Foretelling the ‘Dreaded Disease:’ A Panel Discussion About Communicating with Patients in the Era of Pre-Screening and Early Cancer Detection

On June 10, 2022, The New York Times told the stories of Jim Ford and Susan Iorio Bell.

After an experimental biomarker-based blood test detected Mr. Ford’s early-stage pancreatic cancer, physicians used surgery, chemotherapy, and radiation to destroy it, likely saving his life.

A similar test found a cancer-associated protein circulating in Ms. Bell’s blood. But imaging tests revealed no signs of a tumor. Ms. Bell remains shaken by her prospects of developing a disease that has already afflicted both her parents.

Mr. Ford and Ms. Bell’s experiences spotlight both the promise and the potential pitfalls of genetic pre-screening and blood-based early detection tests in cancer care. By identifying people whose bodies express cancer-related biological signals sooner, these tools could help physicians and patients get ahead of the second-leading cause of death in the United States. But widespread clinical adoption would leave some patients with positive test results of uncertain significance, raising unanswered questions about if and when the “dreaded disease” may take hold of their bodies. And in the absence of large-scale clinical trials, physicians have no way of knowing whether commercially available tests will add years to patients’ lives, prompt oncologists to treat diseases that would not have caused serious symptoms, or turn up unusually dangerous cancers that will prove fatal even after aggressive treatment.

A patient will share views and questions about the risks and benefits of pre-screening and early detection in cancer care. A test developer and two medical experts will respond.