According to GlobalData, in the US, 78 million individuals aged 50-75 years will undergo colorectal cancer (CRC) screening this year. With the US CRC screening test market expected to grow to $2.4bn by 2030, there is a strong drive to design innovative, minimally invasive, accurate cancer screening tools.

The recent Prevention of Colorectal Cancer Through Multiomics Blood Testing (PREEMPT) clinical trial, run by Freenome, enrolled more than 35,000 individuals. Freenome is a privately owned biochemical company that specialises in medical artificial intelligence (AI) platforms to detect cancers in their early stages. The Freenome test has a specificity and sensitivity of 94% for early-stage (I/II) colorectal adenocarcinoma. Their multiomics approach, moreover, incorporates tumour-derived and non-tumour-derived signals from various CRC markers to detect early-stage cancer.

The PREEMPT trial is designed to recruit a diverse patient pool by incorporating virtual and traditional recruitment, creating trial sites in every state, and gathering participants from different racial and socioeconomic backgrounds and both insured and noninsured individuals. In addition, Freenome worked with CVS Health Clinical Trial Services to reach patients who had scheduled colonoscopies to be included in this trial. This resulted in an 11.3% Black and 10.3% Hispanic study population, whereas most other CRC screening test clinical trials had 5% and 1%, respectively.

Environmental, social and governmental (ESG) issues will drive corporate strategies and operational decisions. According to GlobalData’s ESG Strategy Survey 2021, 86% of 1,500 ESG executives worldwide believe that ESG plays a major role in investment decisions. For example, Roche contributed nearly $600m in two funding rounds to back the PREEMPT trial. Because of this, GlobalData predicts there will be a rise in more inclusive clinical trials in the near future. Freenome’s ability to include individuals across racial and socioeconomic barriers during the Covid-19 pandemic should inspire future clinical trial design.

In this new generation of cancer detection technology combined with the increased importance of ESG issues, there will be positive changes in the layout of future clinical trials, investment opportunities and the collection of diverse data surrounding new medical devices.