Personalized CBC Testing Could Help Diagnose Early-Stage Diseases in Healthy Individuals

A complete blood count (CBC) screening is a standard examination most physicians request for healthy adults. This test is essential for evaluating a patient’s overall health with a single blood sample. Currently, CBC results are interpreted using a universal reference interval, but a new study suggests this approach may overlook critical health deviations. The study, published in Nature, found that these reference intervals, or setpoints, are individualized and that one healthy patient’s CBC setpoints can differ from 98% of other healthy adults.

While CBC indices can change due to factors like genetics, medical history, and age, this new study, led by researchers from Mass General Brigham (Somerville, MA, USA), suggests that each patient has a specific “setpoint”—a baseline value around which measurements naturally fluctuate. By considering these personalized CBC setpoints, doctors could identify early-stage diseases in otherwise healthy adults, such as diabetes, heart disease, and kidney failure, which could greatly benefit from early detection and intervention.

The study demonstrated that setpoints offer a two- to four-fold relative risk stratification for several diseases, comparable to that of conventional screening methods. The researchers highlight that this discovery opens new avenues for studying how CBC thresholds vary among individuals. Additionally, the information from CBC setpoints could be used to design more targeted treatment plans and help determine whether further screening is necessary for accurate diagnosis.

“Complete blood counts are common tests, and our study suggests CBCs vary a lot from person to person even when completely healthy, and a more personalized and precision medicine approach could give more insight into a person’s health or disease,” said senior author John Higgins, MD, of the Center for Systems Biology and Department of Pathology at Massachusetts General Hospital. “The long-term stability and patient-specificity of setpoints may provide new opportunities for the personalized management of healthy adults envisioned by precision medicine.”