Early Detection of Cancer- Cancer research UK Flashcards
What is early detection and diagnosis research?
Research which seeks to enable the detection of consequential cancer, or pre- cancerous states, at the earliest possible time point at which an intervention might be made, seeks to understand the role of patients, healthcare professionals and healthcare providers in cancer diagnosis, and to develop diagnostics in a population or clinical context.
What does early detection and diagnosis research include?
- Discovery and validation of marker signatures which detect (and prognose/stratify)
- Developing technologies which will enable detection of robust, informative signals
- Translational and clinical research; proof of concept for new ED&D approaches
- Utility and health economic impact
- Influence patient/clinician behaviour
- Policy/health system delivery
To detect cancers at the earliest possible stage, we need to find what?
A small number of cancer cells amongst trillions of healthy cells. Ideally, we would want to know where the cancer is and if the cancer will be consequential or benign.
What are the considerations for early detection tests?
- Who is the target? (e.g. monitoring high risk individuals, screening the general population)
- What is the sensitivity? - A sensitive test picks out cancer when it’s there so fewer cancers are missed (false negatives)
- What is the specificity? - A specific test doesn’t pick up something else and say it’s cancer by mistake (false positives)
- Where would the test be done (e.g. home, GP’s office, hospital)?
- What is the cost of the test and its implementation?
What can early detection tests measure?
1. Blood tests • CTCs • ctDNA • Genomic/methylation changes • Exosomes • Platelets • Proteins
- Faecal tests
• Blood
• Volatile organic compounds - Urine tests
• DNA
• Proteins
Other measurement modalities include breath and salvia. Cancer diagnosis may also
require imaging and would be confirmed with biopsies and pathology.
Earlier detection also raises what concern?
Over diagnosis and over treatment.
Want to identify abnormal cells that will lead to cancer, not cells that are very slow or non progressive to the extent that they may lead to cancer but the cancer will definetely not be the cause of death
What are challenges to the early detection field?
Bio and tech complexity
Fragmented expertise
Lack of visibility and identity
Poor industry and engagement
Lack of knowledge and exchange
Lack of scale
What are the challenges to the early detection of Colorectal cancer?
- Screening uptake not high, vague early symptoms often not reported to GP
- Some pre-cancerous growths (polyps) are difficult to detect through colonoscopy
- Lack understanding of links to inherited conditions
What are the opportunities for the early detection of Colorectal cancer?
- Low-cost, accessible alternative to FOBT/FIT and/or colonoscopy to improve screening uptake and diagnosis
- Mechanism to enhance sessile polyp visibility during colonoscopy
- Improved understanding of genetics of inherited predisposition, to identify at-risk families for screening
What screening methods are used for Colorectal cancer?
Faecal Occult Blood Test (FOBT) and now Faecal Immunochemical Test (FIT) every 2 years, age 60-74
What is used for the initial detection of Colorectal cancer?
Symptomatic FIT, Colonoscopy, CT Scan
What are the challenges for the early detection of pancreatic cancer?
• Lack of symptoms leads to late presentation
• Poor vasculature of tumours reduces take-up of
imaging contrast media
• Two types of pre-cancer lesion – not all
develop into cancer- Which will become malignant? And when?
What are the opportunities for the early detection of pancreatic cancer?
- Novel detection methods needed for asymptomatic cancer screening
- Method to enable risk-stratification of cystic pre-cursor lesions (preferably non-invasive)
- Approach for visualising microscopic lesions missed by CT scans
What is used to screen for pancreatic cancer?
Screening: No UK-wide programme
What is used for the initial detection of pancreatic cancer?
CT scan
