Efforts to improve early cancer detection rates have been given a boost with a new major international alliance of researchers backed by £55m of funding.
The unit will bring together six universities and charities across the UK and the US to share expertise, ideas and resources to increase the scale of research.
The hope is to improve understanding of how cancer arises, develop tests and imaging techniques and design clinical trials to speedily bring innovations to the public. The earlier cancers are detected, the easier they can be treated and the better the chance of survival.
At present, there are routine screening programmes in the UK for bowel, breast and cervical cancer, while targeted screening for lung cancer is being piloted. But while experts say these programmes save lives there is more to be done: current methods do not pick up all cases while for many cancers no screening technologies exist.
“There’s still a major unmet need,” said Prof David Crosby, head of early detection research at Cancer Research UK, which is part of the alliance and is contributing £40m over the next five years. “In fact around half of cancers are still diagnosed at an advanced stage and the outcomes for those people are very poor.”
The £55m collaboration, dubbed the International Alliance for Cancer Early Detection (ACED), will also delve into knotty issues such as why many people skip screening appointments, and explore how new techniques can be made easily accessible.
“With this alliance one of the things that we are very committed to is taking things all the way through from the bench to the bedside,” said Prof Rebecca Fitzgerald of the University of Cambridge, another of the UK institutions.
There are even hopes it might one day be possible to offer a tailored approach to prevention whether through surgery or drugs.“There could eventually be drugs that we can give you that nip things in the bud because we can predict what is likely to go wrong in you,” said Crosby.
The alliance is looking to develop simple detection techniques based on blood, urine or even nasal swab samples, as well as working with sophisticated imaging techniques such as hyperpolarised MRI – this allows researchers to investigate how cancer cells generate energy and is showing promise in prostate cancer research.
Prof Robert Bristow of the University of Manchester, which is also part of the alliance, said another project involves collecting pre-cancerous cells, immune cells and blood vessel cells from individuals with tissues at high risk of cancer and 3D printing them. This will allow scientists to change conditions such as oxygen levels or nutrients to explore what might trigger cells to become cancerous – potentially shedding light on the characteristics of early cancers and even ways to prevent them.
“In a human being we never get to see a cancer being born,” said Crosby, adding that established cancers might behave differently to early ones. “If you can essentially give birth to a cancer in a piece of synthetic human tissue in the lab, you can see what it is like on day one and hopefully be able to detect and intercept it,” he said.
The researchers acknowledged that some routine screening programmes, including for breast cancer, have been criticised for over diagnosis – a situation where cancers that would not have caused harm are found, often leading to unnecessary treatment.
However, they say the alliance will explore techniques that will be better able to find problematic cancers, and distinguish them from those that are harmless – such as the use of MRI imaging to detect prostate cancer rather than traditional biopsies.
They are also looking at ways to identify people at high or low risk of certain cancers, meaning those at high risk could be offered more frequent screening than those at low risk.
The announcement of the alliance comes just weeks after it was found that cancer survival rates in the UK, while improving, are lagging behind those of other countries such as Norway, Canada and Australia. Sara Hiom, Cancer Research UK’s director of early diagnosis, said that is down to a number of reasons, including a lack of diagnostic staff that delays diagnosis.
“GPs need faster access to smarter tests, so that they only need to send people at the highest risk of cancer to hospital for further investigation,” she said. “ACED will aim to fast-track development of these types of tests and get them into clinical practice as soon as it is safe to do so.”