A blood test which can detect 50 cancers could be offered to a million people in a pilot programme from next summer, according to the head of the NHS.
The test, which is currently available in the US, is also able to pinpoint where in the body the disease is coming from with 85% accuracy.
Amanda Pritchard, NHS chief executive, said the Galleri test has the potential to “transform cancer care forever”. If early results are successful, a pilot programme involving one million patients over two years is scheduled to begin next summer.
The test is being given to 142,000 people without symptoms across England, and will report results next year.
New tools that can both expedite cancer diagnosis and potentially avoid invasive and costly investigations
Brian Nicholson, associate professor at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said the findings suggest that multi-cancer early detection tests (MCEDs) can play a role “to confirm that symptomatic patients should be evaluated for cancer before pursuing other diagnoses”.
He said: “Most patients diagnosed with cancer first see a primary care physician for the investigation of symptoms suggestive of cancer, like weight loss, anaemia, or abdominal pain, which can be complex as there are multiple potential causes.
“New tools that can both expedite cancer diagnosis and potentially avoid invasive and costly investigations are needed to more accurately triage patients who present with non-specific cancer symptoms.”
How does the Galleri test work?
The Galleri test works by looking for chemical changes in fragments of genetic code – cell-free DNA (cfDNA) – that leak from tumours into the bloodstream.
Some cancer tumours are known to shed DNA into the blood a long time before a person would start experiencing symptoms.
The test does not detect all cancers and does not replace NHS screening programmes, such as those for breast, cervical and bowel cancer.
In the US, it has been recommended for people at higher risk of cancer, including the over-50s.
Professor Helen McShane, director of the NIHR Oxford Biomedical Research Centre, said: “We are committed to diagnosing cancers earlier, when they can be cured, and this study is an important step on that journey.”
Developed by Californian company Grail, the test is also being trialled in the NHS to see if it can detect hidden cancers in people without symptoms, with results expected later this year.
NHS national director for cancer, Professor Peter Johnson, said: “This study is the first step in testing a new way to identify cancer as quickly as possible, being pioneered by the NHS. Earlier detection of cancer is vital and this test could help us to catch more cancers at an earlier stage and help save thousands of lives.
“It also shows once again that the NHS is at the forefront of cutting edge, innovative technology.”
How accurate is the test?
In the Symplify trial, the test was able to detect signs of cancer in 323 out of the 6,238 people who had visited their GP with suspected symptoms, in England or Wales.
Of those 323 patients, 244 were subsequently diagnosed with cancer, giving a positive predictive accuracy of 75%, the researchers said.
Overall, the test correctly revealed cancer 66% of the time. Around 2% of patients with a negative result were found to have cancer.
The accuracy of the test was also dependent on the stage of the cancer – ranging from 24% for very early-stage (stage I) tumours to 95% for advanced disease (stage IV).
The most common cancer diagnoses were bowel (37%), lung (22%), uterine (8%), oesophago-gastric (6%) and ovarian (4%).
Lawrence Young, professor of Molecular Oncology at the University of Warwick, described the results as “very encouraging”, showing that “we are edging towards an era when blood testing for cancer alongside other tests of symptomatic patients, could really impact early diagnosis and significantly improve clinical outcome”.
However, he added: “The current, overall sensitivity of this test remains an issue particularly for certain types of cancer other than those of the upper gastrointestinal tract. The real challenge is to diagnose those cancers that are difficult to detect. e.g lung, pancreas, and use a positive blood test to instigate other investigations such as imaging.
“To really trust that a negative result on blood testing means no cancer will require more studies.”
Dr Richard Lee, consultant physician in respiratory medicine at the Royal Marsden Hospital and team leader for the early diagnosis and detection team at The Institute of Cancer Research, London, said MCEDs “could help to enable quicker diagnostic testing in those who are deemed to be at high risk”.
He added: “Further research studies are needed to better understand where these tests sit alongside existing screening offerings and early diagnosis of those with worrying symptoms.
“These remain a research test and are not ready for routine clinical use, but could be a very important tool for cancer diagnosis in the future.”
