{"entity":{"id":"idea-prev-lmic-five-cancer-methylation-test","kind":"idea","name":"A ten-dollar blood test for the five cancers that kill most people in poorer countries","aka":[],"tldr":"Most cancer deaths are in low and middle income countries, where scans and endoscopies are scarce. A cheap methylation blood test tuned to liver, stomach, oesophageal, cervical and breast cancer could fill the gap.","summary":"Most cancer deaths occur in low and middle income countries where scans and endoscopies are scarce, so this idea develops a narrow-panel targeted-methylation blood test, run on low-cost sequencing or PCR, tuned to liver, stomach, oesophageal, cervical and breast cancer at a marginal cost of around ten dollars. Current MCEDs cost far more and target the US cancer mix; narrowing the target set and using PCR cuts cost, and liver and gastric cancers shed methylated DNA relatively well. A positive result would lead to ultrasound or endoscopy. The test is case-control development then a prospective 20,000-person cohort in a high-incidence region, with IARC as a partner. Speculative in maturity, it addresses The hardest cancers are found late and Most of the world has almost no cancer care.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022)","url":"https://doi.org/10.1126/science.aay9040"}],"tags":[],"related":[],"cancers":["hcc","gastric","esophageal","cervical"],"sections":["early-detection"],"technologies":["mced","methylation-profiling"],"targets":[],"drugs":[],"companies":[],"institutions":["iarc"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-early-detection","b-global-access"],"keyPapers":["paper-crosby-science"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A five-cancer assay with marginal cost of $10 or less achieves at least 60% stage I-II sensitivity for liver, gastric and oesophageal cancer at 99% specificity, and is cost-effective at LMIC thresholds.","rationale":"Narrowing the target set and using PCR rather than deep sequencing sharply cuts cost; liver and gastric cancers shed methylated DNA relatively well.","test":"Case-control development, then a prospective 20,000-person cohort in a high-incidence region.","maturity":"speculative","actor":"philanthropy","cost":"medium","horizonYears":6},"route":"/ideas/idea-prev-lmic-five-cancer-methylation-test/","neighbours":{"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"methylation-profiling","kind":"technology","name":"DNA methylation profiling","route":"/technologies/methylation-profiling/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"}],"institution":[{"id":"iarc","kind":"institution","name":"International Agency for Research on Cancer (IARC / WHO)","route":"/institutions/iarc/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"paper":[{"id":"paper-crosby-science","kind":"paper","name":"Early detection of cancer","route":"/key-papers/paper-crosby-science/"}],"roadmap":[{"id":"global-access-roadmap","kind":"roadmap","name":"Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation","route":"/roadmaps/global-access-roadmap/"}]}}