The Canon Event
Before the moment everything changes, there’s a chance to see it coming.
About Canon Events
In every person’s life, there are moments that condense everything that came before — and shape everything that comes after. These pivotal points leave a mark, clear as day, often remembered vividly for years. Millennials, like me, call them canon events. While many of these events are joyous — a birth, a graduation, a revelation — some are seared into memory for darker reasons.
For millions, that canon event is hearing three words: “You have cancer.”
Why Cancer, Why Diagnostics, Why Now
Why Cancer?
Cancer has been with us since the dawn of humanity. Egyptian mummies show signs of bone tumors, and Hippocrates described it 2,500 years ago. Today, despite decades of research, cancer remains the second leading cause of death worldwide, and the first in many high-income countries [1][2].
Yes, we’ve made major strides. U.S. death rates have dropped by roughly one-third since 1991, thanks to advances like immunotherapy (e.g., CAR‑T, checkpoint inhibitors), the HPV vaccine, and decreased smoking—saving over 4 million lives [3].
But these successes are not enough.
Once cancer spreads, even the best treatments often struggle. For most solid tumors, five-year survival rates drop sharply when diagnosed at Stage III or IV. And over the past two decades, improvements in late-stage treatment have slowed compared to earlier periods [4].
In pediatrics, the stakes are even more extreme. Childhood cancers are rarer, which makes research harder: fewer patients means smaller trials, and ethical constraints make them even more complex. Yet early detection here can be the difference between cure and tragedy. In acute lymphoblastic leukemia (ALL), the most common pediatric cancer, early diagnosis and appropriate treatment can push survival above 90% [5]. But delayed diagnosis narrows those odds.
Why Diagnostics?
Diagnostics are the beginning of every cancer story, and they shape everything that follows.
In the era of precision medicine and prevention, it’s becoming clear that if we want to improve cancer outcomes globally, we must start earlier. Early diagnosis is proven to boost cure probability by up to four times compared to late-stage detection [6]. For instance, the 5-year survival rate for colorectal cancer is over 90% when caught early, but drops to 15% when detected at Stage IV [7], and for breast cancer, the 5‑year survival rate is over 99 % vs ~31 % in late-stage [3].
That’s not just a medical difference. It’s a human one.
And it’s not only about when we detect, but how well. The right diagnosis can guide the right treatment — reducing over-treatment, under-treatment, and unnecessary suffering. For example:
HER2 testing in breast cancer helps match patients to trastuzumab (Herceptin) [8].
EGFR mutation testing in lung cancer guides targeted therapies like osimertinib [9].
Historically, cancer diagnosis meant a painful, invasive biopsy — often of tissue deep within the body. Biopsy remains the gold standard today, but it’s expensive, slow, and not always feasible (e.g., when tumors are inaccessible or patients are fragile).
Over the past 20 years, diagnostics have evolved dramatically. Imaging (CT, MRI, PET), molecular pathology, and next-generation sequencing (NGS) have transformed what we can detect and how early we can do it. The pace of improvement in diagnostics has far outpaced that of treatments — offering real hope for earlier, smarter interventions [10].
Today, newer methods include:
Liquid biopsy (using blood or urine to detect tumor DNA)
Circulating tumor cell (CTC) analysis
Exosome-based detection
Nanoparticle-based MRI enhancements
AI-enhanced imaging analysis
Multi-cancer early detection tests (MCED)
Liquid biopsy, in particular, shows immense promise. By analyzing tumor DNA fragments (ctDNA) in the bloodstream, it enables non-invasive, real-time insight into cancer’s presence, evolution, and treatment response. It’s fast, accessible, and scalable. And it's likely the next frontier in democratized cancer detection.
Why Now?
The U.S. is spending more on healthcare than ever — $4.5 trillion in 2022, or 17.3% of GDP, nearly 3x the OECD average [11]. Cancer alone cost the U.S. $208.9 billion in 2020, including treatment, lost productivity, and caregiving costs [12]. With an aging population and rising prevalence of chronic disease, this number will only grow.
Meanwhile, the era of AI is bringing new life to diagnostics. Deep learning has already proven useful in radiology and pathology — from detecting breast cancer in mammograms to spotting mutations in sequencing data. But clinical adoption has lagged. Many systems focus instead on administrative AI — billing, contract management, revenue cycle ops — while the clinical core remains under-automated.
That’s changing.
Breakthroughs in circulating tumor DNA, epigenetic profiling, and AI-enhanced data analysis have led to massive trials and regulatory wins. For example:
GRAIL’s Galleri test: detects >50 types of cancer from blood using methylation signatures [13].
Guardant Health’s Shield test: FDA-approved for colorectal cancer screening [14].
DYNAMIC trial (NEJM): showed ctDNA-guided treatment reduced chemotherapy without affecting outcomes in colon cancer [15].
This is where genomics, data science, and public health converge. For the first time, we have the tools to see cancer before it shows itself — from a simple blood draw.
Imagine 5 years from now: walking into your local pharmacy, getting a drop of blood drawn, and knowing — within days — whether cancer is silently growing inside you. Just like a pregnancy test, but for life itself.
That’s not science fiction. It’s what diagnostics is becoming.
Why This Series?
We’re writing this series to understand what’s coming — and what’s still missing.
We’re not oncologists. We’re a curious outsider and a clinician, joining forces to explore how diagnostics — especially liquid biopsy — could radically reshape outcomes. Our goal is to make these insights accessible to everyone: clinicians, investors, founders, policymakers, and patients alike.
We believe better diagnostics won’t just save lives — they’ll change what a cancer diagnosis means.
And maybe, just maybe, they’ll turn canon events into new beginnings.
References
WHO Cancer Fact Sheet (2024): https://www.who.int/news-room/fact-sheets/detail/cancer
CDC Leading Causes of Death (2022): https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Ezra Health Blog (2023): Why Early Cancer Detection Is Crucial for Effective Treatment — https://ezra.com/blog/why-early-cancer-detection-is-crucial-for-effective-treatment
SEER Data – Cancer Trends Progress Report (2022)
NCI: Childhood Acute Lymphoblastic Leukemia Treatment (PDQ)
NORC at the University of Chicago (2023): Just One in Seven Diagnosed Cancers Found Through Routine Screening — https://www.norc.org/research/library/new-research-highlights-just-one-in-seven-diagnosed-cancers-foun.html
American Cancer Society: Colorectal Cancer Survival Rates
Wolff et al., ASCO/CAP HER2 Testing Guidelines
Soria et al., FLAURA Trial, NEJM 2018
Nature Reviews Cancer: “Diagnostics vs Treatment – Where Progress Is Faster?” (2020)
CMS National Health Expenditures (2022)
NIH Cancer Costs and Statistics (2020)
Klein et al., Annals of Oncology 2021 – Galleri Performance Study
Guardant Health Press Release (2023)
Tie et al., NEJM 2022 – DYNAMIC Trial