OnCo
ideasIdea

Multi-cancer blood test as the first step for patients with non-specific symptoms

People with vague symptoms like fatigue and weight loss get many scans. A blood test could point to which organ to look at first, or safely reassure.

SYMPLIFY (Oxford) showed an MCED in symptomatic patients had high specificity and useful tissue-of-origin accuracy. Propose an RCT in Rapid Diagnostic Centre pathways: MCED-directed work-up versus standard work-up, with time to diagnosis, imaging use, and stage as endpoints.

Hypothesis
MCED-first triage shortens median time to diagnosis by at least seven days and cuts imaging procedures per cancer diagnosed by at least 25% without missing cancers.
Rationale
Cancer prevalence in symptomatic referrals (about 7%) is ten times that of screening, so positive predictive value is far better and overdiagnosis less of a concern.
What would test it
Run a 6,000-patient RCT across ten NHS Rapid Diagnostic Centres.
Maturity
early clinical
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.

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