What We Learned from Talking to Clinicians About Early Liver Cancer Detection

Over the last several months, the OmicXHealth team conducted a series of structured interviews with hepatologists, gastroenterologists, oncologists, and clinical researchers as part of the regional NSF I-Corps program through UC Berkeley. Our goal was simple: to understand clinical decision making around liver cancer screening and uncover where current approaches fall short.

These conversations provided critical insight into how early detection works today and where innovation is urgently needed. Below are seven key lessons shaping our product and clinical strategy.

1. Screening decisions are made by hepatologists, not primary care.

We initially expected that family physicians would be the primary users of an early liver cancer test. Clinicians quickly corrected that assumption.

Once chronic liver disease is confirmed, patients transition to the care of a hepatologist who oversees screening, monitoring, and follow up including surveillance for hepatocellular carcinoma, or HCC. As a result, our development and integration strategy is now centered around hepatology workflow and clinical decision support within specialty care.

2. The barrier is not lack of interest. It is the lack of accurate tools.

Doctors are highly motivated to catch liver cancer earlier. However, current tools leave too much uncertainty.

The standard approach, which combines AFP blood testing and ultrasound, often misses early stage disease. This is especially true for patients living with obesity or fatty liver disease, two populations at increasing risk of HCC. Physicians want better diagnostic performance, and the message was clear: any new blood based test must demonstrate significantly higher sensitivity and specificity to change clinical practice.

3. Direct to consumer liver cancer screening is not viable today.

While direct to consumer testing has expanded in other areas of preventive health, liver cancer presents a different reality. Most high risk patients expect insurance covered care, and clinicians told us that self pay screening is not practical for the populations who need it most.

At this stage, the path forward involves clinical adoption and reimbursement, not consumer self ordering.

4. Monitoring treatment response and recurrence is a high value use case.

Patients who have survived liver cancer are highly engaged in their follow up care. Clinicians highlighted a clear need for blood based tools that can detect recurrence or assess treatment response earlier than imaging alone.

This population represents a motivated group with strong clinical justification for more sensitive monitoring, making it an important potential application for our technology.

5. Direct to consumer testing may be more feasible for multi cancer or post diagnosis testing.

Clinicians suggested that consumer directed testing could play a role in two areas

• Multi cancer early detection, where awareness and perceived value are higher

• Post treatment and survivorship, where patient motivation is strong

These insights will help guide future product pathways and partnerships.

6. Evidence requirements vary across clinicians.

Some specialists are willing to pilot new technologies backed by strong analytical validation and CLIA laboratory certification. Others prefer to wait for prospective, head to head clinical trial data before adopting a new screening tool.

Understanding these thresholds influences our clinical validation design and phased market entry strategy.

7. Awareness of liquid biopsy screening is still low, even among specialists.

Several clinicians were unaware that FDA approved blood tests already exist for colorectal cancer screening. One gastroenterologist told us:

"I still prefer colonoscopy because it is both diagnostic and therapeutic."

To drive adoption, new options must be clearly better than imaging based approaches and supported with strong education and evidence.

This performance standard guides the development of our liver cancer test.

Expert support strengthens our clinical direction

Two nationally recognized leaders in liver cancer care provided letters of support for our research grant applications and have agreed to serve as informal clinical advisors. Their perspectives reinforce the critical need for more sensitive early detection methods and the potential for blood based molecular testing to transform screening.

What comes next for OmicXHealth

These insights are directly informing our next phase of development as we move toward:

• Clinical pilot studies

• Broader validation with hepatology centers

• Evidence generation to support regulatory and reimbursement pathways

At OmicXHealth, we are committed to building a solution that meets the standard clinicians asked for: a test that detects early stage liver cancer when it is most treatable, with higher accuracy, greater consistency, and improved equity compared to existing options.

Onward.