The Guardian view on a new test for cancer: grounds for optimism
Substantial improvement in the early detection of cancers was among the key aims set out last year in NHS England’s long-term plan. Although survival rates have been improving, it has long been recognised that too often they lag behind the best performing countries in Europe. Late diagnosis is widely recognised as being among the causes, since cancers found early are far more susceptible to treatment. Against this backdrop, last week’s announcement that a new blood test is to be trialled on 165,000 people from next year, in the hope that it will help identify early-stage cancers, is an exciting development.
The test, known as Galleri, looks for abnormal DNA, and is most likely to have an impact on those cancers – including lung, ovarian and pancreatic – that are typically diagnosed late, and for which there is currently no screening programme. Another UK study using blood tests created by the same US healthcare company, Grail, to detect lung cancer (Britain’s biggest cancer killer), is already under way. As ever with research, there are no guarantees, and NHS England has a mountain to climb: currently just 55% of cancers are diagnosed at stages 1 or 2. The aim is to reach 75% by 2028. But at the end of a year that has placed the NHS under huge strain, it is encouraging that some of the pledges in the long-term plan may be on the way to being met.
Things will very likely get worse before they get better. Earlier this year, Cancer Research UK estimated that 2.1 million people across Britain were waiting for cancer screening appointments that had been postponed due to the pandemic. The fear is that many thousands of cases may have gone undiagnosed, or become inoperable. Pressure on mental health and other services is also growing, with promises of additional funding not sufficient to meet the growing need. The disastrous outsourcing of coronavirus testing and tracing has only served to intensify
pressures on hospitals and other providers.
Yet this has been an extraordinary year for medical science – as well as for disease. The development of not just one, but three vaccines, all of which appear to be effective against Covid-19, is remarkable. That two of these represent a dramatic departure in the field of vaccine research, since they employ a new technique involving injecting the virus’s mRNA (messenger ribonucleic acid), opens up the possibility that the boost given to research by the pandemic could bring longerterm benefits.
Scientific breakthroughs on their own do not solve all our health problems. Just as vaccine scepticism and the logistics of distribution must be tackled as part of the pandemic response, so public attitudes – including a reluctance among some groups to seek treatment – must form part of any cancer strategy. Simon Stevens, the chief executive of NHS England, warned recently that an “epidemic of obesity”, which is linked to 13 cancers, risks undoing the progress made on reducing smoking. Obesity is closely linked to poverty. These are more than caveats; it does not make sense to view health in isolation from other aspects of public policy. But still, at the end of a bleak year, the prospect of a new and relatively non-invasive cancer screening test, is one reason for hope.