Patient Education and Early Diagnosis of Cancer

Cancer is a silent killer that creeps up on people.  Currently only  ~50% of cancers are diagnosed at an advanced stage, when it is very difficult to treat.  To improve cancer treatment, we need to increase patient education about cancer symptoms and at the same time develop new ways to test for it.  Patient education and early diagnosis of cancer is essential in the battle against this horrific disease.. Generally speaking, patient awareness of asymptomatic conditions is poor.  When asked about their risk of getting cancer, the vast majority believe that it is very low. They are shocked to learn that 40% of the population will be diagnosed with cancer at some time during their lifetime.  Education about risk and vigilance of early symptoms is very important. Public education programs are helping to get the message out there.  In 2022, the UK saw the greatest number of patients seeking cancer screening in its history, leading to higher diagnosis levels at earlier cancer stages.  The National Health Service (NHS) program was remarkably successful based on its targeted awareness program.  In cases where cancer can be identified with physical screening, the NHS is aiming to diagnose 75% of cancers at stage I or II by 2028.

Princess Kate Helps with Patient Education

In late March of 2024, Princess Kate made a statement about her early stage abdominal cancer.  Her statements in the UK press triggered immediate and positive reaction. In response to her announcement, there was a fivefold increase in views of information about cancer symptoms. Peter Johnson, M.D., NHS England’s national clinical director for cancer commented: “There is no doubt that talking about cancer saves lives....”

Physical Cancer Screening

Unfortunately, physical screening is only able to identify four types of cancer (breast, cervical, colorectal, and lung).  Only 14% of cancer is identified based on a screening that is recommended by a doctor.  Other forms of cancer must be identified by symptoms (many of which are only identified at late stage).  There is clearly a gap in the current approaches that should be addressed.  Efforts are under way to develop new methods to identify cancer at an earlier stage.  Organizations like the National Cancer Plan are part of these efforts.

Using Blood Tests To Detect Cancer

Going forward, we will increasingly use blood tests to identify cancer even before symptoms become apparent. These blood tests are often referred to as "liquid biopsies" or "circulating tumor DNA (ctDNA) tests." They work by detecting fragments of DNA that are shed by tumors into the bloodstream.  A number of companies are working on tests, such as GRAIL, Guardant Health, Exact Sciences and Illumina.  Initial reporting about the GRAIL test was encouraging.  However, Alex Dickinson, Board Member of Congrove, recently provided discouraging observations about this test.  In a LinkedIn posting  he wrote about initial use of the test among San Francisco firefighters.   "[With this group] the test did not identify the statistically expected number of cancers, provided false positives for half the cancers it did identify, and missed at least three cases of confirmed cancer. In other words, the exercise showed Galleri to be a disaster."  These results are a stunning contradiction to earlier information from GRAIL, which led to the purchase of the company by Illumina .

Healthcare Professionals Would Work With Patients Based On Test Results

Given this news, we can hope that other companies will advance their testing to aid in the fight against cancer. Until now, cancer screening could only be done in person.  Now companies like Freenome are presenting patients with alternatives.  CEO Mike Nolan said, “The pandemic has proven that patients want us to meet them somewhere else, in addition to the healthcare system,” he continued, highlighting Freenome’s aim to cater to patients via alternative points of care such as retail pharmacies, telehealth platforms and federally qualified health centers.  Their blood test would allow patients to screen for colorectal cancer. These dual developments are highly encouraging in the battle against cancer, which continues to be a silent killer.  Patient awareness is increases along with methods that can be used to screen for a larger variety of cancer types.  We haven't won the war against cancer yet, but this offers a chance to win a major battle.

Using Research To Understand Patient Journeys and Awareness

AIM works with clients to understand the complex issues related to awareness and testing.  This research can be used to "hear the voice of patients" and facilitate faster testing, leading to the treatment that patients will need.