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The future of early cancer detection

Nature Medicine volume 28, pages 666–677 (2022)Cite this article

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Abstract

A proactive approach to detecting cancer at an early stage can make treatments more effective, with fewer side effects and improved long-term survival. However, as detection methods become increasingly sensitive, it can be difficult to distinguish inconsequential changes from lesions that will lead to life-threatening cancer. Progress relies on a detailed understanding of individualized risk, clear delineation of cancer development stages, a range of testing methods with optimal performance characteristics, and robust evaluation of the implications for individuals and society. In the future, advances in sensors, contrast agents, molecular methods, and artificial intelligence will help detect cancer-specific signals in real time. To reduce the burden of cancer on society, risk-based detection and prevention needs to be cost effective and widely accessible.

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Fig. 1: Evolution of cancer.
Fig. 2: Roadmap to implementing risk-stratified early detection in the population.
Fig. 3: Novel technologies for one-off and continuous monitoring strategies.
Fig. 4: New paradigms for early cancer detection.

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Authors and Affiliations

  1. Early Detection Programme, Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK

    Rebecca C. Fitzgerald

  2. Centre for Cancer Genetic Epidemiology, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK

    Antonis C. Antoniou

  3. Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK

    Ljiljana Fruk

  4. Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK

    Nitzan Rosenfeld

Authors
  1. Rebecca C. Fitzgerald
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  2. Antonis C. Antoniou
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  3. Ljiljana Fruk
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  4. Nitzan Rosenfeld
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Correspondence to Rebecca C. Fitzgerald.

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Competing interests

R.C.F. is named on patents relating to Cytosponge and associated assays that have been licensed by the Medical Research Council to Covidien (now Medtronic). R.C.F. is a founder and shareholder for Cyted. A.C.A. is a named inventor of BOADICEA v5, licensed by Cambridge Enterprise (University of Cambridge). N.R. is co-founder and Chief Scientific Officer of Inivata and is an inventor on patents related to cancer detection and molecular analysis.

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Nature Medicine thanks Marnix Jansen, Martin Eklund and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Karen O’Leary was the primary editor on this article and managed its editorial process and peer review in collaboration with the rest of the editorial team.

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Fitzgerald, R.C., Antoniou, A.C., Fruk, L. et al. The future of early cancer detection. Nat Med 28, 666–677 (2022). https://doi.org/10.1038/s41591-022-01746-x

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