{"entity":{"id":"paper-detect-a-science-2020","kind":"paper","name":"DETECT-A: a blood test plus PET-CT found treatable cancers in 10,000 women with no symptoms","aka":[],"tldr":"The first prospective interventional study of a multi-analyte blood test (CancerSEEK) in asymptomatic people: 26 cancers were first detected by the blood test, most of them localised, and the test roughly doubled the number of cancers caught by standard screening.","summary":"DETECT-A enrolled 10,006 women aged 65-75 with no history of cancer in the Geisinger health system. A blood test measuring mutations in cell-free DNA and protein markers (CancerSEEK) was performed; a confirmed positive led to whole-body PET-CT, and imaging-positive participants were referred for diagnosis.\n\nTwenty-six cancers were detected by the blood test, of which 17 were localised or regional; 15 of the 26 underwent PET-CT imaging and nine of those were surgically excised. Standard-of-care screening detected a further 24 cancers, so combining the blood test with existing screening roughly doubled detection (from about a quarter to about half of incident cancers). Fewer than 1% of participants had an unnecessary invasive procedure.\n\nIt proved that a blood-first screening pathway can be safely operationalised and that many blood-detected cancers are at a curable stage.","asOf":"2026-09-08","links":[{"label":"DOI","url":"https://doi.org/10.1126/science.abb9601"}],"tags":[],"related":["paper-pathfinder-lancet-2023"],"cancers":["pancreatic"],"sections":["early-detection"],"technologies":["mced","liquid-biopsy","pet-ct"],"targets":[],"drugs":[],"companies":[],"institutions":["johns-hopkins"],"pathways":[],"terms":["ppv","ctdna","stage-shift","cfdna"],"trials":[],"people":["bert-vogelstein","kenneth-kinzler","nickolas-papadopoulos"],"bottlenecks":["b-early-detection","b-overdiagnosis"],"keyPapers":[],"journals":["science"],"dependsOn":[],"notes":[],"journal":"Science","year":2020,"doi":"10.1126/science.abb9601","pmid":"32345712","authors":"Lennon AM, Buchanan AH, Kinde I, et al.","paperType":"observational","findings":["Blood test alone detected 26 of 96 incident cancers (about 27% sensitivity); with standard screening the combined sensitivity was about 52%","17 of 26 blood-detected cancers were localised or regional; of 15 that underwent PET-CT, nine (60%) were surgically excised","The blood test found cancers in organs with no standard screening (ovary, kidney, appendix, uterus, lymphoma)","Participants did not reduce their uptake of standard screening after joining the study"],"whatItMeans":"A blood test can find early, treatable cancers in people who feel well, including cancers for which no screening exists. It is not a replacement for mammography or colonoscopy but a possible addition. Larger randomised trials are needed to show benefit outweighs harm.","caveats":["Single-arm, single health system, women only; no mortality endpoint","Sensitivity of about a quarter for all incident cancers means most cancers were missed","PET-CT confirmation for all positives is costly and exposes participants to radiation","CancerSEEK's commercial successor tests differ in design, so performance does not transfer directly"],"changedPractice":false,"participants":10006},"route":"/key-papers/paper-detect-a-science-2020/","neighbours":{"paper":[{"id":"paper-vogelstein-cancer-genome-landscapes-science-2013","kind":"paper","name":"Cancer genome landscapes: about 140 driver genes, and each tumour needs only a handful","route":"/key-papers/paper-vogelstein-cancer-genome-landscapes-science-2013/"},{"id":"paper-pathfinder-lancet-2023","kind":"paper","name":"PATHFINDER: the first prospective test of a multi-cancer blood test in people without symptoms","route":"/key-papers/paper-pathfinder-lancet-2023/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"},{"id":"pet-ct","kind":"technology","name":"PET/CT","route":"/technologies/pet-ct/"}],"institution":[{"id":"johns-hopkins","kind":"institution","name":"Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center","route":"/institutions/johns-hopkins/"}],"term":[{"id":"cfdna","kind":"term","name":"Cell-free DNA (cfDNA)","route":"/terms/cfdna/"},{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"},{"id":"detect-a-study","kind":"term","name":"DETECT-A: a blood test plus PET-CT to screen 10,006 women with no symptoms","route":"/terms/detect-a-study/"},{"id":"ppv","kind":"term","name":"Positive predictive value (PPV)","route":"/terms/ppv/"},{"id":"stage-shift","kind":"term","name":"Stage shift","route":"/terms/stage-shift/"}],"person":[{"id":"bert-vogelstein","kind":"person","name":"Bert Vogelstein","route":"/people/bert-vogelstein/"},{"id":"kenneth-kinzler","kind":"person","name":"Kenneth W. Kinzler","route":"/people/kenneth-kinzler/"},{"id":"nickolas-papadopoulos","kind":"person","name":"Nickolas Papadopoulos","route":"/people/nickolas-papadopoulos/"}],"bottleneck":[{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"journal":[{"id":"science","kind":"journal","name":"Science","route":"/journals/science/"}],"drug":[{"id":"cancerguard","kind":"drug","name":"Cancerguard","route":"/drugs/cancerguard/"},{"id":"cancerseek","kind":"drug","name":"CancerSEEK","route":"/drugs/cancerseek/"}]}}