Cancer detection: how the early bird catches the cause.


New screening methods will increase the chances of detecting certain cancers early, when the disease is most likely to respond to treatment

Woman smiling

Better chances: cancer treatment can be more effective when the disease is found early

When it comes to saving lives, early detection is a critical part of modern medicine. The sooner a problem is identified, the more effectively it can be treated.

That’s why screening for cancer is just as important as the development ofnew drugs and surgical interventions.

Bowel cancer is the third most common type of cancer in the UK and more than 100 people are diagnosed every day. Death rates have been falling over the past four decades but it still kills around 16,000 people a year.

So the development of a one-off, five-minute test that can not only diagnose bowel cancer in its early stages but could also allow doctors to take preventative measures to stop it developing in the first place is an extremely exciting breakthrough.

For the past 16 years, Professor Wendy Atkin has been investigating just such a test. Known as flexible sigmoidoscopy – but more commonly called ‘flexi-scope’ or bowel scope – it uses a tube called an endoscope with a tiny camera and light at the end to look for cancers in the bowel and spot very early signs of the disease.

Many bowel cancers develop from symptomless growths called ‘polyps’. If the flexi-scope finds any polyps they can usually be removed quickly and painlessly, there and then – stopping cancer from developing.

Using data from her trial, Prof. Atkin estimated that the test could prevent at least 5,000 people from being diagnosed with bowel cancer every year and at least 3,000 people from dying from the disease. That’s a reduction of 43 per cent in the fatality rate in people who take up the screening.

Cancer Research UK (CRUK) has pushed for this test to be incorporated into the national screening programme for bowel cancer and in 2010 the English government committed to achieving this. The charity is pushing for it to be implemented across the country as quickly as possible. The flexi-scope has the potential to prevent a third of bowel cancers in people tested by catching any polyps early.

Meanwhile, CRUK scientists are researching potential ways to detect cancerous cells in the body before they have had chance to wreak havoc. Ovarian cancer is one type where treatment methods are improving all the time, yet mortality rates remain high.

“We are still losing the majority of women diagnosed,” says Professor Usha Menon, a leading CRUK scientist. “Now we must focus on detecting the disease early enough to put those treatments to work, before it’s too late.”

This is where biomarker research – a technique where cancer cells or substances that indicate cancer are picked up in blood samples – is showing huge promise. Scientists have already identified one marker substance called CA125 that is naturally produced in the body at low levels. But in women with aggressive forms of ovarian cancer those levels are found to have risen dramatically.

At the moment, doctors use standard cut-off levels of CA125 in the blood to assess whether ovarian cancer might be present in women showing early symptoms of the disease. However, what’s really important is how individual women’s CA125 levels change over time – because what might be a normal level of the substance for one woman, could be a sign of something wrong for another.

Prof. Menon is the lead researcher on trials looking into a more personalised approach.

“At the moment, any rise in its levels won’t be flagged-up as a potential problem unless they’re beyond what is considered ‘normal’ for all women,” she explains.

“Now, we are starting to use the biomarker in a more bespoke way, so that any increase at all will be investigated.”

The trial currently involves 200,000 British women. The results look promising and final analysis will be completed next year. If this shows that looking at individualised biomarkers really can save lives, it could form the basis of a screening programme for ovarian cancer.

Says Prof. Menon: “If it works then we have a commitment from the NHS to start an early detection programme, in the same way that women are currently screened for breast and cervical cancer. It’s an exciting development, which could save countless lives by getting treatment for women who need it, before it’s simply too late.”

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