Health and Me

Ishita Roy

Simple Blood Tests Detecting Multiple Cancer; Do They Really Work?

Can a simple test detect multiple <span><a href="https://www.healthandme.com/health/cancer">cancer</a></span> all at once? The New York Times reports that in the spring of 2021, this idea had first came into being, where a simple test could detect different cancer including those that do not have any regular screening. Now, the buzz is even louder around that. The test is called <span>Galleri</span>, and data suggest that its performance has improved. 

Many companies are racing to develop this multi-cancer early-detection blood test and while none are yet approved by the federal regulators, people are already demanding for it. They cost hundreds of dollars. 

The company that manufactures Galleri, GRAIL, said that a total of 420,000 tests had been prescribed so far, which shows a surge from 180,000 as of March 31, 2024. The company is also planning to apply for approval from the Food and Drug Administration (FDA), next year. It is also seeking that Medicare would cover the tests.

<h2>What Does The Research On This New Cancer Detection Test Say?</h2>

While the demand is there, the research on it is limited. Cristian Tomasetti, the director of the Center for Cancer Prevention, Early Detection and Monitoring at City of Hope, a cancer center in Southern California told the NYT, "It feels like the airplane is being built while flying."

Most of the available evidence so far comes from studies conducted by GRAIL and other test developers. In GRAIL’s latest study, nearly 99 percent of the around 23,000 people screened using the Galleri test received a negative result. However, 40 percent of positive findings were later found to be false, and the test detected only 40 percent of cancers that were diagnosed within a year, missing the remaining 60 percent.

The idea behind this test is that when cancer is detected earlier, it is easier to treat. Dr. Elizabeth O’Donnell, who heads a multi-cancer early detection clinic at Dana-Farber Cancer Institute in Boston described the experience as doing something truly meaningful for a patient, particularly when the cancer involved has no established screening test. 

That possibility became real for William Hill, a 56-year-old firefighter from Brockton, Massachusetts, who took the Galleri blood test last year during a firefighters’ conference. Firefighters are often exposed to carcinogens while on duty. His blood sample was sent to a North Carolina laboratory, where scientists analyzed fragments of DNA for patterns that could indicate cancer and identify its likely origin.

Two weeks later, the result came back: a cancer signal had been detected.

Hill said he initially hoped the finding was a mistake, especially since he had already been treated for testicular cancer in the past. Further testing at Dana-Farber, including an abdominal CT scan, confirmed metastatic testicular cancer, and treatment began right away.

Looking back, Hill realized that symptoms he had brushed off, such as back pain and frequent urination, were caused by a tumor pressing against his kidney. At the time, he had attributed them to aging and the physical demands of his job.

While it remains unclear whether the test ultimately changed his long-term prognosis, Hill believes it prompted earlier treatment. He said that without the test, he likely would not have suspected cancer and might have delayed care, allowing the tumor to grow further.

Stories like Hill’s point to the promise of multi-cancer blood tests. However, there is still no solid evidence that they reduce cancer-related deaths. Such proof exists for screenings like breast, cervical, colon, and lung cancer, based on large randomized trials conducted over many years.

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Can a simple test detect multiple cancer all at once? The New York Times reports that in the spring of 2021, this idea had first came into being, where a simple test could detect different cancer including those that do not have any regular screening. Now, the buzz is even louder around that. The test is called Galleri, and data suggest that its performance has improved. Many companies are racing to develop this multi-cancer early-detection blood test and while none are yet approved by the federal regulators, people are already demanding for it. They cost hundreds of dollars. The company that manufactures Galleri, GRAIL, said that a total of 420,000 tests had been prescribed so far, which shows a surge from 180,000 as of March 31, 2024. The company is also planning to apply for approval from the Food and Drug Administration (FDA), next year. It is also seeking that Medicare would cover the tests.What Does The Research On This New Cancer Detection Test Say?While the demand is there, the research on it is limited. Cristian Tomasetti, the director of the Center for Cancer Prevention, Early Detection and Monitoring at City of Hope, a cancer center in Southern California told the NYT, "It feels like the airplane is being built while flying."Most of the available evidence so far comes from studies conducted by GRAIL and other test developers. In GRAIL’s latest study, nearly 99 percent of the around 23,000 people screened using the Galleri test received a negative result. However, 40 percent of positive findings were later found to be false, and the test detected only 40 percent of cancers that were diagnosed within a year, missing the remaining 60 percent.Case StudyThe idea behind this test is that when cancer is detected earlier, it is easier to treat. Dr. Elizabeth O’Donnell, who heads a multi-cancer early detection clinic at Dana-Farber Cancer Institute in Boston described the experience as doing something truly meaningful for a patient, particularly when the cancer involved has no established screening test. That possibility became real for William Hill, a 56-year-old firefighter from Brockton, Massachusetts, who took the Galleri blood test last year during a firefighters’ conference. Firefighters are often exposed to carcinogens while on duty. His blood sample was sent to a North Carolina laboratory, where scientists analyzed fragments of DNA for patterns that could indicate cancer and identify its likely origin.Two weeks later, the result came back: a cancer signal had been detected.Hill said he initially hoped the finding was a mistake, especially since he had already been treated for testicular cancer in the past. Further testing at Dana-Farber, including an abdominal CT scan, confirmed metastatic testicular cancer, and treatment began right away.Looking back, Hill realized that symptoms he had brushed off, such as back pain and frequent urination, were caused by a tumor pressing against his kidney. At the time, he had attributed them to aging and the physical demands of his job.While it remains unclear whether the test ultimately changed his long-term prognosis, Hill believes it prompted earlier treatment. He said that without the test, he likely would not have suspected cancer and might have delayed care, allowing the tumor to grow further.Stories like Hill’s point to the promise of multi-cancer blood tests. However, there is still no solid evidence that they reduce cancer-related deaths. Such proof exists for screenings like breast, cervical, colon, and lung cancer, based on large randomized trials conducted over many years.