Podcast Summary: Advancing Multi-Cancer Early Detection with David Harding of Exact Sciences

Podcast: Becker’s Healthcare Podcast
Host: Erica Spicer Mason (A), Becker’s Healthcare
Guest: David Harding (B), Senior Vice President, Pipeline Products Management, Exact Sciences
Date: October 20, 2025
Duration: ~18 minutes

Overview

This episode explores the landscape of multi-cancer early detection (MCED), focusing on a recent survey of healthcare executives about the adoption, readiness, and challenges around implementing MCED programs in health systems. David Harding, SVP at Exact Sciences and survey author, shares insights on what MCED is, the market’s current state, key barriers, and what needs to happen to make this transformative testing approach a reality for more patients.

Key Discussion Points & Insights

1. Background: What is Multi-Cancer Early Detection?

[01:56]

• MCED refers to a single blood test that can screen for multiple types of cancer, beyond the four currently recommended for standard screening (cervical, breast, colorectal, and in some cases, lung cancer).
• Motivation: 70% of cancers currently have no standard screening option, representing a significant unmet need.
• Understanding how health systems are thinking about MCED is necessary for achieving large-scale patient impact.

“We are very motivated by the 70% of cancers for which there is no screening option available today.”
— David Harding [01:56]

2. Survey Findings: Interest vs. Adoption Gap

[03:58]

• Out of 101 health system leaders surveyed:
  • Only 23% have implemented MCED.
  • Of those not yet offering MCED, 66% expressed interest in adoption in the next 6–12 months.
• Broad patient demand is a major driver. Patients are asking providers for a way to understand their cancer risk beyond the four traditional screenings.
• MCED is seen as a way for systems to be perceived as innovative and to compete for patients.

“Health systems…want to be on the forefront, they want to innovate. And what we find is that many of them are just not quite ready to move forward.”
— David Harding [03:58]

3. Readiness versus Aspiration

[06:48]

• Despite strong interest, only 23% feel truly ready to implement MCED.
• 42% said they are not ready; a separate group hasn’t even started planning.
• The key issue is the gap between aspiration and practical readiness, rooted in various barriers.

4. Key Barriers to MCED Adoption & Solutions

[07:55]

a) Unclear Clinical Guidelines & Evidence

• Lack of standardized guidelines and limited large-scale evidence make clinicians and systems hesitant.
• Exact Sciences and others are creating playbooks and streamlined protocols for MCED-positive patient management to assist early adopters.

“...There is a lot of new data that's emerging all the time. But certain clinicians may feel like, hey, there's not quite enough yet.”
— David Harding [07:55]

b) Equity and Access Challenges

• 47% see equity as a challenge; most MCED tests are currently out-of-pocket/self-pay and not widely covered by insurance.
• Efforts are ongoing to keep pricing accessible and to advocate for insurance/legislative coverage.
• The goal is to avoid MCED becoming a service only for those who can afford it.

“Most of these tests are offered on a, an out of pocket self pay basis. And that certainly presents challenges when it's not uniformly covered by insurance.”
— David Harding [09:00]

c) Operational/Resource Constraints

• 42% cite challenges in integrating MCED into workflows, primary care bandwidth, EHR integration, and coordination across departments.
• Successful strategies include:
  • Integrating MCED ordering into EHRs.
  • Developing clear diagnostic and navigation pathways.
  • Creating MCED triage clinics with multidisciplinary teams.
  • Training and educating providers to ease workflow and knowledge gaps.

“We've done a ton of education of primary care physicians to help ease with the lack of knowledge…”
— David Harding [11:20]

5. Industry Collaboration and Implementation Experience

[13:48]

• Exact Sciences has partnered with 600+ systems and screened over 20 million patients.
• Building streamlined workflows and efficient collaborations with system partners makes MCED implementation feasible.

“All of this is possible. We can do the hard work that allows us to create simplified workflows…to implement new standards of screening.”
— David Harding [13:48]

6. Potential Impact on Cancer Mortality

[14:50]

• Modeling suggests routine MCED could reduce cancer mortality by up to 18%.
• No other single health system tool offers a similar reduction across cancer types.

“Our modeling suggests that regular implementation of multicancer early detection testing can reduce cancer mortality by up to 18%.”
— David Harding [15:10]

• Harding encourages health leaders to remember the real people who have died from unscreened cancers and to let that motivate action.

Memorable Moments & Quotes

• Driving urgency and hope:

  "There's no time like the present. Patients are out there. They have a need. 600,000 people are dying from cancer every single year and there's no time like the present to get started on this."
  — David Harding [16:31]

• Call to action for health systems:

  “It's quite straightforward. There is no giant investment required. It's an investment of a little bit of time and effort. And we are happy to collaborate with you.”
  — David Harding [16:39]

• Personal challenge to listeners:

  “Think of people in their friends and family network who passed away because of cancer and maybe it's because of a cancer that didn't have a standard of care screening option…”
  — David Harding [15:57]

Important Timestamps

• 00:50 – David Harding’s background and experience in cancer diagnostics.
• 01:56 – What is MCED and the motivation behind the survey.
• 03:58 – Survey results: Current adoption vs. future interest.
• 06:48 – The readiness gap: why interest doesn’t equal implementation.
• 07:55 – Top barriers: guidelines/evidence, equity/access, operational constraints.
• 09:00–11:20 – Solutions for workflow, equity, and integration challenges.
• 13:48 – Exact Sciences’ experience collaborating with health systems.
• 15:10 – Projected 18% reduction in mortality with widespread MCED adoption.
• 16:31–16:39 – Final call to action: “no time like the present”.

Conclusion

The episode lays out the transformative potential of MCED for health systems and patients, balanced by realistic discussions around barriers and practical steps for implementation. Harding and Exact Sciences offer both tools and a collaborative approach for health systems ready to move forward, emphasizing that the time for action is now given the immense public health opportunity at stake.