Thread by @CCRobertsARK

Hot Take (🔥):

It's unwise for multi-cancer, earlier detection companies to deploy large-scale screening programs without upfront, hereditary cancer testing.

The most important input variable for large-scale screening is the incidence rate of cancer in the population.

By incidence rate, I'm referring to the number of persons in a group that is diagnosed with cancer. Intuitively, screening 100,000 people aged 65+ will result in better outcomes and economics than screening 100,000 teenagers. Why?

Cancer incidence increases with age.

However, age isn't the only variable affecting cancer risk.

Hereditary cancer testing, which is based on your individual predisposition to cancer(s) as determined by mutations you inherited (e.g. TP53, BRCA1/2, etc.), is a HUGE determinant of cancer risk.

Moreover, hereditary cancer testing, which can be very cheap based on who you order from, need only be done once. Low risk persons can be tested later in life, less frequently, or not at all. High risk persons can be tested earlier or more often.

By risk-stratifying populations based on their individual, hereditary risk, multi-cancer, earlier detection companies could materially improve economics, patient outcomes, and test performance.

EDIT:

I should be more clear, everyone has a copy of genes like TP53, I'm specifically referring to pathogenic variants contained within TP53, which confer exceptionally higher risk of earlier-onset cancer(s).

ghr.nlm.nih.gov/condition/li-f…