NHS to trial blood test that detects over 50 early-stage cancers – BBC Focus Magazine

Last Updated on November 27, 2020 by

A blood test that may be able to spot more than 50 types of cancer will be piloted by the NHS, chief executive Sir Simon Stevens has announced.

The Galleri blood test, which can detect early stage cancers through a simple blood test, will be piloted with 165,000 patients in a deal struck by NHS England.

NHS England said research on patients with signs of cancer suggests the test can identify many types that are difficult to diagnose early, such as head and neck, ovarian, pancreatic, oesophageal and some blood cancers.

Developed by US-based company Grail, the test checks for molecular changes.

If the programme shows that the test also works as expected for people without symptoms, it will be rolled out to become routinely available. The test could help meet the NHS goal of increasing the proportion of cancers caught early, which can be the key to reducing cancer mortality.

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Patients who have their condition diagnosed at stage one – when the tumour is small and hasn’t spread – typically have between 5 and 10 times the chance of surviving compared with those found at stage four – when it has spread to at least one other organ.

“While the good news is that cancer survival is now at a record high, over a thousand people every day are newly diagnosed with cancer,” said Stevens. “Early detection – particularly for hard-to-treat conditions like ovarian and pancreatic cancer – has the potential to save many lives. This promising blood test could therefore be a game-changer in cancer care, helping thousands more people to get successful treatment.”

The pilot, which is due to start in mid-2021, will involve 165,000 people. This will include 140,000 participants aged 50 to 79 who have no symptoms but will have annual blood tests for three years. Another 25,000 people with possible cancer symptoms will also be offered testing to speed up their diagnosis after being referred to hospital in the normal way.

People will be identified through NHS records and approached to take part. Anyone with a positive test will be referred to the NHS for investigation.

Results of these studies are expected by 2023, and if outcomes are positive, then they would be expanded to involve around one million participants across 2024 and 2025.

Reader Q&A: How does radiation kill cancer if it causes cancer?

Asked by: Odysseus Ray Lopez, US

It’s rather like the way guns can be used to commit crime, or stop it. Radiation causes cancer because its high-energy photons can cause breaks in the DNA strands in your cells. Cells can repair this damage up to a point, but sometimes the repair isn’t perfect and leaves some genes defective.

If the break affects one of the many tumour-suppressing genes in your DNA, that cell can become cancerous. But cancer cells are also more vulnerable to radiation than ordinary cells. Part of what makes them cancer cells is their ability to divide rapidly and this normally means that some of the DNA ‘spellcheck’ mechanisms are turned off.

So when a cancer cell suffers a break in a DNA strand, it’s less likely to repair it correctly. Depending where the break occurs, it might either kill the cell outright, or make it reproduce more slowly.

Radiation therapy uses a focused beam that is aimed at just the part of the body with the tumour, and the dose is carefully calculated to cause the minimum collateral damage to healthy cells. Even so, radiation therapy does very slightly increase your chances of developing a second cancer.

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