Trucheck blood test for cancer

What the test is

Many cancers shed a small number of cells into the bloodstream, sometimes at an early stage, before they cause symptoms. Trucheck, made by Datar Cancer Genetics, looks for these circulating tumour cells in a blood sample. If they are found, the laboratory also examines them for markers (features on the surface of the cells) that suggest where in the body they may have come from, which helps to decide which scans to do next.^[1]

The version I offer, Trucheck Intelli, looks for up to 70 types of solid cancer, the cancers that form a lump in an organ, such as cancers of the breast, bowel, lung, pancreas and ovary. It does not look for blood cancers, such as leukaemia and lymphoma.

Who it is for

The laboratory designed the test for adults aged 40 and over who have never had cancer and have no symptoms, and particularly for those with a family history of cancer or other reasons for a higher risk. Between the ages of 35 and 39 it can be considered only when there is a clear reason for a higher risk, such as an inherited gene change, and I record that reason on the request to the laboratory. A risk factor on its own does not always make the test suitable.

It is not part of NHS screening, and it does not replace it. Whatever your result, you should keep going to cervical screening, breast screening and bowel screening when you are invited.

What the evidence shows

Trucheck has been studied in large numbers of people. All the studies so far have been run with the company that makes the test, in its own laboratory, and I am not aware of a large independent study yet. The studies are observational, and none has yet shown whether having the test lowers the chance of dying from cancer. I explain the figures below so that you can weigh them for yourself.

In studies that tested people already known to have cancer alongside healthy people, the test found cancer cells in about 9 in 10 of those with cancer,^[1] including early-stage cancers.^[2]

In people without symptoms, which is how most people would use it, the most useful figures come from a 2026 study of 7,183 people who felt well.^[2] Of these, 44 had a positive result, about 6 in every 1,000 people tested. Of those 44, 16 were found to have an early-stage cancer, about 1 in 3; in 10, scans found no cancer, at least so far; and 18 were still being followed up when the study was written.

A negative result was reassuring in that study, but the follow-up was short, and no test finds every cancer.

Positive results without cancer were more common in other studies. In an earlier study of almost 14,000 people without symptoms, about 4 in every 100 had a positive result,^[1] and the laboratory’s own figures from everyday use put this at between 1 and 4 in every 100.

In people with conditions that are not cancer, about 1 in 5 had a positive result.^[2]

The conversation before the test

I always see you before the test, because the decision to have it deserves thought. We talk about your reasons for wanting it, your own and your family’s history, and whether there is a more suitable test for you, such as genetic testing if there is a strong family history. We go through what a positive and a negative result would mean, and what would happen next in each case, so that there are no surprises, and we decide together whether the test is right for you.

Some people decide, after that conversation, that the test is not for them. That is a perfectly good outcome.

Having the test

I offer Trucheck at the CRP Clinic in Epsom only. The blood sample is taken there on a Friday morning: two tubes of blood from a vein in your arm, which takes a few minutes. The sample is kept cool and sent to the laboratory the same day. If you have had a blood transfusion in the last ten days, the test should wait.

The result comes back in about 12 to 14 working days, and I telephone you to go through it. If the laboratory finds cells in the first sample, it asks for a second sample to confirm the finding before reporting the result as positive. If a sample gives an unclear result, the laboratory asks for a new blood sample.

If the result is positive

A positive result is not a diagnosis. It means there is a higher risk of a cancer being present, and further tests are needed to find out. The laboratory can sometimes tell which organ the cells it found are likely to come from, but not always. If it can, the next step is a scan aimed at that organ. If it cannot, the next step is a whole-body MRI scan. MRI uses a strong magnet and radio waves, not X-rays, so there is no radiation, and in one appointment it takes detailed pictures from the head down through the chest, abdomen and pelvis. I arrange these, and any further tests the scans point to, and refer you to the right specialist if anything is found.

The scans, any further tests and any further consultations are not included in the price of Trucheck. They are paid for in the usual way, through your insurer if you are insured and they agree to cover them, or by you. After a positive result, up to £1,000 of the cost of the recommended scans is refunded to you.

Waiting for further tests can be an anxious time. A whole-body scan also often finds small things that are harmless but need further tests to be sure.

Sometimes the scans find nothing: that may mean the blood result was a false alarm, or that a cancer is too small to see yet.

In that case the test can be repeated after three months and then every six months for up to two years. Each repeat test costs £300, and we would agree together whether that, or another plan, is right for you. These possibilities are among the main things to consider before having the test.

If the result is negative

A negative result means no cancer cells were found in your sample. It lowers the chance that you have one of the cancers the test covers, but it does not rule cancer out. Keep going to your NHS screening appointments, and see your GP about any new symptom without waiting for your next test.

The cost

The test costs £1,200. This covers the laboratory test, a consultation with me before the test, including counselling about what the result could mean, and one telephone call to discuss your result. Further tests, such as a scan after a positive result, and any further consultations are not included, although up to £1,000 of the cost of the recommended scans is refunded. Repeat tests during the two years of follow-up cost £300 each. Most insurers do not pay for screening tests in people without symptoms.