Alessandra Franceschetti, Director, Ipsos Global Oncology Monitor August 2025
WOULD YOU WANT TO KNOW?
The Paradox of Early Cancer Detection
Alessandra Franceschetti, Director, Ipsos Global Oncology Monitor August 2025
WOULD YOU WANT TO KNOW?
The Paradox of Early Cancer Detection
Alessandra Franceschetti, Director, Ipsos Global Oncology Monitor August 2025
Introduction
In March 2019, my mother was diagnosed with stage IIIb colorectal cancer. I live in the UK, my parents in Italy, and I remember receiving the call from my father with the news. The first challenge in processing the information was, in fact, a lack of it; my father couldn't bring himself to say the infamous 'C- word'. It took me about two weeks to fully understand the situation - that my mother had cancer, that it was colorectal cancer, and, fortunately, that it had been caught before reaching the metastatic (advanced) stage. Five years on – the pivotal point in colorectal cancer at which a patient is often considered cured - my mother’s tests are all encouraging. She is cancer-free.
This close-family diagnosis meant that, at 42 years of age, I started to think seriously about regular colonoscopies. If you had told me, a few years before, that one day I would be grateful for a colonoscopy, I would have laughed. Yet here I am, a cancer data analyst who now books regular screenings with the same sense of ritual as a dental check-up.
But what if, instead of waiting for symptoms or family history to prompt us into action, we could know years in advance what might be hiding beneath the surface? What if a simple blood test could flag cancer before it ever made itself known? Would we want to know, even if it’s too early to do anything about it?
When the test knows before you do
I listen to a lot of podcasts, including those relevant to my work. One that feels pertinent to my experience and this piece was an episode of The Cancer SIGNAL series, centred around Valerie, a 54-year-old real estate professional from Arizona¹. She felt perfectly healthy, but a proactive multi-cancer early detection (MCED) blood test – one that screens for multiple cancer types simultaneously - flagged a signal for gallbladder or pancreatic cancer. After a multitude of scans and a biopsy, her doctors found a minuscule gallbladder tumour - so early that even the specialist struggled to locate it. Valerie became one of the first ever patients with this type of cancer to be treated without chemotherapy, all because her cancer was caught at a stage that would have been invisible to traditional screening.
Valerie’s journey wasn’t a straightforward process. She had to push for the test, facing scepticism from her own GP, and ultimately paid out of pocket for a procedure not yet covered by insurance. The more resistance she met, the more determined she became. “Information is power,” she said.
But is it always?
While there is a vast body of evidence proving that early treatment of cancer leads to better outcomes², do we want to live with the knowledge that we are pre-symptomatic? That something is wrong, but maybe not yet quite wrong enough to treat? What if it is treatable but the relevant therapies are not yet available – or even accessible? On the flip side, what if medical intervention is pursued too soon, resulting in potential surgical complications or unnecessary exposure to side-effect-inducing therapy, when more conservative approaches may have been sufficient? Regardless of the odds, there are multiple considerations that might shape how we respond.
The double-edged sword of knowledge
The PATHFINDER study³, which tested MCED screening in people over 50 with no prior cancer diagnosis, found that adding this diagnostic blood test onto routine screening more than doubled the number of cancers identified; in addition, anxiety levels reported among participants were similar to those arising from standard screening tests. Both are outcomes one might consider positive.
On the flip side, the journey from a positive test to diagnostic clarity was not without its challenges. This process, which remains unavoidable as blood test results must be confirmed using traditional methods, stretched to three months for many participants - a period undoubtedly filled with uncertainty and anxiety. Moreover, the issue of 'false positives' - where the test identifies a cancer signal but further examination fails to confirm an existing cancer - adds another layer of complexity. While the PATHFINDER study reported a false positive rate of less than 1%, it still means that for every 1,000 people tested, up to 10 may endure the unnecessary stress of a false alarm. Which leads to an ethical dimension to factor into this story: while the stress felt of waiting for test results - and even the occurrence of false positives - may be currently unavoidable, is it morally justifiable to put people through this kind of mental strain? Especially if cancer is detected but treatments are not available or accessible?
This is the paradox: early detection offers hope but also hands us new burdens. Not only economical, due to the increasing costs of testing, follow-up testing and treating more and more people, but also personal and psychological ones (more on this later).
