinical trials are underway to develop MCD tests?
• What research is NCI doing on MCD tests?