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Aggressive Cancers and the Promise of Early Detection: Strategic Implications for US Healthcare Leaders

Tomasz M. Beer, MD, FACP

 

Physicain Boardroom

 

Aggressive cancers—those that grow quickly, metastasize early, and resist treatment—are killing Americans at a rate that demands new detection strategies. In 2025 alone, over 2 million new cancer cases and more than 618,000 deaths are projected to occur, with pancreatic, liver, and lung cancers among the least favorable prognoses.1 These cancers are often detected only after symptoms appear, when they are far harder and more expensive to treat and when—most importantly—treatments are less effective, and outcomes remain poor for many.2,3

As the US population ages and healthcare disparities persist, the impact of inaction also increases. Late-stage cancer care can cost up to 7 times more than early-stage treatment.4 For healthcare executives committed to working toward better outcomes and managing overall costs of cancer care, it is imperative to integrate innovative solutions like multi-cancer early detection (MCED) technologies into care pathways.

The Burden of Aggressive Cancers

Despite a 34% decline in age-adjusted overall cancer mortality from 1991 through 2022, cancer has remained the second leading cause of death overall, as aging of the population has served as a counterbalance to improvements in treatment.1,5 The prevalence and lethality of aggressive cancers are also climbing. By 2040, pancreatic and liver cancers are projected to be the second and third leading causes of cancer-related deaths, with lung cancer remaining as the leading cause.6

The impact of these cancers extends beyond oncology, as late-stage diagnoses increase intensive care unit (ICU) utilization, lengthen hospital stays, and strain palliative care services, representing a dual human and financial burden.

The Cancerguard™ Test: A New Frontier in Early Detection

The Cancerguard test by Exact Sciences exemplifies how MCED technology can help address and screen for these high-mortality cancers. The Cancerguard test evaluates both DNA methylation and protein biomarkers in a patient’s blood, and is the first and only MCED test to combine these classes of cancer-associated signals.7,8

The Cancerguard test has demonstrated an overall sensitivity of 64.1% and 67.8% sensitivity for the 6 most aggressive cancers (those with the shortest 5-year survival)—pancreatic, esophageal, liver, lung, stomach, and ovarian cancers—at high specificity.9

These performance levels offer the potential for earlier detection of cancers historically diagnosed too late, while minimizing false positives that can drive unnecessary costs. A patient testing positive with the Cancerguard test could be fast-tracked to clinical evaluation and confirmatory imaging within days, thanks to the streamlined imaging-based diagnostic resolution strategy recommended for the Cancerguard test. Successful earlier detection has the potential to shift cancer diagnosis to earlier stages and treatment from palliative to curative intent.

Strategic Considerations for Healthcare Executives

Healthcare leaders must evaluate the integration of MCED technologies like the Cancerguard test within broader cancer care strategies. Key considerations include:

  • Enhanced patient outcomes: MCED testing can be embedded into preventive care, such as annual wellness visits or high-risk outreach programs. Integration within existing screening protocols enables early detection, providing your patients with comprehensive care.
  • Quantified benefits: Evaluating claims data may help estimate the impact an MCED program may have on late-stage treatment costs and quality metrics.
  • Data integration: MCED outcomes data may be leveraged within oncology registries, electronic health records, and quality reporting systems. This may enable longitudinal tracking and payer value demonstrations.
  • Improved health equity: Offering MCED through tactics such as community-based testing and payer partnerships can help reach rural, minority, and underserved populations, who are often disproportionately affected by aggressive cancers.10,11

Conclusion

Aggressive cancers pose a growing threat to public health and healthcare system sustainability. For executives, technologies like the Cancerguard test represent a rare convergence of clinical innovation and potential economic benefit. Leaders who act now by piloting MCED programs and aligning early detection with value-based care can set the standard for 21st-century oncology.

This article was brought
to you by:

Exact Sciences
Tomasz Beer, MD, FACP

Tomasz M. Beer Bio:

Tomasz M. Beer, MD, FACP, is Vice President and Chief Medical Officer, Multi-Cancer Early Detection, Exact Sciences, Madison, WI.

 

 

 

 

 

Important Information about the Cancerguard Test

Rx only.

The Cancerguard™ test is indicated for use in adults ages 50-84 with no known cancer diagnosis in the last three years. It detects alterations in circulating tumor DNA and tumor-associated protein levels which are commonly associated with cancer. The test does not detect all cancers and is not a replacement for existing recommended cancer screening or diagnostic modalities for cancer. Current recommended screening for cancer should also be followed. The test is not indicated for screening of breast and prostate cancer and was not evaluated for the detection of precancerous lesions. Due to the potential for follow-up imaging with IV contrast CT after a positive test result, careful consideration should be given before ordering the Cancerguard test for patients with a history of adverse reactions to iodine based IV contrast or for women who are, may be, or plan to become pregnant.

Results should be interpreted in the context of a patient’s medical history, clinical signs, and symptoms. A negative result does not rule out the presence of cancer of any type. A positive Cancerguard™ test result means that the blood test identified a cancer signal that may indicate the presence of cancer. This result alone does not confirm the presence of cancer. Further clinical evaluation by a healthcare provider (which may include blood tests such as complete blood count and comprehensive metabolic panel) and follow-up imaging are needed to locate and confirm a diagnosis of cancer or determine that cancer is not present. While there are no established guidelines for imaging following a positive Cancerguard test result, there is a published follow-up workflow based on expert clinician opinion and results from an exploratory, prospective, interventional study [Kisiel et al Life (Basel) 2024 Jul 24; Lennon et al, Science, 2020]. The proposed workflow in the Kisiel et al publication includes an intravenous-contrast enhanced computed tomography (IV contrast CT of chest, abdomen/pelvis, and soft-tissue neck) and if necessary, positron emission tomography-computed tomography (18F FDG PET-CT) from the skull-base to mid-thigh. Alternative follow-up procedures (e.g. targeted imaging, endoscopic procedures, CT without IV- contrast) may be appropriate in the context of the patient’s medical history and clinical evaluation [Lennon et al, Science, 2020]. False positive and false negative test results can occur.

The Cancerguard test was developed, and the performance characteristics validated by Exact Sciences Laboratories following College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA) regulations. This test has not been cleared or approved by the US Food and Drug Administration. The test is performed at Exact Sciences Laboratories. Exact Sciences Laboratories is accredited by CAP, certified under CLIA regulations, and qualified to perform high-complexity clinical laboratory testing.

Exact Sciences and Cancerguard are trademarks of Exact Sciences Corporation.
© 2025 Exact Sciences Corporation. All rights reserved.  M-US-CAG-00481 8/2025

References:

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  9. Data on file. Cancerguard Test Development Study. 2025. Exact Sciences, Madison, WI.
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