Screening shouldn't be one-size-fits-all. It should be based on your risk.
40% of cancers are tied to things you can change. The remaining 60% needs risk-stratified screening matched to your actual risk profile, not population averages. We build a three-generation family history, assign a risk tier for each cancer type, and create a screening calendar with evidence grading for every recommendation. You know exactly what to do, when to do it, and how strong the science is behind it.
How this protocol works
This isn't just testing. It's a coached cycle designed to get you where you want to be.
What we measure
Three-generation family history
Cancer-specific risk assessment
Cancer type, age at diagnosis, vital status, both maternal and paternal lines. A first-degree relative with early-onset cancer changes what you should screen for, when to start, and how often.
Risk-tier stratification
Tier 1/2/3 per cancer type
You may be Tier 1 (average risk) for one cancer and Tier 3 (high risk) for another. The screening calendar is personalized per cancer type, not a single blanket recommendation.
Validated risk models
Quantified, not guessed
Tyrer-Cuzick for breast cancer, USPSTF criteria for lung cancer, risk-stratified approaches for each cancer type. These are the tools oncologists use. We apply them before there's a diagnosis.
Guideline-concordant screening
The right test at the right time
Colonoscopy, mammography, PSA, lung CT, ordered based on your risk tier, not just your birthday. Each recommendation comes with an evidence grade so you know what's proven and what's promising.
Galleri liquid biopsy
Multi-cancer early detection (optional)
Screens for 50+ cancer types from a single blood draw. Promising, but honest context matters: overall sensitivity is about 50%, and randomized trial results on mortality reduction are still pending. We discuss limitations before ordering.
Modifiable risk factor review
Prevention, not just detection
Insulin resistance, visceral fat, chronic inflammation, vitamin D, physical activity, alcohol, tobacco. These markers from your other protocols feed directly into your cancer risk picture.
What’s different after this protocol
You have a cancer screening plan that actually fits your risk. Not the same colonoscopy-at-45 checklist everyone else gets. A plan where each recommendation is tied to your specific family history, your metabolic data, and a risk tier assigned per cancer type.
Every recommendation comes with an evidence grade. [A] means randomized trial data showing mortality reduction. [B] means strong observational evidence. [C] means expert inference, available if you want it, with an honest conversation about limitations. No guessing which tests are backed by real science and which are mostly marketing.
If advanced screening like Galleri or whole-body MRI makes sense for your risk profile, you’ll know. If it doesn’t, you’ll know that too. And the 40% of cancer risk that’s modifiable? Your work in other protocols is already addressing it. This one connects those dots.
What this protocol delivers
- A cancer risk tier for each major cancer type, based on your personal and family history
- A personalized screening calendar with evidence grading ([A], [B], or [C]) for every recommendation
- Prevention interventions tied to your specific modifiable risk factors, connected to your work in other protocols
- An honest assessment of advanced screening options (Galleri, whole-body MRI) and what the evidence actually supports for your risk level
- If genetic counseling is indicated: referral and coordination
- Reassessment built into your membership so the plan evolves as evidence and your data do
Standard screening follows age. We follow risk.
The standard approach to cancer screening is population-based. Colonoscopy at 45. Mammogram at 40. PSA… maybe. If you’re average risk, these guidelines work reasonably well.
But most people don’t know whether they’re average risk.
A first-degree relative with early-onset cancer changes everything: what you should screen for, when to start, how often. Dense breast tissue, BRCA status, insulin resistance, chronic inflammation, HPV exposure, each shifts your individual risk profile. And nobody is pulling all of this together into one plan.
Then there’s the technology problem. Whole-body MRI, liquid biopsy, AI-enhanced imaging, these tools exist, and the evidence for each varies widely. Some have randomized trial data. Some don’t. Knowing which is which matters more than which one sounds impressive.
We grade every recommendation so you can make real decisions instead of anxious ones.
How this works
Three stages: collect your risk picture, order the screens that match it, build the calendar you’ll actually use.
See what each stage covers
Cancer risk assessment. Your team collects a three-generation family history: cancer type, age at diagnosis, vital status, both maternal and paternal lines. Your personal risk factors are documented, including prior cancers, biopsies, radiation exposure, reproductive history, tobacco, alcohol, and sun exposure. Data from your other Protocol work is reviewed: inflammation markers, insulin levels, visceral fat, vitamin D, physical activity. Your physician assigns a risk tier per cancer type using validated models like Tyrer-Cuzick for breast cancer and USPSTF criteria for lung cancer.