This new reality could also give rise to profound new questions. For example, if a test finds a few cancer cells in your lung, do you quit smoking? What if your employer or insurer demands that you do? The line between empowerment and surveillance could grow thinner. And, as historian Yuval Noah Harari observes, medicine is the one field where we willingly surrender our freedom to machines and tests, letting them tell us what’s wrong before we feel it ourselves⁴. As AI and early detection tools become more advanced, we may find ourselves in a world where we are always 'a little bit sick' – where there’s always something to improve, monitor, or worry about.
As we navigate this landscape of increased early detection capabilities, it's crucial to consider how this newfound knowledge might influence our behaviours and the choices we make.
Behavioural change: driven by fear, hope, or both?
The prospect of these burdens may influence the decision to take such a test in the first place. In a recent poll conducted on behalf of Ipsos⁵, 89% of the 1,204 respondents cited that if there was a blood test to detect cancer at early stages, they would want to take it. Interestingly, the figure dropped to 80% among those who do not live close to a big hospital or a cancer centre. Does the lack of proximity to appropriate cancer care influence the uptake of such a test?
In the podcast, ‘Early Diagnosis of Alzheimer’s: Understanding the Bigger Picture’⁶, my Ipsos colleagues discussed survey results showing that approximately 1 in 2 respondents would be willing to take a test to either confirm symptoms of Alzheimer’s or confirm their predisposition to it. It is interesting to consider why the propensity to take such a test is lower here. While new treatment options for Alzheimer’s can slow disease progression, and research for curative treatments is ongoing, Alzheimer’s is widely perceived as ‘hard to treat’. By contrast, it is generally known that many cancers can be treated effectively if caught in time, and the earlier the better. People’s willingness to be tested is likely impacted by their ability to take positive action in the event of a diagnosis. The Alzheimer’s discussion also highlighted how a strong support network is often critical to a person’s openness to learning about their risk, a factor likely to be equally important in early cancer detection.
The threat of serious illness, especially cancer, can be both a motivator and a source of anxiety. In instances where the consequences of one’s choices are so starkly visible - e.g. learning that a smoking habit has led to an abnormal test result, or that a sedentary lifestyle has contributed to a diagnosis - the need for change can feel urgent and personal. Some, like Valerie, become more proactive, e.g., tracking their habits, adjusting their diets, quitting smoking or exercising more. Apps and wearables can help them visualise goals, turning abstract risk into daily action. For others, it can heighten fear and stress, leading to avoidance or denial. The more clearly someone sees the impact of their behaviour, the greater the emotional weight attached to making (or not making) a change.
It would be remiss not to point out that the use of early detection methods is not just a matter of personal choice; access to tests is dictated by healthcare economics and the resources and decisions of the healthcare systems we are served by. This is a broad topic that warrants a separate article, but it’s an important point of note here. That being said, MCED testing is still in its infancy, and we only expect accessibility and uptake to increase from here on in.
Ultimately, however, the decision to actually undergo early testing, regardless of what could be detected, is deeply personal and shaped by individual values, support, and life circumstances.
Rising early-onset cancers in an era of advanced detection
While the use of MCED tests in routine cancer screening remains low currently, early cancer detection is increasing. In the UK, for example, nearly 59% of cancers are now caught early⁷ - the highest ever level recorded. As Table 1 illustrates, routine screening is expanding in many markets, with new tests for multiple cancers on the horizon.
Table 1: Examples of cancer screening ages and screening age expansions
Source: Compilation of statistics from Oncolibrary⁸ and OECD⁹; USPSTF = U.S. Preventive Services Task Force; ACS = American Cancer Society
Table 1: Examples of cancer screening ages and screening age expansions
Source: Compilation of statistics from Oncolibrary⁸ and OECD⁹; USPSTF = U.S. Preventive Services Task Force; ACS = American Cancer Society
However, alongside this development is a worrying trend: cancer is being diagnosed in younger people at higher rates than ever before. Breast cancer incidence in women under 50 has increased by nearly 1.5% per year over the past decade¹⁰, and early-onset cancers worldwide are up 79% since 1990¹¹. The logical assumption may be that expanding screening programmes to include earlier age groups naturally results in detecting more cancers earlier in life. However, while this may lead to the discovery of some cancers earlier, data show that there are independent factors causing an increase in cancer incidence in younger people¹². Lifestyle changes, such as diets high in processed foods, greater environmental exposures to pollutants and toxins, and genetics all play their part. (For more on this topic, see a recent article by my colleague, Pieter De Richer: Does Everything Really Cause Cancer?).
