The U.S. National Cancer Institute plans to study whether blood tests can save lives by detecting early cancers.
report their tests can detect many tumors at an early stage, when they are easiest to treat. GRAIL is already offering its $949 test, which requires a prescription, to people over age 50 and others with an elevated risk of cancer. It has also launched a 140,000-person trial in the United Kingdom.
“The complexities are quite staggering,” NCI Division of Cancer Prevention Director Philip Castle told an agency advisory board last week. Advisers acknowledged the challenges but agreed on the effort’s importance. “I applaud the NCI. I think that this is critical and they have to do this,” said Sylvia Plevritis, a biomedical data scientist at Stanford University.Insider discussed NCI’s ambitious plans with Castle recently; this interview had been edited for clarity and brevity.
Q: The estimate from past studies is that 1% of participants will have a positive test indicating they have cancer, and then some subset will actually have cancer? Among the positives [in past studies], in one-third, nothing is found. And in one-third there’s no cancer, there’s some other benign condition that caused [the false alarm]. And one-third of the people have cancer. The harms are manyfold. The test could reduce advanced-stage cancer but not reduce mortality.
And conversely, when you get a negative test, will people not do their standard of care screening because they got this fancy cancer test that said, “I’m negative?” That could counter the benefits of these tests. The exciting thing is, we don’t have screening tests for the lethal cancers like pancreas and ovarian. We’re desperate. But we have to put our emotions aside and do our due diligence to evaluate these technologies and be able to speak with confidence about what this can and can’t do.
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