Smarter Screening, Sooner: The Role of Diagnostic Innovation in Early Cancer Detection

Finding and treating cancer is a race against time. When a patient is diagnosed with clinically significant cancer, the hope is that speedy and efficient treatment will emerge victorious and improve outcomes. Luckily, the act of catching cancer early in its progression, before it has spread to other organs or systems, is an opportunity to get ahead. Early diagnosis of cancer is an important strategy because when patients have timely diagnoses, they are more likely to have improved outcomes, fewer problems associated with treatment, and lower costs compared to those diagnosed at later stages. 

Unfortunately, notable roadblocks and disparities can limit access or extend the time it takes to get a diagnosis. For some types of cancer, screening rates for uninsured age-eligible adults are 50 percent lower than those for insured adults. Certain racial and ethnic groups, people living in rural areas, and lower-income individuals are all susceptible to healthcare barriers like a lack of transportation, a lack of childcare, and health literacy challenges. For others, cultural barriers, like low awareness of screening recommendations, a fear of a cancer diagnosis, and distrust of medical institutions, can also inhibit cancer screenings. This complex situation requires solutions from all sides, but the development and implementation of innovative diagnostic methods have the potential to improve cancer detection for underserved communities. 

The role of innovative diagnostics in improving access and outcomes

The ability to catch cancer early depends largely on the diagnostic tests and protocols used. Many older diagnostic tests and screening protocols require a cascade of tests to confirm a cancer diagnosis. This can be time-consuming and introduce a number of risks: that cancer will be missed if testing is stopped too soon, that patients will be subject to unnecessary, invasive testing, or that patients will be diagnosed with low-grade or indolent disease (i.e., overdiagnosis). While many of these protocols revolve around the principle of “better safe than sorry,” barriers and the toll of testing can be significant. Diagnostic testing costs money, and a series of tests, including imaging and biopsies, can bury low-income and uninsured patients in debt. In cases where indolent, slow-growing cancer is found, the cancer diagnosis itself can cause major anxiety and distress—even if the cancer is unlikely to be symptomatic or require treatment.

Luckily, there are more new diagnostic tests being developed now than ever before—and this has the potential to benefit everyone, from doctors to patients. New tests can dramatically streamline this cancer screening process. Some can provide clearer answers with less invasive methods, which is invaluable when working in communities with deep-rooted mistrust of health care providers. Others can help doctors assess the risk of clinically significant cancer more efficiently, potentially cutting down on the number of tests some patients need. 

Improved diagnostics in practice with prostate cancer

Prostate cancer screening and diagnosis have long been dependent on the prostate-specific antigen (PSA) test, in concert with tests like MRIs. Ultimately, a biopsy is the final step for diagnosing and staging cancer. However, only about a quarter of men who have their prostate biopsied following an elevated PSA result are diagnosed with prostate cancer.

To improve on this prostate cancer diagnostic landscape, we’re seeing the rise of biomarker tests that can detect cancer risk from a single blood draw. Running these diagnostics after an elevated PSA test can help physicians make a more informed decision about what additional testing a patient truly needs. These tests can also work in concert with other diagnostics, like imaging, to bolster confidence in findings without the need for an invasive procedure, like a biopsy. 

When examining accessibility to prostate cancer screening, what promises do these tests bring? Faster answers. Fewer tests and lower costs. Most importantly, these new tests can provide the advantage of time. For patients with clinically significant prostate cancer, it can help them start treatment that much faster. For patients unlikely to have clinically significant prostate cancer, urologists can use the resulting test results to educate patients and help them understand that they can be followed more casually over the coming months and years. 

Shifting the treatment paradigm to build trust

Technology doesn’t exist in a vacuum. We need to develop a better paradigm of care to make sure everyone gets the support they deserve and help patients trust their physicians to suggest a path that makes the most sense for them. With so many underserved communities plagued by diminished trust in healthcare providers, patients need to know that there are always options. By taking these steps together, we’ll finally be making progress toward making cancer diagnostics accessible for everyone.