Can a blood test for cancer fulfill its life-saving promise?

Joyce Ares was just 74 years old and was fine when he agreed to provide blood samples for research. So she was surprised when her screening test returned positive for signs of cancer.

After repeated blood tests, PET scans, and needle biopsies, she was diagnosed as follows: Hodgkin lymphoma..

“I cried,” said a retired real estate broker. “Think of it as a little tear,’OK, what are we doing now?'”

Residents of the ore canby volunteered to undergo a blood test, which is being claimed as a new frontier for cancer screening in healthy people. Look for cancer by checking for DNA fragments released from tumor cells.

Such a blood test called Liquid biopsyIs already used in cancer patients to adjust treatment and see if the tumor recurs.

Currently, one company is promoting blood tests to people without signs of cancer as a way to detect tumors in the pancreas, ovaries, and other parts of the body for which there is no recommended screening method.

It’s an unsolved question Blood test for such cancer — When added to routine care — may help improve American health and reach White House goals Cut cancer mortality in half The next 25 years.

Advances in DNA sequencing and data science have enabled California-based blood tests. Grail And other companies are competing to commercialize them.

Also, U.S. government researchers have probably lasted seven years, with 200,000 participants to see if blood tests can detect more cancers earlier and fulfill their promise to save lives. We are planning a large-scale experiment by a person.

“They sound great, but we don’t have enough information,” he said. Dr. Lori Minasian Of the National Cancer Institute involved in research planning. “There is no clear data showing that it reduces the risk of dying from cancer.”

Grail is far more advanced than any other company, with 2,000 doctors willing to prescribe a $ 949 test. Most insurance plans do not cover costs. The test is sold without approval from the medical group or recommendation from the US health authorities. This type of test does not require a review by the Food and Drug Administration.

“In the case of medicines, the FDA demands that not only is the benefit proven, but it is much more likely to outweigh the harm, not for devices like blood tests,” he said. Dr. Barry Kramer Lisa Schwartz of the Foundation for the Truth of Medicine.

Grail will seek approval from the FDA, but sells the test when submitting the data to the FDA.

The history of cancer screening has taught attention. In 2004, Japan stopped mass screening of infants after a study found that childhood cancer did not save lives. Last year, a 16-year study of 200,000 women in the United Kingdom found that regular screening for ovarian cancer made no difference in death.

Such cases Discover some surprises: Screening finds some cancers that do not need to be cured. Inside out? Many dangerous cancers grow so fast that they escape screening and turn out to be deadly anyway.

And screening can be more harmful than good. Anxiety due to false positives. Unnecessary costs. And the serious side effects of cancer treatment: PSA test for men Even if slow-growing prostate cancer does not cause problems, it can cause treatment complications such as incontinence and impotence.

Evidence of screening tests for breast, cervical, and colon cancer is the strongest. Screening for lung cancer is recommended for some smokers.

The recommended tests (mammography, PAP test, colonoscopy) look for one cancer at a time. New blood tests look for many cancers at once. That’s an advantage, according to Grail executive Dr. Joshua Obman.

“We screen for four or five cancers in this country, [many] Cancer deaths are due to cancer that we aren’t looking for at all, “Ofman said.

Dr. Tomash Beer The Dean of the Oregon Health & Science University in Portland led a company-sponsored study in which Joy Suarez participated in 2020. After a disastrous winter of her chemotherapy and radiation, her doctor told her that the treatment was successful.

Her case is not outlier, “But that’s a kind of expected ideal result, and not everyone has it,” Beer said.

There were other early stage cancers detected among the study participants, but some did not have much clear experience.

Jacob Marquez, clinical research coordinator at the Night Cancer Institute at the University of Oregon Health and Sciences in Portland, Oregon, will draw blood from clinical research participant David Parker on March 14. Parker is one of the hundreds of people taking part in a new liquid biopsy exam. Technology that can detect early signs of cancer in human blood.

(Gillian Flaccus / Associated Press)

For some, blood tests led to scans where the cancer was never found, which may mean that the result was a false positive, or that there is a mysterious cancer that will appear later. May mean.

For others, blood tests detected cancer that turned out to be progressive and aggressive, Beer said. Elderly participants with bad cases declined treatment.

Grail continues to update the tests as he learned from these studies, targeting 140,000 British citizens to see if blood tests can reduce the number of cancers found late. We sponsor exams with health services.

Ares feels lucky, but it’s impossible to know if her test added a healthy year to her life or if it didn’t make a real difference, said the National Cancer Institute’s Cancer Prevention. Kramer, a former director of the department, said.

“I sincerely hope that Joyce has benefited from taking this test,” Kramer said of her experience. “But unfortunately, at the individual Joyce level, we can’t tell if that’s the case.”

Cancer treatment can have long-term side effects, “I don’t know how fast the tumor grew,” he said. Treatment of Hodgkin lymphoma is so effective that delaying treatment until symptoms may have resulted in the same happy outcome.

So far, health experts have emphasized that the GRL blood test is not a diagnosis of cancer. A positive result triggers further scans and biopsies.

“This is a diagnostic test path that has never been tried before,” Kramer said. “Our ultimate destination is a test with a clear net profit. If we don’t do it carefully, we’ll be off the road.”