# DETECT-A: a blood test plus PET-CT found treatable cancers in 10,000 women with no symptoms

Source: https://onco.cc/key-papers/paper-detect-a-science-2020/  
OnCo record `paper-detect-a-science-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

Twenty-six cancers were detected by the blood test, of which 17 were localised or regional and 12 were treated with surgery with intent to cure. 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.

It proved that a blood-first screening pathway can be safely operationalised and that many blood-detected cancers are at a curable stage.

## Fields

- Kind: Key paper
- Last checked: 2026-09-08
- Journal: Science
- Year: 2020
- DOI: 10.1126/science.abb9601
- Authors: Lennon AM, Buchanan AH, Kinde I, et al.
- 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; 12 patients had surgery with curative intent; 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
- What it means: 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

## Sources

- DOI: https://doi.org/10.1126/science.abb9601
- ClinicalTrials.gov NCT03934866: https://clinicaltrials.gov/study/NCT03934866

## Connected records

- key papers: [Cancer genome landscapes: about 140 driver genes, and each tumour needs only a handful](https://onco.cc/key-papers/paper-vogelstein-cancer-genome-landscapes-science-2013/), [PATHFINDER: the first prospective test of a multi-cancer blood test in people without symptoms](https://onco.cc/key-papers/paper-pathfinder-lancet-2023/)
- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- technologies: [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/), [PET/CT](https://onco.cc/technologies/pet-ct/)
- institutions: [Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center](https://onco.cc/institutions/johns-hopkins/)
- terms: [Cell-free DNA (cfDNA)](https://onco.cc/terms/cfdna/), [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [DETECT-A: a blood test plus PET-CT to screen 10,006 women with no symptoms](https://onco.cc/terms/detect-a-study/), [Positive predictive value (PPV)](https://onco.cc/terms/ppv/), [Stage shift](https://onco.cc/terms/stage-shift/)
- people: [Bert Vogelstein](https://onco.cc/people/bert-vogelstein/), [Kenneth W. Kinzler](https://onco.cc/people/kenneth-kinzler/), [Nickolas Papadopoulos](https://onco.cc/people/nickolas-papadopoulos/)
- bottlenecks: [Overdiagnosis and false alarms](https://onco.cc/bottlenecks/b-overdiagnosis/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- journals: [Science](https://onco.cc/journals/science/)

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