The director of Tata Memorial Hospital (TMH) in Mumbai, the country’s largest cancer treatment centre, has criticised a newly launched screening test for early detection of cancer, saying that such tests “exploit the innocent public”.
While the blood-based test is being marketed as a breakthrough technology for 16 types of solid tumours, TMH director Dr. C.S. Pramesh argues that screening tests that are not backed by strong evidence cause increased anxiety and guilt.
The blood test, launched by Thyrocare and Datar Cancer Genetics, promises to detect cell clumps named ‘circulating ensembles of tumour-associated cells’ (C-ETACs), which are present in cancer patients before clinical manifestations. The test is priced at ₹8,999.
Last week, when Thyrocare’s managing director Dr. A. Velumani tweeted a pamphlet announcing the test as “disruptive cancer diagnosis”, the TMH director took to the social media to put forward his points. Dr. Velumani later deleted his tweet.
“There are very few screening tests for early detection of cancer, like mammography for breast cancer or visual inspection with acetic acid (VIA) for cervical cancer, which are backed by evidence. It took us 15 years of research to establish the VIA and it showed 30% reduction in mortality,” Dr. Pramesh told The Hindu .
He said that without mortality reduction, screening tests change nothing, except causing more anxiety and guilt. “For example, there are screening tools for prostate and thyroid cancers, but they don’t save lives. In countries like South Korea, the ultrasound of the neck for thyroid cancer is extremely popular due to aggressive marketing and thus leads to unwanted thyroid surgeries,” he said.
When The Hindu reached out to Datar Cancer Genetics, a spokesperson said their study is based on robust science proven through a clinical trial involving more than 16,000 individuals. “Many oncologists in India have expressed their keenness to explore this test for large-scale use, and we believe that the test will provide breakthrough for early detection,” the spokesperson said.
They said they respected the views of senior oncologists and recognised that Dr. Pramesh is one of them. “However, we stand by our study and are confident of the accuracy and utility of the science and technology,” the spokesperson said.
Dr. Pramesh argued that the study was done on 5,500 cancer patients and 10,600 asymptomatic individuals. “Ninety per cent of the results deal with patients who already had a diagnosis of cancer and are therefore completely irrelevant in the screening arena. Why have the authors not focused on the 10,600?” he asked.
A spokesperson from Thyrocare said they were a logistics partner of Datar Cancer Genetics. “In our opinion, it is [a] cost-effective, supportive, non-invasive, blood test for cancer that should be used when the patient has some indications. Though it suggests the possibility, only medical fraternity should draw diagnostic conclusions. This is already happening in many diagnostic tests that have false positive or false negative outcomes, however small percentage it is.”
Referring to Dr. Velumani’s deleted tweet, the spokesperson said, “While exchanging information on social media, though it is not ideal, it turned towards unfair arguments. Hence the tweet was deleted.”
