Could a blood test detect lung cancer?
Lung cancer accounts for 1 in 5 cancer-related deaths in the United States. While doctors say lung cancer is often treatable if caught early, millions of Americans who should be getting screened for the disease each year are not either due to lack of awareness or reluctance to undergo a CT scan.
So, what if a simple blood test could detect lung cancer? That’s what researchers and doctors at Allegheny Health Network (AHN) are going to study over the next two years.
AHN and DELFI Diagnostics Inc. recently announced a collaboration to evaluate the effectiveness of DELFI’s “FirstLook” blood test to enhance lung cancer screening. For the next 24 months, researchers at the AHN Cancer, Medicine and Primary Care Institutes will work to determine if the blood test helps doctors to better identify those who are most at risk of this disease and who would benefit from follow-up CT screening. Researchers will also try to determine if the test improves adherence to lung cancer screening guidelines.
How does it work?
The FirstLook blood test uses a breakthrough technology called whole-genome machine learning to analyze fragments of DNA that are markers of cancer in the blood. A previous clinical trial showed that the test has a negative predictive value of 99.8%, meaning that if the blood test is negative, it’s highly unlikely a CT scan will identify lung cancer.
“When a patient undergoes testing, the results of the test will let their doctor know if the chance of them having lung cancer is low and they won’t need another lung cancer screening until next year,” says Dr. Ali Zaidi, medical director of aerodigestive research at AHN Cancer Institute. “Or it will tell the doctor that they need a scan of their lungs to get a closer look. DNA is packaged abnormally in cancer cells, resulting in abnormal fragment patterns when cancer cells die and release their DNA into the bloodstream, compared to normal cells.”
Researchers will work over the next two years to determine if the FirstLook blood test helps to boost earlier lung cancer diagnoses and reduce death rates.
“The test will be available via the network’s pulmonary and primary care practices where eligible patients will submit a blood sample,” says Zaidi. “Ultimately, as a convenient, point-of-care test, we are hopeful that more people in our region will undergo lung cancer screening.”
Who should get screened?
The American Cancer Society recommends yearly screening for lung cancer with a low-dose CT scan for people 50 to 80 years old who have a 20-pack per year or greater smoking history and currently smoking or quit fewer than 15 years ago. While early detection is key in fighting the disease, most eligible patients do not undergo screening before signs or symptoms appear.
“Despite being the leading cause of cancer deaths in the United States, lung cancer screening rates remain low at around 5%,” says Dr. Amy Crawford-Faucher, chair of AHN Primary Care Institute. “Several factors contribute, including fear of diagnosis, lack of awareness about screening guidelines, scheduling constraints, and concerns about the cost of potential follow-up care.”
She adds that with the addition of a documented smoking history, the lung cancer screening recommendation is more complex compared to breast, colon and cervical cancer and hasn’t yet made it into the public’s consciousness to the same degree.
“Office-based testing boasts significantly higher patient completion rates than tests requiring separate appointments elsewhere,” says Crawford-Faucher. “The hope is that easier access would improve overall screening rates and help prioritize those who truly do need a CT scan, which could lead to more timely scheduling of the scan.”
Patients who are 50 years and older, have a specific history of smoking as outlined by the American Cancer Society and are interested in undergoing testing should contact their AHN primary care physician or AHN pulmonologist to discuss it. It is also expected to be available via AHN’s community-based cancer screening events in the future. Insurance coverage for each person is different and patients can call 1-800-589-2182 to find out how much they may have to pay for the test.