ideasIdea
A cancer blood test for older people arriving at A&E with unexplained symptoms
One in five cancers in the UK is first found in an emergency, usually late. Adding a cancer test to the blood already taken in A&E for over-60s with vague symptoms could catch some earlier.
Emergency presentation carries much worse survival, and many of these patients attended A&E months earlier with non-specific complaints. Propose adding an MCED or targeted marker panel to blood drawn in emergency departments for patients aged 60 and over with weight loss, anaemia, or non-specific pain, with a defined follow-up route.
Hypothesis
Emergency department add-on testing detects cancer in at least 3% of tested patients, with at least half at stage I-III, and reduces subsequent emergency-route diagnoses in the tested population.
Rationale
Emergency-department patients have high pre-test probability and are already having blood drawn; the missed opportunity is documented in linked-data studies.
What would test it
Pilot in three emergency departments, 5,000 tests, registry-linked outcomes.
Maturity
speculative
Who has to act
clinic
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks
- Most lethal cancers are found late · Screening exists for only a few cancers. Pancreatic, ovarian, liver, oesophageal and most lung cancers are found when cure is unlikely.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.