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Published online 17 October 2007 | Nature 449, 770-771 (2007) | doi:10.1038/449770a
News: Business
Missing the mark
Genetic tests to detect cancer are feasible. But with researchers drowning in a sea of biomarkers and little financial incentive to get the tests on the shelves, the idea is floundering. Virginia Gewin reports.
The genomic revolution brought in its wake the promise that it would be possible to detect —and arrest — the earliest signs of cancer. By tapping in to molecular biomarkers, initial signs of disease would be seen and effective treatments implemented.
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Great Article! However, one paragraph (see below) is perhaps a bit too pessimistic for my taste; earlier detection of cancer probably results in improved survival, even without improved treatment strategies: "Cangen is confident that its test — a panel of 15 DNA segments — can identify tumours well ahead of existing diagnostics. But although detection may come a little earlier, a patient's primary treatment option remains the same: surgery. That means that the overall impact on patient survival rates may be relatively small."
I thought the idea of early detection as a way to improve the survivor rates and existing treatment options for patients was the golden rule for most cancer types. Seems this article suggest that if there is no information gained from a biomarker test that either leads the Doctor to a new treatment course for patients once detection has occurred or links the test some how to a new drug, then Doctors will be less likely to order these tests. This premise is new to me and I doubt it is true. "But in the absence of such therapies, there isn't a huge incentive for doctors and the health-care insurers that pay for most medical services in the United States to buy the tests." Assays which test the blood or urine for markers are many fold less intrusive and invasive than the options Doctors now have available to them for detection. This is a big incentive for Doctors to help their patients. Doctors also have the incentive because CT scans, cystoscopies, endoscopic examinations, colonoscopies, etc. can also be many fold less sensitive and several fold more expensive than biomarker assays. To me the article very much overstated the lack of incentives for Doctors to use these test.