Blog
New
Screening vs Monitoring in Cancer: Why One Assay Design Does Not Fit All
Screening vs Monitoring in Cancer: Why One Assay Design Does Not Fit All
Rita Bhui
6 Min Read
Share
Different Clinical Questions Require Different Assays
Cancer testing is no longer limited to diagnosing disease. Today, molecular tests are used at different stages of a patient's journey from detecting cancer in healthy individuals to monitoring treatment response and identifying relapse.
At first glance, these applications may seem similar. Both involve analysing cancer-related biomarkers, often using the same technologies such as PCR or next-generation sequencing (NGS).
But they answer very different clinical questions.
Different Goals, Different Assay Requirements
Cancer screening aims to detect cancer as early as possible, often before symptoms appear. The test must examine large numbers of healthy individuals, where only a very small fraction will actually have cancer. It therefore needs:
Extremely high sensitivity to detect tiny amounts of tumour DNA
Very high specificity to avoid unnecessary false positives
Cost-effective, scalable testing for large populations
Cancer monitoring, on the other hand, follows patients who have already been diagnosed. Because the patient's tumour is already known, monitoring often focuses on specific biomarkers identified during diagnosis rather than broad screening. Here, the goal is different:
Measure treatment response
Detect minimal residual disease (MRD)
Identify relapse as early as possible
The requirements are therefore different: broad, highly sensitive detection for screening versus focused, highly sensitive tracking for monitoring. One assay design cannot optimally serve both purposes.
The Challenges of Scaling Sensitivity and Multiplexing
Traditional assays are often designed around a specific set of biomarkers and a specific clinical use. As testing becomes more complex, this creates several challenges.
Broader panels mean more targets to design, optimize, and validate.
Higher sensitivity often requires deeper sequencing, increasing cost and reducing scalability.
More biomarkers increase assay complexity and the risk of interactions between targets.
Larger studies require assays that perform consistently across many samples.
As a result, increasing the number of targets or the required sensitivity can quickly increase cost, complexity, and development time.
Designing Purpose-Built Assays with Multiplexing
AlgoBio takes a different approach. Our proprietary Sequence Transduction technology converts different targets into predefined DNA sequences, allowing us to build highly multiplexed PCR assays around a common detection framework.
This makes assay development faster and more cost-effective while allowing the assay to be tailored to the clinical need.
For screening, we can combine a broad set of cancer-related targets into a single multiplex assay, enabling large numbers of samples to be screened efficiently.
For monitoring, the assay can be tailored to a patient’s known tumour-specific biomarkers for sensitive, repeated testing.
Our multiplexing approach enables:
Broader target coverage in a single assay
Faster assay development using predefined sequences
Cost-effective multiplex PCR instead of separate tests for each target
Faster, scalable screening across large numbers of samples
Purpose-built assays for both screening and monitoring.
Toward More Purpose-Built Cancer Testing
Cancer screening and cancer monitoring may use similar technologies, but they have fundamentally different goals.
As precision oncology continues to evolve, success will depend on designing assays that match the clinical question rather than expecting one assay to solve every problem.
By combining computational design with multiplex molecular testing, AlgoBio enables assays that are optimized for their intended use supporting earlier detection, better treatment monitoring, and more informed clinical decisions.
Different Clinical Questions Require Different Assays
Cancer testing is no longer limited to diagnosing disease. Today, molecular tests are used at different stages of a patient's journey from detecting cancer in healthy individuals to monitoring treatment response and identifying relapse.
At first glance, these applications may seem similar. Both involve analysing cancer-related biomarkers, often using the same technologies such as PCR or next-generation sequencing (NGS).
But they answer very different clinical questions.
Different Goals, Different Assay Requirements
Cancer screening aims to detect cancer as early as possible, often before symptoms appear. The test must examine large numbers of healthy individuals, where only a very small fraction will actually have cancer. It therefore needs:
Extremely high sensitivity to detect tiny amounts of tumour DNA
Very high specificity to avoid unnecessary false positives
Cost-effective, scalable testing for large populations
Cancer monitoring, on the other hand, follows patients who have already been diagnosed. Because the patient's tumour is already known, monitoring often focuses on specific biomarkers identified during diagnosis rather than broad screening. Here, the goal is different:
Measure treatment response
Detect minimal residual disease (MRD)
Identify relapse as early as possible
The requirements are therefore different: broad, highly sensitive detection for screening versus focused, highly sensitive tracking for monitoring. One assay design cannot optimally serve both purposes.
The Challenges of Scaling Sensitivity and Multiplexing
Traditional assays are often designed around a specific set of biomarkers and a specific clinical use. As testing becomes more complex, this creates several challenges.
