# A cancer blood test for older people arriving at A&E with unexplained symptoms

Source: https://onco.cc/ideas/idea-prev-emergency-department-cancer-test/  
OnCo record `idea-prev-emergency-department-cancer-test` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

One in five cancers in the UK is first found in an emergency, usually late. Adding a cancer test to the blood already taken in A&E for over-60s with vague symptoms could catch some earlier.

## Summary

Emergency presentation carries much worse survival, and these patients often attended A&E months earlier with non-specific complaints. Propose adding an MCED or targeted marker panel to blood drawn in emergency departments for patients aged 60 and over with weight loss, anaemia, or non-specific pain, with a defined follow-up route.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Emergency department add-on testing detects cancer in at least 3% of tested patients, with at least half at stage I-III, and reduces subsequent emergency-route diagnoses in the tested population.
- Rationale: Emergency-department patients have high pre-test probability and are already having blood drawn; the missed opportunity is documented in linked-data studies.
- Proposed test: Pilot in three emergency departments, 5,000 tests, registry-linked outcomes.
- Maturity: speculative
- Actor: clinic

## Sources

- Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022): https://doi.org/10.1126/science.aay9040

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- technologies: [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- key papers: [Early detection of cancer](https://onco.cc/key-papers/paper-crosby-science/)

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