Screening tests ordered. Based on your risk tier. Colonoscopy, mammography, PSA baseline, lung CT, whatever your risk profile calls for. Each test includes its evidence grade so you know exactly how strong the recommendation is. Optional advanced tests like Galleri liquid biopsy and whole-body MRI are discussed with an honest look at what the evidence supports and where it falls short. Prevention interventions are prescribed as well: smoking cessation, alcohol reduction, exercise reinforcement, HPV vaccination check.
Results and your screening calendar. All results reviewed with your physician. Your personalized screening calendar is built out: exact tests, timing, evidence grades, and next steps. Any findings requiring follow-up get referrals. The calendar is integrated into your annual Protocol reassessment so it stays current.
How we assign risk tiers
After your family history and data review, we assign a tier per cancer type. You might be Tier 1 for colon cancer and Tier 3 for breast cancer. The screening plan reflects that.
- Tier 1, average risk. Standard guidelines, standard intervals.
- Tier 2, elevated risk. Earlier start or closer intervals, or an added modality.
- Tier 3, high risk. Enhanced screening and, where it fits, advanced imaging.
What each tier looks like in practice
Tier 1, average risk. Follow evidence-based screening guidelines per age and sex. Standard intervals. No additional modalities needed.
Tier 2, elevated risk. Earlier screening onset, shorter intervals, or additional modalities. A family history pattern or personal risk factor puts you above population baseline.
Tier 3, high risk. Enhanced screening, genetic counseling referral, and advanced imaging where evidence supports it. This is where Galleri and whole-body MRI enter the conversation, with pre-test counseling about sensitivity, false positive rates, and what the current trial data does and doesn’t show.
How we grade evidence
Not all screening recommendations are created equal. We tell you which is which.
[A]. Randomized trial evidence for mortality reduction. This test has been proven to save lives. Do this.
[B]. Observational data or strong biological rationale. The evidence is solid. Recommended.
[C]. Expert inference. The test is available, the logic is sound, but the definitive trial data isn’t in yet. We’ll have an honest conversation about what you’re getting and what you’re not.
Galleri, for example, is a [C]. It screens for 50+ cancer types from a blood draw, but overall sensitivity sits around 50% and the NHS-Galleri randomized trial hasn’t reported mortality outcomes. That doesn’t mean it’s useless. It means you should know that before you pay out of pocket for it.
Common questions
Is this protocol right for me?
A few patterns fit. Cancer runs in your family and nobody has built a screening plan that reflects your actual risk. You've heard about Galleri or whole-body MRI and want a straight read on whether either makes sense for you, not a sales pitch and not a dismissal. Nobody has ever pulled your family history, your metabolic data, and your lifestyle into one cancer risk picture. If you're already working on insulin, inflammation, exercise, and vitamin D in other protocols, this is where those efforts show up as cancer prevention too.
How does this work?
Your team builds the risk assessment and screening calendar based on your family history, personal risk factors, and data from other protocols. Screening tests themselves (colonoscopy, imaging) are scheduled on their own timeline.
Should I get a Galleri test or whole-body MRI?
Maybe. The Galleri liquid biopsy is promising but the NHS-Galleri randomized trial results are still pending. No demonstrated mortality reduction yet. Whole-body MRI is available for high-risk members with counseling about false positive rates. We discuss both honestly, including what the evidence does and doesn't support. You decide.
Do I need to complete other protocols first?
No. But your results are richer with data from other protocols. Inflammation markers from Cardiovascular, insulin levels from Metabolic Health, body composition from Physical Capacity, and vitamin D from Nutrient Optimization all feed into your cancer risk assessment. If you start here, we work with what we have and fill gaps as you go.
Is this just more screening?
No. Most cancer prevention programs default to more tests for everyone. We match screening intensity to your actual risk. If you're Tier 1 for a given cancer, you follow standard guidelines. If you're Tier 3, you get earlier onset, shorter intervals, and additional modalities. The goal is the right amount of screening, not the maximum amount.
What comes after this protocol?
Cancer prevention connects to work you're already doing elsewhere. Insulin resistance from Metabolic Health is a growth factor for several cancer types. Inflammation markers from Cardiovascular Risk matter here too. Exercise volume from Physical Capacity reduces risk across many cancer types, and vitamin D levels from Nutrient Optimization factor into several risk models. Your team recommends what to prioritize based on your results.
What does this cost?
The risk assessment, tier assignment, and screening calendar are included in Protocol membership: $695/mo, or $7,500/yr prepaid (save $840). Advanced screening like Galleri and whole-body MRI are optional add-ons at member cost with counseling before ordering. The Foundation Assessment is the on-ramp: $1,500 standalone, included with annual membership.
From the Protocol blog
Cancer Prevention & Screening is coming soon.
This protocol isn't available yet. Book a discovery call and we'll tell you when it's launching, and which available protocol might be the right starting point for you now.
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