Ipsos’ Global Oncology Monitor data speaks to this generational shift: the proportion of newly diagnosed and drug-treated patients under 55 in the US rose from 13% in 2020 to 18% in 2024. This trend was even more pronounced in certain cancer types, including cervical and testicular cancers [see fig. 1]:
Figure 1: % reported newly diagnosed US patients <55yrs receiving anti-cancer drug treatment, 2020 vs 2024 (select tumours)
Source: Ipsos Global Oncology Monitor (January 2020 – December 2024; US physicians reporting on drug-treated cancer patients; participating physicians were primary treaters and saw a minimum number of patients per month. Sample sizes / number of patients; n=2020; 2024: All solid & heam tumours (14,480; 20,692), Bone & Sarcoma (167; 245), Breast (1,911; 3,490), Cervical (136; 122), Melanoma (583; 1,188), Ovarian (259; 301), Pancreatic (373; 595), Testis (35; 66). Data collected online).
Figure 1: % reported newly diagnosed US patients <55yrs receiving anti-cancer drug treatment, 2020 vs 2024 (select tumours)
Source: Ipsos China Oncology Monitor (January – December 2024, physicians reporting on n=1,045 drug-treated never-smoker patients with NSCLC; participating physicians were primary treaters and saw a minimum number of patients per month. Data collected through pen and paper). Sample sizes / number of patients; n=2020; 2024: All solid & heam tumours (14,480; 20,692), Bone & Sarcoma (167; 245), Breast (1,911; 3,490), Cervical (136; 122), Melanoma (583; 1,188), Ovarian (259; 301), Pancreatic (373; 595), Testis (35; 66). Data collected online).
I’ve highlighted only the tumours where this notable uptick was observed. And it's also important to note that the Ipsos data captures only drug-treated patients, which may not reflect similar patterns in tumours typically treated with early surgery, e.g. colorectal cancer. Despite this, these numbers support the wider hypothesis that early-onset cancers are increasing.
Younger patients face unique challenges, from disruptions to career and family life to the psychological impact of confronting serious illness at a formative age¹³. Partners can become carers, parents take in adult children, and a new infrastructure of mental and social support needs to emerge to meet these needs. All of this underscores the importance of MCED tests, and other diagnostics that support early detection, becoming more widely available. Cancer screening ages may be decreasing, but screening programmes are still skewed towards older age groups overall. MCED tests can help detect cancers in younger people that may otherwise be overlooked until they progress.
Are we ready for the future of cancer detection?
Alongside technological advances that increase our diagnostic capabilities, the shift toward earlier and more proactive cancer detection is part of a broader global trend that Ipsos calls 'Conscientious Health.' According to the 2024 Global Trends report¹⁴, 68% of people worldwide actively seek out health information themselves, rather than relying solely on what doctors tell them. This growing appetite for self-education reflects a profound change in how individuals engage with their health: becoming empowered, informed, and often driving their own diagnostic journeys.
This cultural shift changes how we see ourselves, our bodies, and our futures. For some, it's a lifeline; for others, a source of new anxieties.
Either way, the abundance of information can overwhelm, and navigating trustworthy sources becomes critical. As new technologies like blood-based cancer tests become more available, individuals face complex decisions about when and how to use them, balancing hope, fear, and practical considerations.
Conclusion
Behind every statistic is a story, behind every test result, a life in flux. The challenge for all of us - patients, families, clinicians, and the wider healthcare and pharmaceutical industry - is to ensure that the promise of early detection leads not just to longer lives, but to better ones. Anticipating and responding to shifting patient demographics, changing treatment pathways, and the psychosocial needs of a new generation of cancer patients is a shared responsibility that touches us all.
