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Public service announcement: There are already blood tests for detecting pancreatic cancer and other cancers on the market, and more coming, depending on where you live. So get tested, if this is something you are worried about.

I believe the only commercially available one in the US is Grail's Galleri (https://www.galleri.com).

More info on this category of tests: https://www.cancer.org/cancer/screening/multi-cancer-early-d...

There are many tests in the pipeline -- although the technology is there, the regulatory and evidence process is slow. (Data relating to detecting cancer early, by its nature, takes a long time and a lot of people to prove out.)

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The Galleri website says:

>Assumes screening is available for all prostate, breast, cervical, and colorectal cancer cases and 43% of lung cancer cases (based on the estimated proportion of lung cancers that occur in screen-eligible individuals older than 40 years).

Doesn't list pancreatic.

EDIT: never mind, I found a more complete list.

https://www.galleri.com/what-is-galleri/types-of-cancer-dete...

If Grail's Galleri is that great, why isn't it part of an annual checkup?

It's expensive, accuracy isn't very high, and no one has done the studies to demonstrate that it actually improves subject outcomes. By its very nature that type of research takes a long time because the investigators have to wait years to detect a difference in subject survival rates or other significant endpoints.

There's a huge amount of funding going into the liquid biopsy space so things will improve. But don't expect rapid changes in clinical practice.

Annual might not be any good. I knew a guy who had a history of colon cancer in his family. He got checked annually from his mid 30s on. At 46, a few months after a clear checkup, he visited his doctor who sent him for another check, and bam: he had cancer.

NHS is evaluating it now in a trial. https://www.nhs-galleri.org

An update on that trial: https://www.bmj.com/content/386/bmj.q1706

It doesn't look great.

Absolutely right! This test is hyped. It has abysmally low sensitivity of 16% to detect stage I cancers and overall 44% for cancers of other stages. It is extremely poor sensitivity for any detection test.

Sounds great.

> The Galleri test is available by prescription only.

But JFC I can't stand being required to get permission from one of those glorified bureaucrats just to collect data on my own body.

If you're feeling like your doctor/PCP is a gatekeeper, get a new one, seriously. Maybe I've been lucky, but my doctors have always written scripts for anything I ask for, assuming there's some validity to my need, and (though I've never tried) we're not talking about controlled substances.

Diagnostic test... they may not know what to do with the results, but I doubt you'll get pushback for a script. Insurance may give you a hard time, however, so assume you're going out of pocket.

> If you're feeling like your doctor/PCP is a gatekeeper, get a new one, seriously.

The problem is that even if they open the gate upon approach, they are still keeping it. It’s not about being denied, it’s about being required to ask permission.

There are online services that will pretty much rubber stamp your prescription for the test. AgelessRx and Function Health are two.

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