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Paper short abstract

We explore ambivalence around emerging technologies of multi-cancer testing, situating these tests within a changing landscape of anticipation of cancer. We highlight a paradox: knowing more through testing can exacerbate uncertainty, extending the 'not-yet' of cancer.

Paper long abstract

Political commitments about cancer have produced a boom in cancer diagnostics. Multi-cancer tests (MCTs), which detect signals of several cancers simultaneously, are heralded as the next breakthrough in cancer detection. We situate this technological shift in what Andersen (2023) describes as a change the anticipation of cancer, in the temporal and social experience of living with the possibility of cancer before formal diagnosis is made. We conceptualise testing as an anticipatory practice that carries expectations of the future, driven by hopes for managing, mitigating, or preventing possible future harms. We use the idea of haunting to describe how cancer testing brings the past, the absent, or the not-yet into the present (Derrida. 1993). We report on speculative workshops in the UK where healthcare professionals and lab staff described how they imagined MCTs could impact their practice. Discussions illustrated the haunting presence of cancer in healthcare encounters. A utopia was where testing provided a reliable insight into the absence or presence of cancer, with new knowledge easily aligning with existing cancer detection infrastructures. Dystopia was a perpetuation of the not-yet of cancer, chasing signals with no fixed referent in the body, or generating information that contradicted existing knowledge sources. We reflect on the potential of MCTs to amplify anticipation of cancer. Paradoxically knowing more through testing could generate further uncertainty, as multiple signals multiply the work of making cancer absent. We contribute to exploration of the disconnect between policy drivers of testing and the lived ambivalence of testing-in-practice.