Major study shows the psychological impact of early cancer screening is surprisingly small  

Multi‑cancer early detection (MCED) blood tests represent one of the most promising advances in cancer today. But with any new technology, and especially one with results linked to cancer, an important question follows: how do people emotionally and psychologically respond to the testing process, and receive results? 

The PATHFINDER study - one of the largest real‑world evaluations of MCED testing - offers insights, and ones that may surprise you.  

What is the PATHFINDER study? 

PATHFINDER is a large, prospective study, where participants were followed for a year. It was designed to understand how an MCED blood test, like the Galleri® test, performs in everyday clinical settings. The study included more than 6,600 adults aged 50+ across seven major U.S. health networks. All participants were healthy at the time of enrollment, with no symptoms or suspicion of cancer. 

While one of the main objectives of PATHFINDER was to study the time to, and extent of, diagnostic testing required to confirm the presence or absence of cancer, an additional aspect of the research focused on the psychological impacts during and after receiving MCED test results. 

Emotional measures evaluated 

Researchers examined patient‑reported outcomes, meaning they captured the emotional, psychological, and behavioural responses of participants after getting their MCED test result. To gather data, the team used multiple clinical tests to evaluate emotional impact, anxiety, overall life quality, and satisfaction with having taken the test.  

Distress, uncertainty and emotional impact  

Distress, uncertainty, and emotional impact were evaluated using the MICRA scale. The MICRA scale - short for Multidimensional Impact of Cancer Risk Assessment - is a validated psychological questionnaire used to measure how people emotionally and cognitively respond after receiving results from cancer‑related genetic or risk‑assessment tests.  

MICRA was originally created to evaluate the psychological impact of receiving genetic test results, particularly in individuals tested for BRCA1/2 and other hereditary cancer risks. It is used in adults (18+) who have undergone cancer‑related genetic or risk‑assessment testing. 

Anxiety  

Anxiety levels were evaluated using PROMIS anxiety reports, which are standardized, validated patient‑reported outcome measures used to assess the severity of anxiety symptoms in adults and children. 

PROMIS evaluates a wide range of anxiety‑related symptoms, from fear and panic, to worry and dread, nervousness and tension, hyperarousal (feelings of restlessness), and somatic symptoms like racing heart and dizziness. 

PROMIS Anxiety questionnaires ask people how often they experienced specific anxiety symptoms in the past 7 days. Responses follow a frequency scale such as: Never, Rarely, Sometimes, Often, Always.  

Overall quality of life  

The SF‑12 assessment - formally known as the 12‐Item Short Form Health Survey (SF‑12) - is a widely used, validated questionnaire that measures a person’s overall health‑related quality of life. The SF‑12 captures both physical and mental health status using 12 questions to produce two summary scores.  

It provides a Physical Component Summary (PCS), which reflects physical functioning, pain, general health, and ability to perform daily activities and a Mental Component Summary (MCS), which shows emotional well‑being, vitality, social functioning, and mental health. 

Screening satisfaction and likelihood of future cancer screening 

In addition to these scoring measures, PATHFINDER also evaluated study participants to understand their satisfaction with having taken the test and likelihood of continuing guideline‑recommended cancer screening. 

Participants completed these assessments immediately after getting their blood drawn for testing, after receiving their test result, and again at intervals over the following year. 

PATHFINDER psychological findings: emotional impact is real, short-lived, but also, empowering 

By tracking emotional responses, quality of life, and screening behaviours over a year following testing, researchers found that anxiety spikes were brief, day‑to‑day wellbeing stayed steady, and participants remained highly satisfied with the testing experience. In fact, the vast majority intended to keep up with guideline-recommended screening. 

Anxiety briefly increased after a positive test results - but returned to normal 

Participants who received a cancer signal detected result experienced a short‑term rise in anxiety. This happened both in: 

• True positives (cancer later confirmed), and 
• False positives (no cancer found) 

However, in all cases, anxiety returned to baseline within 12 months. This result shows that the emotional impact of getting a Cancer Signal Detected result happens but is temporary and small. 

Quality of life remained stable throughout the study 

Regardless of whether participants had a true positive, false positive, or negative result, and after receiving a Cancer Signal Detected result and diagnostic workup, their overall quality‑of‑life scores stayed within the normal range for the entire year. MCED testing did not appear to harm day‑to‑day wellbeing. 

People were overwhelmingly satisfied with the test 

The vast majority - 97% - said they were satisfied, very satisfied, or extremely satisfied with their MCED experience. Satisfaction remained high across all groups: 

• 97% of those with negative results 
• 92% of those with true positives 
• 82% of those with false positives 

Even people who received unexpected or stressful results still felt the test was valuable. 

MCED testing in additional to standard-of-care encouraged continued screening 

More than 95% of participants said they planned to follow their doctor’s recommended cancer screenings after the study. MCED testing should be done in addition to guideline-recommended screening, and almost all of the study participants indicated they plan to continue with them. 

What does this mean overall? 

The PATHFINDER study provides strong evidence that early cancer detection through MCED testing offers meaningful clinical value. Emotional downsides do exist, especially after a Cancer Signal Detected result, but are small and short‑lived, and most people were satisfied with their decision to do the MCED test afterwards.

Ultimately, PATHFINDER showed that MCED testing can deliver important clinical benefits with very little lasting patient distress. It remains a powerful tool for catching cancer early, when it’s most treatable. 

Take action 

The Galleri® test by GRAIL sets the standard for multi-cancer early detection and is ideal for those who are seeking a more proactive approach to cancer screening in addition to guideline-recommended cancer screenings. 

Through a single blood draw, this innovative, clinically validated test screens for 50+ cancer types, like pancreatic and ovarian cancer, before they become symptomatic, improving the opportunity for early diagnosis, when treatment can be most effective. Learn more. 

For deeper insights into the investigative mechanisms and outcomes of this research, you can learn more about this research here. 

This article was written by Medcan’s editorial team in collaboration the innovation team and with review and contribution from Medcan genetic counsellor, Justin Lorentz, and editors at GRAIL.

This content is for informational purposes only and should not be taken as medical advice. Please consult a Medcan clinician or your healthcare provider for guidance tailored to your health needs. 

Important Safety Information: The Galleri test is recommended for use in adults with an elevated risk for cancer, such as those age 50 or older. The test does not detect all cancers and should be used in addition to routine cancer screening tests recommended by a healthcare provider. The Galleri test is intended to detect cancer signals and predict where in the body the cancer signal is located. Use of the test is not recommended in individuals who are pregnant, 21 years old or younger, or undergoing active cancer treatment. Results should be interpreted by a healthcare provider in the context of medical history, clinical signs, and symptoms. A test result of No Cancer Signal Detected does not rule out cancer. A test result of Cancer Signal Detected requires confirmatory diagnostic evaluation by medically established procedures (e.g., imaging) to confirm cancer. If cancer is not confirmed with further testing, it could mean that cancer is not present or testing was insufficient to detect cancer, including due to the cancer being located in a different part of the body. False positive (a cancer signal detected when cancer is not present) and false negative (a cancer signal not detected when cancer is present) test results do occur. 

Lab / Test information: The GRAIL clinical laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and accredited by the College of American Pathologists. The Galleri test was developed and its performance characteristics were determined by GRAIL. The Galleri test has not been cleared or approved by the Food and Drug Administration. This test is not Health Canada or FDA approved, and has not been endorsed by any professional medical societies at this time. The GRAIL clinical laboratory is regulated under CLIA to perform high-complexity testing. The Galleri test is intended for clinical purposes.