Broader panels mean more targets to design, optimize, and validate.
Higher sensitivity often requires deeper sequencing, increasing cost and reducing scalability.
More biomarkers increase assay complexity and the risk of interactions between targets.
Larger studies require assays that perform consistently across many samples.
As a result, increasing the number of targets or the required sensitivity can quickly increase cost, complexity, and development time.
Designing Purpose-Built Assays with Multiplexing
AlgoBio takes a different approach. Our proprietary Sequence Transduction technology converts different targets into predefined DNA sequences, allowing us to build highly multiplexed PCR assays around a common detection framework.
This makes assay development faster and more cost-effective while allowing the assay to be tailored to the clinical need.
For screening, we can combine a broad set of cancer-related targets into a single multiplex assay, enabling large numbers of samples to be screened efficiently.
For monitoring, the assay can be tailored to a patient’s known tumour-specific biomarkers for sensitive, repeated testing.
Our multiplexing approach enables:
Broader target coverage in a single assay
Faster assay development using predefined sequences
Cost-effective multiplex PCR instead of separate tests for each target
Faster, scalable screening across large numbers of samples
Purpose-built assays for both screening and monitoring.
Toward More Purpose-Built Cancer Testing
Cancer screening and cancer monitoring may use similar technologies, but they have fundamentally different goals.
As precision oncology continues to evolve, success will depend on designing assays that match the clinical question rather than expecting one assay to solve every problem.
By combining computational design with multiplex molecular testing, AlgoBio enables assays that are optimized for their intended use supporting earlier detection, better treatment monitoring, and more informed clinical decisions.
Different Clinical Questions Require Different Assays
Cancer testing is no longer limited to diagnosing disease. Today, molecular tests are used at different stages of a patient's journey from detecting cancer in healthy individuals to monitoring treatment response and identifying relapse.
At first glance, these applications may seem similar. Both involve analysing cancer-related biomarkers, often using the same technologies such as PCR or next-generation sequencing (NGS).
But they answer very different clinical questions.
Different Goals, Different Assay Requirements
Cancer screening aims to detect cancer as early as possible, often before symptoms appear. The test must examine large numbers of healthy individuals, where only a very small fraction will actually have cancer. It therefore needs:
Extremely high sensitivity to detect tiny amounts of tumour DNA
Very high specificity to avoid unnecessary false positives
Cost-effective, scalable testing for large populations
Cancer monitoring, on the other hand, follows patients who have already been diagnosed. Because the patient's tumour is already known, monitoring often focuses on specific biomarkers identified during diagnosis rather than broad screening. Here, the goal is different:
Measure treatment response
Detect minimal residual disease (MRD)
Identify relapse as early as possible
The requirements are therefore different: broad, highly sensitive detection for screening versus focused, highly sensitive tracking for monitoring. One assay design cannot optimally serve both purposes.
The Challenges of Scaling Sensitivity and Multiplexing
Traditional assays are often designed around a specific set of biomarkers and a specific clinical use. As testing becomes more complex, this creates several challenges.
Broader panels mean more targets to design, optimize, and validate.
Higher sensitivity often requires deeper sequencing, increasing cost and reducing scalability.
More biomarkers increase assay complexity and the risk of interactions between targets.
Larger studies require assays that perform consistently across many samples.
As a result, increasing the number of targets or the required sensitivity can quickly increase cost, complexity, and development time.
Designing Purpose-Built Assays with Multiplexing
AlgoBio takes a different approach. Our proprietary Sequence Transduction technology converts different targets into predefined DNA sequences, allowing us to build highly multiplexed PCR assays around a common detection framework.
This makes assay development faster and more cost-effective while allowing the assay to be tailored to the clinical need.
For screening, we can combine a broad set of cancer-related targets into a single multiplex assay, enabling large numbers of samples to be screened efficiently.
For monitoring, the assay can be tailored to a patient’s known tumour-specific biomarkers for sensitive, repeated testing.
Our multiplexing approach enables:
Broader target coverage in a single assay
Faster assay development using predefined sequences
Cost-effective multiplex PCR instead of separate tests for each target
Faster, scalable screening across large numbers of samples
Purpose-built assays for both screening and monitoring.
Toward More Purpose-Built Cancer Testing
Cancer screening and cancer monitoring may use similar technologies, but they have fundamentally different goals.
As precision oncology continues to evolve, success will depend on designing assays that match the clinical question rather than expecting one assay to solve every problem.
By combining computational design with multiplex molecular testing, AlgoBio enables assays that are optimized for their intended use supporting earlier detection, better treatment monitoring, and more informed clinical decisions.