I’m flabbergasted that you think the entire field of early detection of cancer from blood tests hasn’t thought of this.
The problem with this kind of screening is even tests that are highly accurate in a population with a high incidence rate are super duper inaccurate when used against the general population. False positives often have significant consequences, including invasive tests and surgeries with their own risks. tl;dr Bayes' rule is a bitch. [2, 3] I doubt they've solved this problem - but I sure hope they have because why wouldn't I?!
> "A patient goes to see a doctor. The doctor performs a test with 99 percent reliability--that is, 99 percent of people who are sick test positive and 99 percent of the healthy people test negative. The doctor knows that only 1 percent of the people in the country are sick. Now the question is: if the patient tests positive, what are the chances the patient is sick? - The intuitive answer is 99 percent, but the correct answer is 50 percent...." [3]
[1] https://www.nhs.uk/conditions/prostate-cancer/should-i-have-...
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082531/
[3] https://sphweb.bumc.bu.edu/otlt/mph-modules/bs/bs704_probabi...
This test would be a fear driven profit center for these companies. I don’t like them at all. Easy way to sell the test isn’t it? “You don’t want cancer do you?”
My father was diagnosed with pancreatic cancer. The doctors gave him six months to live. They said “if she goes on chemo will get a year”. Both myself and my sister-in-law who is in oncology nurse advised him not to go on chemo. But he did. He died a month after starting chemo because it caused his bile duct to clog and it shut down his liver.
Yeah, so doing nothing, that’s my motto.
Science can be a breakthrough and really interesting and yet still no practical for use in medicine.
A really good example was Pfizer's inhaleable insulin. I mean, I don't need some MBA to tell me it's better than sticking yourself with a needle! Turns out it was a wildly impractical solution looking for a problem that doesn't exist.
Same thing with cancer diagnostics. Unless you can draw a line all the way from diagnostic use to results to improved outcomes, it's just data.
Pfizer’s inhaled insulin was approved by the FDA.
But nobody wanted to use it because it didn’t solve a real problem.
> Unless you can draw a line all the way from diagnostic use to results to improved outcomes, it's just data.
This is why we do trials, to figure out if we can draw a straight line from results (pre-clinical) to outcomes (clinical). This is the question that the cancer diagnostic trial will hopefully answer - can we improve outcomes using these diagnostics?
I don't completely see the relevance of your story about inhaled insulin. As far as I can tell it was not better than standard of care in a meaningful way, whereas with this trial there really isn't a standard of care to speak of, and this is going to be the largest such trial to date. Plenty of drugs fail to make an impact in the market, for a variety of reasons, which can't always be predicted ahead of time.
Elsewhere you write that this is not going to provide actionable information. I largely agree with this statement - as of today. I also think that this trial will provide valuable information about the landscape of cancer diagnostics in general, information which may be increasingly relevant in the future and may turn out to be actionable. This is the most relevant quote from the source article that speaks to why they are doing this:
> Q: Given the doubts, why proceed? > A: The exciting thing is, we don’t have screening tests for the lethal cancers like pancreas and ovarian. We’re desperate. But we have to put our emotions aside and do our due diligence to evaluate these technologies and be able to speak with confidence about what this can and can’t do.
For 75 million dollars, the cost of a year of maintenance for a handful of fighter jets, I think it's worth it, and I'd much rather have the NCI running this than a private company. If this trial completely falls on its face and public money keeps being expended in this direction, then I would certainly revisit my opinion about the worthiness of trials of this nature.