Providing independent clinical excellence since 2005
Posted on Monday November 2, 2026 in Diagnostic & Health Screening
Beyond the Heart: Should We Be Screening for Cancer Before Symptoms Develop?
Advances in cardiovascular prevention are reshaping how proactive clinics think about cancer detection — and what that means for your patients and yourself.
For busy people, or to tune in when on the move, a Google NotebookLM audio podcast is available as a story beneath.
The patient sitting in front of me had no symptoms. He was fifty-four, a non-smoker, with a total cholesterol his GP had declared entirely satisfactory and a blood pressure hovering just below the threshold for treatment. By every conventional metric, he was fine. A coronary CT scan told a different story: significant plaque burden in his left anterior descending artery, and a fat attenuation index measurement placing him in a high-risk category for a cardiovascular event within the next decade. He left that appointment on a statin, an antihypertensive, and with a clear plan — and asking a question I now hear regularly: if we can find heart disease before it causes symptoms, why can’t we do the same for cancer?
It is a reasonable question, and one that has fundamentally shaped how Surrey Cardiovascular Clinic has evolved. Central to our preventive programme is the Fat Attenuation Index, or FAI — developed at Oxford and commercialised by Caristo Diagnostics — which uses information already contained within a standard coronary CT to assess inflammation in the fat surrounding the coronary arteries. The landmark CRISP-CT study, published in The Lancet in 2018, demonstrated that elevated FAI was associated with significantly increased cardiovascular mortality over five years. The ORFAN study, published in The Lancet in 2024, extended and strengthened that association, establishing FAI as a clinically meaningful prognostic tool.
The same metabolic milieu that accelerates coronary atherosclerosis is also associated with an increased risk of colorectal, pancreatic, and endometrial malignancies. It was this overlap in risk profile that led SCVC to introduce the Galleri multi-cancer early detection blood test as an optional component of its proactive health screening programme.
Galleri, developed by GRAIL, detects cell-free DNA shed by tumour cells and uses methylation patterns to predict where in the body a signal originates, across more than fifty cancer types, the majority of which have no current NHS screening programme.
The PATHFINDER 2 study reported a positive predictive value of approximately forty percent, which compares favourably with most screening tests in unselected populations. The NHS-Galleri trial, enrolling approximately one hundred and forty thousand participants, was more sobering: detection rates were meaningful, but the trial was not powered to demonstrate a reduction in cancer mortality within its initial reporting period, and the NHS concluded the evidence was insufficient for population-wide adoption.
This is not a reason to dismiss Galleri — it is a reason to counsel patients honestly. A negative result does not exclude cancer; sensitivity across all stages, particularly stage one, remains incomplete. The NHS’s caution reflects legitimate concerns about population-scale economics and false-positive harm. It does not negate the potential value of the test for an informed, motivated individual who understands its limitations and would act on an early signal if one were found.
The clinical overlap I see most consistently is in men in their mid-forties to mid-sixties presenting with visceral obesity, borderline testosterone, insulin resistance, erectile dysfunction, and declining energy. Erectile dysfunction in a man of fifty with cardiovascular risk factors is not simply a quality-of-life issue — it is frequently an early marker of endothelial dysfunction, the same process that precedes clinically apparent coronary artery disease. I treat it as a prompt for thorough cardiac assessment.
The NHS does not operate a national prostate cancer screening programme. The major European randomised trial, ERSPC, showed a significant reduction in prostate cancer mortality with PSA screening, but at the cost of substantial overdiagnosis. What has shifted the calculus is the widespread adoption of multiparametric prostate MRI and the PI-RADS scoring system, which stratifies findings from one to five by suspicion level. An abnormal PSA now typically leads to MRI before biopsy, substantially reducing unnecessary invasive investigation. For men who understand this landscape, an informed decision-making conversation is entirely appropriate. The NHS’s position reflects the difficulty of rolling this out equitably at population scale. It does not mean an informed individual should be denied the opportunity to decide for himself.
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https://www.scvc.co.uk/diagnostic-health-screening/cardiologists-evolving-tools/
https://www.scvc.co.uk/diagnostic-health-screening/game-changing-cardiology-technologies-2023/
https://www.scvc.co.uk/diagnostic-health-screening/types-of-ct-to-diagnose-chd/
https://www.vat-trap.com/post/can-we-use-ai-to-predict-cardiovascular-death
https://www.scvc.co.uk/diagnostic-health-screening/mens-health-cardiovascular-clinic/
Blog post:
https://www.scvc.co.uk/diagnostic-health-screening/cancer-screening-cardiovascular-prevention/
Referenced version (UK English only):
https://mhaat.vercel.app/s-cancer-screening-cardiovascular-prevention.html
Wix / SCVC embeds — supplied as separate files in the download, not in this document:
s-cancer-screening-cardiovascular-prevention-aicp-ref-embed.html — referenced-edition card + AI Companion Pack (top of the article)
s-cancer-screening-cardiovascular-prevention-aicp-embed.html — AI Companion Pack only
Atrial fibrillation is common, especially with increasing age, and in most cases it can be managed safely and effectively. Understanding your type of AF, your stroke risk and your treatment options allows care to be structured and reassuring, helping you live confidently and well with the condition.
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