The following was originally published in the News Journal on December 17, 2022.
What makes a cancer diagnosis especially difficult are the what-ifs that arise for those diagnosed and the people who love them — what if I don’t respond to treatment? What if my loved one’s cancer comes back or metastasizes? What if the cancer had been detected earlier? Unfortunately, many of these what-ifs address issues beyond the control of patients and providers. As an oncologist, I don’t deal in what-ifs in my practice; however, I think questions around early detection — what if I’d called my doctor, received a biopsy or underwent routine screening sooner — provide valuable insight into how we might prevent later state diagnoses and decrease cancer mortality in our communities.
Early detection is key in the fight against cancer, leading to better cancer outcomes and fewer lives lost, and new technology is emerging to meet this need. are blood-based panels analyzing body fluids for biological signals that may result from cancer cells. These biological signals indicate whether cancer is present and, more specifically, with what cancer we’re dealing. Data indicate that MCED tests can screen for dozens of cancers at the same time, including some rare cancers. If clinical trials demonstrate benefit and the FDA approves, these types of tests would be an incredible asset in cancer care and have the potential to save countless lives. I am thrilled at the prospect that my patients — and those of my colleagues — might be able to catch and treat disease sooner before any progression.
Despite this innovation in cancer research, a lack of basic, early detection screening for many types of cancer persists, resulting in later stage diagnoses when treatments are limited and outcomes poorer. These disparities can largely be tracked along racial, socioeconomic and geographic lines. Early detection tools need to be made more accessible to help address disparities, particularly among demographic groups where cancer is the leading cause of death — Hispanics, Asian Americans and Native Americans. Designed to build on and complement existing early detection technologies, a simple blood based MCED test is less invasive and more accessible than screening opportunities that are currently available.
At present, Medicare only covers early detection tests for breast, cervical, colorectal, lung and prostate cancers. There is active legislation in Congress that seeks to expand Medicare coverage for early detection screening by way of MCED tests; the Medicare Multi-Cancer Early Detection Screening Coverage Act would create a pathway for the Centers for Medicare and Medicaid Services to initiate an evidence-based coverage process for a multi-cancer screening test once it has demonstrated benefit through clinical trials and is FDA approved. We know that individuals’ risk of cancer increases with age; around 60% of people who have cancer are 65 years or older, making improvements in Medicare coverage for early detection screening all the more critical.
This bill, which has received bipartisan support and co-sponsorship from 54 senators, would also give the Secretary of Health and Human Services authority to cover new multi-cancer technology in the future, without the need for additional legislation. In focusing on this groundbreaking technology, policymakers in Washington signal to their constituents that early detection and patient health are priorities.
As a practitioner in and resident of Delaware, I applaud Sen. Tom Carper and Sen. Chris Coons’ and Rep. Lisa Blunt Rochester’s support for the Medicare MCED Screening Coverage Act. I urge my neighbors across the country to connect with their legislators and insist on their support for this legislation. This is an opportunity to catch cancer sooner, reduce cancer-related suffering and eliminate cancer patients’ what-ifs around early detection.
Stephen S. Grubbs, M.D., a Delaware oncologist, is vice president for care delivery for the American Society of Clinical Oncology and a volunteer with ACS CAN.
