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This Is The Big Reason America Is Losing The War On Cancer

November 2, 2016, 7:33 PM UTC
Fortune Brainstorm Health 2016
Fortune Brainstorm Health Wednesday, November 2, 2016 San Diego, CA 7:45 AM CONCURRENT BREAKFASTS: THE BIOPSY’S DANGEROUS CASCADE: HOW TO LESSEN THE NEED FOR INVASIVE TESTING Intervention Track Hosted By: Insigniam Current medical tests are too often marred by high rates of overdiagnosis (“false positive” results) or they too often miss the danger altogether (“false negatives”). Many common tests today are neither sensitive enough to catch disease-in-the-making or specific enough in their assessments, leading to a raft of follow-up tests and procedures. The testing “industry” is utterly ripe for disruption—but can new technologies truly do a better job than the current crop of lab tests and imaging scans? Several new tools, claim their inventors, can do just that—accurately diagnosing everything from the flu to Alzheimer’s and HIV. Here, sorting the hype from the reality. Firestarters:
Dr. Igor Barani, Chief Executive Officer, Enlitic 
Dr. Helmy Eltoukhy, Co-founder and CEO, Guardant Health Dr. Elad Gil, Co-founder and CEO, Color Dr. Crystal Mackall, Co-leader, Stand Up To Cancer-St. Baldrick’s Foundation Pediatric Cancer Dream Team and Associate Director, Stanford Cancer Institute; Co-medical Director, Standford Laboratory for Cell and Gene Medicine Dr. Gabriel Otte, Co-Founder and CEO, Freenome Inc. Moderator: Clifton Leaf, Fortune Photograph by Stuart Isett for Fortune Brainstorm Health
Stuart Isett Attribution-NonCommercial-NoDerivs Creative Commons

Here’s a not uncommon experience in medical care in 2016: A man goes to the doctor. He learns his PSA levels—or the amount of a protein produced by the prostate—are high, which is often the case in men with prostate cancer. The doctor can’t tell him what the patient’s elevated PSA reading means, and sends him to get a biopsy.

Then, the invasive and expensive procedure finds abnormal cells, but no sign of cancer. So he gets sent for a second, even more rigorous biopsy, with similar results. What does it mean? No one can tell him; no medical treatment is given.

Little has been gained in this fruitless medical investigation, yet it has cost the healthcare system a significant sum, and created considerable stress for the patient and his family. Are medical tests the solution or the problem?

The diagnosis from the group of cancer experts attending Fortune’s Brainstorm Health conference in San Diego on Wednesday: Both.

At a roundtable discussion involving two dozen of the field’s leading researchers, founders, CEOs and patient advocates, attendees agreed that new technology holds considerable promise, as rapidly advancing fields of machine learning and big data analytics could create more effective, less invasive tests to diagnose or detect risk for cancer. But the visions, so far, are far from the current reality.

And the excitement around these efforts reminds some of the high hopes that emerged with the mammogram and the PSA test.

“It was an absolute article of faith, a fairy godmother speech that if we could find cancer earlier we could cure that cancer,” said J. Leonard Lichtenfeld of the American Cancer Society. “It didn’t make the difference we thought it would.”

Lichtenfeld added, “Our technology science is moving ahead rapidly. Our applications science—what really makes a difference to impact health and save lives—not as quickly.”

Anna Barker, a professor at Arizona State University who heads up the National Biomarker Development Alliance, agreed. “The problem isn’t technology. We have hundreds of people that can detect changes in the genome.” The problem with tests is that we don’t have the proper tools to evaluate them.

“We need biomarkers,” she said, referring to biological markers that are used to measure a physical state or condition (like cholesterol and blood pressure). “We talk a lot about biomarkers, but the truth is we don’t have any. With cancer, we haven’t changed that much in terms of overall survival. The biggest problem is in biomarkers.”

That’s not for lack of identifying them. Barker notes that while there are 500,000 biomarkers published, less than one per year has been approved since 1993.