$1K Screening Test May Upend Cancer Management

A multicancer early detection test that can screen for over 50 types of cancer is getting a lot of buzz, but not all doctors are on board with administering it. Grail's Galleri test, which costs $949 and isn't covered by most insurance plans, fits with the growing trend of wealthy patients seeking early diagnostics. The Wall Street Journal reports that one such concierge health service in New York offers Galleri testing in exam packages, some of which include full-body MRIs and biological aging tests and can run between $5,000 and $20,000. More than half their patients inquire about Galleri, and about 10% follow through. The Financial Review sees such MCED tests as "part of a major change predicted to sweep through the cancer world, and change the way the disease is managed." Grail is only one of about 20 companies in, or about to be in, the market.

While early detection can be life-saving—the Journal talks to one woman whose gallbladder tumor was spotted because of the test—some doctors want to put the brakes on using Galleri until a few kinks are worked out. One big red flag is a significant number of false positives (over half turned out false in one study), as well as false negatives. Doctors warn that false positives can lead to anxiety and unneeded (and expensive) testing, while false negatives could encourage people to skip screenings. The test is also not yet FDA-approved, and the American Academy of Family Physicians doesn't recommend mass screenings. "Let's wait and see. I don't think there's enough evidence right now," says Dr. Lori Minasian of the National Cancer Institute.

And human or machine error is a whole other story. Per the New York Times, 400 letters reporting false negatives were sent to 400 people this May—not due to faulty test results, but a software error. The vendor that Grail contracts with identified the error quickly, and says they sent notification to customers within 36 hours. The liquid biopsy test flags cancer signals in DNA left behind by tumors in the bloodstream, and Galleri reports that 130,000 of them have been sold since its release in 2021. The company says it is meant to supplement cancer screenings. It is undergoing independent studies to track its false reporting results and is working with insurance companies to gain wider coverage. (Cancer in people under 50 is up 79% since the '90s).