The fine print of at-home diagnostics
Hims & hers promises a medical future that is as simple as using an app on your phone. Hopefully, this starts the transition to becoming our healthcare that can be done anywhere.
Every year, millions of people get together to watch the Super Bowl. The majority for the game, many for the halftime show, but a group that watch the Super Bowl just for the advertisements. This year, many of those ads seemed to sell the same thing: a faster, easier, more convenient version of life.
Hidden away in the celebrity cameos and weight-loss ads, was a promise of a better medical future. Hims & Hers, the brand focused on individualized care targeting weight loss, skin care, mental health, and more, has recently expanded its capabilities into lab testing. More specifically, into at-home cancer diagnostics. Hims & Hers has announced a partnership with Grail, company, to develop the Galleri screening test, which can detect up to 50 cancers before symptoms arise.
Wait, a cancer diagnosis delivered without seeing anyone? Well, it’s not that simple.
Galleri is not a true at-home test, it cannot diagnose cancer on its own, and a positive result still requires follow-up medical testing. As companies market screening tools as part of a seamless digital health future, it is worth asking what these tests actually do and whether the advertising is getting ahead of the reality.
When I first heard about this test, my mind instantly thought of Theranos and its similarities. So, I started wondering how the Galleri test actually works.
Every cell comes with an instruction manual. This manual is your DNA, and it contains all the information to build/run a human body. But the cells don’t read every page at once, instead they use “sticky notes” to decide which sections to read and which to ignore.
In biology, these sticky notes are methyl (-CH3) groups that only attach to specific parts of DNA. This process, DNA methylation, is essential and normal for cells to work. However, in cancer, the sticky notes change, covering critical instructions that cause cells to stop working properly. The Galleri test analyzes DNA fragments in blood and detects abnormal patterns, offering a new way to identify cancer early.
However, the advertisement for at-home testing may be misleading. To obtain results, you either need to hire someone to draw your blood or visit one of the few testing centers nationwide. Not to mention, this test cannot diagnose you; it's a screening test. If the test results are positive or inconclusive, further testing is required. And their false positive rate is not as low as they claim. For every 20 people who test negative, one will test positive, and it can be very traumatic to receive a false positive for a cancer test.
However, this is a step in the right direction for at-home testing. Companies like Tasso have already been offering at-home blood draws that do not require any complex equipment. Tasso delivers kits directly to the user and applies the simple device to the upper arm. With the press of a button, the device can collect up to 5mL of blood without ever leaving your home. Tasso has even partnered with laboratories to measure wildfire smoke exposure in remote locations. At-home tests are now becoming possible, so Hims & Hers wasn’t too far off. They just aren’t an at-home test quite yet. So, there is a future where we can truly have at-home screenings, increasing the number of people who can test from anywhere. Maybe even while watching the future Super Bowls.
Maya Singh is a third-year PhD student in bioengineering at the University of Washington, where she focuses on creating low-cost tests to measure long-term HIV medication levels. She is passionate about being at the intersection of global health, engineering, and public policy to understand the impact of her work on people living with HIV.