Experts at Queen Mary University of London say rollout of a simple cancer blood test for the whole population could happen in the next decade
A blood test for a host of cancers could prevent half of cases reaching an advanced stage, modelling shows.
Scientists are assessing the effectiveness of annual screening using tests currently being trialled by the NHS which look for early signs of cancers before symptoms start. The team at Queen Mary University of London say rollout of a simple test for the whole population could happen in the next decade. Study author Peter Sasieni, professor of cancer epidemiology at the university, said: “The advances in molecular biology and artificial intelligence means that we are now able to find tiny fragments of many cancers in a small blood sample. That is incredible.
“We need to show that using these tests in people without symptoms can help identify cancers earlier when they can be successfully treated, thereby preventing advanced cancer and reducing the numbers dying from cancer.”
Currently only four types of cancer have NHS screening tests – breast, bowel, cervical and lung cancer – but can involve either a scan or an invasive biopsy. Multi cancer early detection tests have been touted as a “game changer”.
Instead of screening for one disease at a time, as the NHS does for breast, bowel, and cervical cancer, for example, technology now exists that has the potential to test for dozens of cancers from a single blood sample. The NHS is currently trialling such tests, including the Galleri test and miONCO-Dx test.
The latest findings, published in the journal BMJ Open, have modelled rollout of a universal cancer test annually and every two years and show this could boost early detection and stop cancers reaching the stage where treatments fail.
Researchers looked at two scenarios where a range of patients in the general population had either “fast-growing” tumours – which remain at stage I for two to four years before progressing, or “fast aggressive” tumours – which remain at stage I for one to two years before advancing. Cancer types studied included bladder, breast, cervical, bowel, kidney, liver and bile-duct, lung, ovarian, pancreatic, prostate, skin and blood cancers such as leukaemia.
Yearly screening under the fast tumour growth scenario led to a higher number of diagnoses than usual care – 370 more cancer signs were detected per year per 100,000 people screened. There were also 49% fewer late-stage diagnoses and 21% fewer deaths within five years than patients receiving usual care.
Screening every two years was not as effective as annual screening – 292 more cancer signs were picked up per year per 100,000 people screened compared to usual care. There were also 39% fewer late-stage diagnoses and 17% fewer deaths within five years. The researchers concluded that a blood test every one or two years has “the potential to intercept 31-49% of cancers at stage I-II that would otherwise present at stage III-IV”.
Prof Sasieni, who also has a lead role on the trial of the Galleri test, said: “I am very excited about the science behind these tests, but we need to ensure that the technological game-changer translates to clinical benefit. That is why we are conducting a huge randomised controlled trial to see whether the prediction made by this modelling is reasonably accurate.
Prof Sasieni said he hopes that “by 2032, there should be sufficient evidence to say categorically how many lives can be saved by annual screening”. He added: “That could lead to national rollout being completed within the next 10 years.”
Our sister paper the Sunday Mirror first reported last year that the mRNA testing technology had been developed by British scientists able to check for the 12 most common and lethal types of cancer. The mIONCO-Dx blood test costs £120 and checks for cancers of the lung, breast, prostate, pancreas, colon, ovaries, liver, brain, esophagus, bladder, bone and soft tissue sarcoma, as well as gastric cancer.
A key issue being assessed is “false positives” which can be devastating for both mental and physical health. Medical regulators and the NHS have set a very high bar for such a test to be considered effective given the risk of such harm.