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Better health through earlier cancer detection

Joshua Ofman, M.D., MSHS Chief Medical Officer, GRAIL | April 23, 2021

Prevent Cancer Foundation invited GRAIL to share this piece as part of their sponsorship of the 2021 Prevent Cancer Dialogue, where they will be presenting on multi-cancer early detection technology. The second webcast of the Prevent Cancer Dialogue series is May 5, 2021. You can register (for free) here.

We have made significant strides in our fight against cancer, with advances in prevention, detection and treatment leading to increased survival for many patients. Yet cancer remains the second leading cause of death in the United States.1 

We know that finding cancer early has a major impact on outcomes. Cancers found in earlier stages have much better five-year survival rates than those found in later stages.2 When cancers are found early, the care team can begin treatments when they have greater confidence of success and we all have a greater chance of keeping our loved ones with us for longer.

Cancer screenings are essential in aiding early detection. But, today in the U.S., we only have available recommended screenings for five types of cancers (breast, cervical, colorectal, high-risk lung, and prostate).3 In fact, more than 70% of cancer deaths are caused by cancers with no recommended screening.4 This means there’s a tremendous opportunity to shift the way we are focused on defeating cancer, from a ‘break it and fix it’ system to one focused on prediction, prevention and early detection.

Emerging technology is our biggest hope in this fight against cancer, including advances in multi-cancer early detection (MCED) technologies. MCED tests could help bend the mortality curve in the right direction. Using machine learning and genomic sequencing, we hope to use MCED tests to detect cancer growing in the body in early stages with a single blood draw. The goal of MCED tests is to be able to detect dozens of cancers, many of which are lethal cancers with no current recommended screening tests, like pancreatic, stomach and liver cancers.

In addition to helping individuals detect cancers sooner, with this technology we want to help enable a population-health-based approach for cancer screening, which we’ve never had before. Instead of single screenings for a handful of individual cancers, with MCED, we could start screening individuals for many cancers, driving a higher cancer detection rate (CDR) in the population.

Increasing the CDR, the overall number of cancers detected out of the overall number of expected cancers in a population, would have a tremendous impact on public health as we could shift diagnoses to earlier stages of disease and open more opportunities for earlier, more impactful interventions.

A recent study modeled the potential impacts of using an MCED test once per year in the United States and found that late-stage cancer diagnoses (stages III and IV) could be reduced by 78%.5 Among those with cancer intercepted earlier, this could reduce 5-year cancer mortality by nearly 40%, reducing all cancer-related deaths by more than a quarter.

Advocacy leadership from organizations like the Prevent Cancer Foundation and scientific leadership in the form of new technologies to detect cancer sooner are creating a path toward a world where no one dies from cancer. Learn more about multi-cancer early detection tests.

Endnotes

1. U.S. Centers for Disease Control and Prevention. An Update on Cancer Deaths in the United States. Available at: https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm

2. Hawkes N. Cancer survival data emphasize importance of early diagnosis. BMJ. 2019 Jan 25;364:l408.

3. American Cancer Society. Guidelines for the Early Detection of Cancer. Available at:  https://www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html

4. Surveillance, Epidemiology, and End Results (SEER) 18 Regs Research Data, Nov 2017 Submission. Includes persons aged 50-79. Estimated deaths per year in 2020 from American Cancer Society Cancer Facts and Figures 2020. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf

5. Hubbell E, Clarke C, Aravanis A, Berg C. Modeled Reductions in Late-stage Cancer with a Multi-Cancer Early Detection Test. Cancer Epidemiol Biomarkers Prev. March 1 2021 (30) (3) 460-468.

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