Clinicians raise concerns over pilot of blood test for multiple cancers

Cancer alliances across England are preparing to pilot the multi-cancer early detection (MCED) test Galleri—a blood test that detects abnormal DNA from cancer cells—from next year after NHS England agreed to buy one million of the tests.

The Grail interim implementation pilot will target areas of higher deprivation and offer the test to people aged 50-77.1 It will run from July 2024 to June 2026 in areas not included in the current NHS-Galleri trial—a randomised controlled trial involving 140 000 asymptomatic participants.

NHS England has said the pilot of the test “as a screening tool” will go ahead if the interim results from NHS-Galleri, to be published in March 2024, are “promising.” Doctors and researchers have raised concerns about the implications of this, however, and whether the data to support the decision will be open to scrutiny from the wider scientific community.

While NHS England told The BMJ that it has “criteria” which the test has to meet for the pilot to go ahead, it did not provide details. Current evidence suggests the test has an overall sensitivity of 16.8% for stage 1, 40.4% for stage 2, 77% for stage 3, and 90.1% for stage 4 cancers.2

“To my knowledge, the criteria that will be used to decide if …