Test yourself
12 questions
01
According to the essay, what is the 'implied promise' that patients carry home from any screening programme?
AThat the test will detect all possible diseases
BThat a negative result means safety
CThat a positive result guarantees a diagnosis
The essay opens by distinguishing two promises: the explicit one (the test looks for something specific) and the implied one the patient carries home – that a negative result means safety.
02
How does the essay describe the public health infrastructure surrounding multi-cancer early detection, compared to established screening?
AIt has a well-developed framework modelled on mammography
BIt exists outside any established public health framing or patient education
CIt follows WHO-mandated guidelines for novel diagnostics
The essay states that multi-cancer early detection exists outside the infrastructure of established screening – no public health framing, no decades-long patient education programme.
03
What technology does the Galleri test use to detect cancer signals?
AProtein biomarkers in serum samples
BCell-free DNA with methylation patterns read by machine learning
CCirculating tumour cells captured by microfluidic filtration
The essay describes tumours shedding fragments of DNA into the bloodstream carrying methylation patterns that differ between cancerous and non-cancerous tissue, read by machine learning.
04
In the PATHFINDER study, how many of the 92 participants with a detected signal were ultimately confirmed as false positives?
A23
B57
C81
The essay cites that among 92 participants with a detected signal in PATHFINDER, 57 were ultimately confirmed as false positives.
05
What was the median time to diagnostic resolution for participants with a false positive result in the PATHFINDER study?
A42 days
B162 days
C365 days
The essay states the median time to diagnostic resolution was 162 days – five months of clinical investigation and psychological distress.
06
What is the essay's stated overall sensitivity of the Galleri test across all cancers and stages?
A99.5%
B78.3%
C51.5%
The essay states overall sensitivity across all cancers and stages is 51.5%.
07
According to the essay, what is the approximate sensitivity for Stage I cancers?
A51.5%
B17–20%
C35–40%
The essay states that for Stage I cancers, sensitivity is approximately 17–20%, meaning roughly four out of five Stage I cancers present at the time of testing will be missed.
08
The essay identifies the most underappreciated risk of a screening test with moderate sensitivity as:
AThe financial cost of repeated testing
BMissing cancers that are present and converting appropriate vigilance into inappropriate reassurance
CDetecting too many cancers that would never have caused harm
The essay argues the greatest risk is not finding things that aren't there, but missing things that are and thereby converting appropriate vigilance into inappropriate reassurance.
09
Why does the essay suggest the NHS-Galleri trial's primary endpoint may not capture the test's real benefit?
AThe trial was too small to detect a statistically significant difference
BA cancer caught early enough to prevent Stage IV may instead appear at Stage III, leaving the bundled III+IV composite unchanged
CThe test was administered too infrequently to catch fast-growing cancers
The essay explains that when the test shifts a cancer from Stage IV to Stage III, both fall within the same composite endpoint – so the test's success becomes invisible to the metric designed to measure it.
10
In the prespecified group of twelve high-mortality cancers, what reduction in Stage IV diagnoses did the NHS-Galleri trial find in the second and third screening rounds?
AGreater than 20%
BApproximately 10%
CNo measurable reduction
The essay cites a greater than 20% reduction in Stage IV diagnoses for the twelve high-mortality cancers in the second and third screening rounds.
11
The essay notes that the NHS-Galleri findings discussed are based on:
AA peer-reviewed publication in The Lancet
BA corporate press release, not yet peer-reviewed
CAn interim analysis presented at ASCO 2025
The essay explicitly states that everything in public discussion is based on a corporate press release, not a peer-reviewed paper, with full data expected at ASCO in late May or early June.
12
For which category of cancers does the essay argue multi-cancer blood testing has the strongest case for being additive?
ACancers where established population screening already exists, such as breast and bowel
BCancers that account for the majority of cancer deaths but have no existing screening programme
CAll cancers equally, because the test screens for over fifty types
The essay argues that for cancers like pancreatic, ovarian, liver, and oesophageal – where the current screening infrastructure is nothing – the question is whether a first-generation test is additive.
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