My mother’s diagnosis and the stories that I hear changed the way I see my own body, my future, and the very notion of control over my health. And while I face my own screenings with a mix of dread and gratitude, I believe we need to approach this new era with both optimism and an open mind regarding the advances and potential new challenges. Early detection is more than a medical breakthrough; it is a profound cultural shift. Navigating it successfully demands that we harness its life-saving potential with wisdom and manage its human complexities with empathy.
To hear us discuss the benefits and challenges of early Alzheimer's diagnoses, listen to our podcast.
About the Research
The Ipsos Global Oncology Monitor is a physician-reported multi-client patient record database, capturing prescribing of anti-cancer and supportive care agents. Participating physicians are screened for specialty, level of seniority and number of drug-treated cancer patients seen per study wave and must be the primary decision-maker for their patients. Each wave, participants provide demographic information and de-identified information on a predefined quota of oncology patients (across solid and liquid tumours) seen in consultation, retrospectively. Data used in this article were collected online in the US; sample sizes are provided with the charts.
Data are © Ipsos 2025, all rights reserved.
References and further listening:
- Thiboldeaux, K. (2023) Valerie’s Story: How Early Cancer Detection Led to Pre-Symptomatic Diagnosis [Podcast]. 10th January 2023. https://grail.com/stories/podcast/valeries-story-how-early-cancer-detection-led-to-pre-symptomatic-diagnosis/ (Accessed 30th June 2025)
- Harrison, C.J., Spencer, R.G. and Shackley, D.C. (2019) ‘Transforming Cancer Outcomes in England: Earlier and Faster diagnoses, Pathways to success, and Empowering alliances’, Journal of Healthcare Leadership, Volume 11, pp. 1–11. Available at: https://doi.org/10.2147/jhl.s150924.
- Thiboldeaux, K. (2023) What did the PATHFINDER Study Reveal about Multi-Cancer Early Detection Testing? [Podcast]. 31st October 2023. https://grail.com/stories/podcast/13-what-did-the-pathfinder-study-reveal-about-multi-cancer-early-detection-testing/ (Accessed 30th June 2025)
- Harari, Y.N. (2018). 21 Lessons For The 21st Century. New York: Spiegel & Grau.
- Medefield: Data collected online from 1,204 general population respondents across France, Germany, Italy, Spain, UK and US in June 2025 on behalf of Ipsos. © Medefield
- Brown, H; Levent, A. (2024) Early Diagnosis of Alzheimer’s: Understanding the Bigger Picture. [Podcast]. 5th December 2024. https://www.ipsos.com/en/podcast-early-diagnosis-alzheimers-understanding-bigger-picture (Accessed 30th June 2025)
- NHS England (2025) Early cancer diagnosis in England reaches highest ever level. Available at: https://www.england.nhs.uk/2025/01/early-cancer-diagnosis-in-england-reaches-highest-ever-level/
- P53 Inc (2025) USA vs Europe: Who Does Cancer Screening Better? - OncoDaily, Oncodaily - Oncology News, Insights, Stories. Available at: https://oncodaily.com/oncolibrary/cancer-screening-usa-vs-europe.
- Health at a Glance 2023: Cancer screening (2023) OECD. Available at: https://www.oecd.org/en/publications/2023/11/health-at-a-glance-2023_e04f8239/full-report/cancer-screening_212c79aa.html#WHO201_b994cc975e (Accessed: 4 August 2025)
- Why are cancer rates rising among women under 50? (2025) City of Hope. Available at: https://www.cancercenter.com/community/blog/2025/01/younger-women-with-cancer-rates-rising
- Zhao, J. et al. (2023) ‘Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019’, BMJ Oncology, 2(1), p. e000049. Available at: https://doi.org/10.1136/bmjonc-2023-000049.
- Cancer Rates are Rising in Younger Adults. Here’s What You Need to Know (2019) Texashealth.org. Available at: https://www.texashealth.org/areyouawellbeing/Cancer/Cancer-Rates-are-Rising-in-Younger-Adults-Heres-What-You-Need-to-Know (Accessed: 24 July 2025).
- Cancer.org. (2020). Special Issues for Young Adults With Cancer. [online] Available at: https://www.cancer.org/cancer/types/cancer-in-young-adults/special-issues. [Accessed 17 Jul. 2025].
- Ipsos (2024) Global Trends. Available at: https://www.ipsos.com/en/global-trends-2024/conscientious-health-ipsos
