Catching cancer early via routine screening can greatly improve the chances of surviving the disease. However, in the US, the Centers for Disease Control and Prevention (CDC) currently only supports screening for a few types of cancer including lung, colorectal, cervical, and breast cancer “as recommended by the U.S. Preventive Services Task Force (USPSTF),” the public health agency states.
According to the CDC, screening for other cancer types, such as thyroid, testicular, prostate, pancreatic, and ovarian cancers “has not been shown to reduce deaths from those cancers” and there is not yet enough evidence to support screening for skin, oral, or bladder cancers in healthy people.
There are not yet approved biomarker methods for screening for these cancer types, but researchers have been working on multi-cancer early detection (MCED) tests that can simultaneously detect many different cancer types, though many of these options have several challenges. However, one recently reported example could offer a better alternative to these emerging MCED tests. In the study, a research team based mainly in Sweden developed a non-invasive test for 14 types of cancer using free glycosaminoglycan profiles (GAGomes) as metabolic biomarkers, rather than being based on detecting circulating free DNA like other methods.
In the results of their study published December 5, 2022 in PNAS, the researchers showed that their MCED method using urine and plasma samples detected more cancers than other non-invasive options currently available, which include liquid biopsies based on genomic biomarkers.
In their study, the team explored the use of plasma and urine GAGomes as a cancer detection method for 14 cancer types using 2,064 samples from a mix of 1,260 individuals who either had cancer or were healthy. They found that there were “widespread cancer-specific changes in biofluidic GAGomes recapitulated in an in vivo cancer progression model” and developed three machine learning models based on these changes to detect multiple cancers, as well as a liquid biopsy assay.
Based on the MCED scores from the models, the assay was able to detect stage I cancers with up to 62 percent sensitivity and 95 percent specificity for all 14 cancers studied, compared with 39 to 73 percent sensitivity to 12 types of stage I cancers for other MCED assays. The combined biomarker profiles also “predicted any cancer type with poor prognosis within 18 months with 43 percent” sensitivity.
While the researchers note that more research needs to be done into the association of GAGomes and cancer occurrence in order to minimize “false positives in a clinical setting,” they say the biomarkers show promise for a simple, low-cost test for early detection of multiple cancers.
“Overall, GAGomes appeared to be powerful MCED metabolic biomarkers, potentially doubling the number of stage I cancers detectable using genomic biomarkers,” the researchers stated.