ST. LOUIS – Cancer screenings save countless lives each year. While improved technology means more lives saved, reaching underserved and low-income communities can be difficult.
Dr. Gautum Agarwal, urologic oncologist and director of Mercy’s Office of Precision Medicine, co-authored an opinion article published in the June 28 issue of the Journal of American Medical Association Oncology titled “Advancing Precision Equity With Multicancer Detection Liquid Biopsies.”
The article touches on St. Louis’ history as a critical, but often forgotten, site for uranium processing for the atomic bomb. The inappropriate storage of waste was followed by years of silent leakage contaminating Coldwater Creek, which runs through north St. Louis County near schools and neighborhoods, potentially putting anyone who spent time there at higher risk of certain cancers.
The article states, “The emergence of minimally invasive liquid biopsy tests that analyze cell-free DNA (and other emerging biomarkers) to detect cancers early has the potential to help correct decades of injustice in St. Louis and beyond.”
For decades, it continues, “silent leakage contaminated this otherwise nondescript waterway,
which was frequented by children and families throughout summers and ran close to local schools and parks. The underserved community exposed to this waste may have increased risk of cancers, including lung cancer, bone sarcoma, and leukemia, but public health studies of the community at the time did not recommend cancer screening of residents, likely reflecting limited technologies in a pre-liquid biopsy era.”
Some physicians see the advent of the latest advancement, multi-cancer early detection blood tests, as the path to fulfilling the promise of expanding detection to a wider range of cancers while addressing health disparities along the way.
The multi-cancer early detection test is not yet covered by insurance, making the cost an obstacle for many. Mercy offers a percentage of free tests to those considered high-risk who are unable to pay. It will soon participate in GRAIL’s Real-world Evidence to Advance Multi-Cancer Early Detection Health Equity (REACH) study, which enrolls patients with a preference for those from underserved communities free of charge.
“This is the first version of multi-cancer early detection testing,” Dr. Agarwal said. “As additional trials are completed and the test becomes more efficient in terms of the cost to run the samples, we expect the cost to decrease over time.”
