Flexible new method for early cancer diagnosis

Earlier discovery of cancer and greater precision in the treatment process are the objectives of a new method recently developed. | ScienceDaily

Screening of at-risk groups for certain types of cancer, leading to earlier diagnosis, is being described as an area with major potential, both with regard to saving lives and saving money within healthcare. No tissue samples are needed for the method, and the tumor does not even need to be located. Investments are now being made to roll out this innovation across healthcare and broaden the scope of the research in this field.

The technique was created based on the fact that people with cancer also have DNA from tumor cells circulating in the blood, molecules that can be discovered in a regular blood sample long before the tumor is visible via imaging such as tomography, MRI, X-ray and ultrasound.

The researchers have now increased the sensitivity of detecting tumor DNA in blood thousand-fold by eliminating the background noise from the measurements using “DNA barcoding.”

Full story at ScienceDaily

Link to the research: Anders Ståhlberg, et al. Simple multiplexed PCR-based barcoding of DNA for ultrasensitive mutation detection by next-generation sequencing.  Nature Protocols, 2017; 12 (4): 664

Prescription history could help GPs diagnose cancer earlier

“We want to develop a tool that helps GPs diagnose cancer earlier in the hope of saving more lives.”– Dr Jem Rashbass 

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Cancer Research UK-funded scientists are to examine whether identifying patterns in medication given to patients before they develop cancer could improve early diagnosis.

Looking for patterns in prescriptions and other data could help guide GP referrals, especially in patients with non-specific symptoms that don’t obviously indicate cancer.

Only about half of those with the most common cancers have “red-flag” symptoms. And this is even lower in cancers with poor survival rates such as pancreatic, stomach, ovarian and brain cancer.

This research is being led by Health Data Insight which has received funding through Cancer Research UK’s Pioneer Awards scheme. Together with Public Health England and the NHS Business Services Authority they have created an anonymous dataset of nearly all the primary care prescription data – approximately 80 million medications being prescribed each month.

The researchers will then link this information to data in the National Cancer Registration and Analysis Service to look for trends in medications given to patients before they were diagnosed with cancer.

Read more at Cancer Research UK

Organisational characteristics, teamwork & service delivery in lung cancer diagnostic assessment programmes

Honein-AbouHaidar, G.N. et al. (2017) BMJ Open. 7:e013965.

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Objectives: Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs.

Conclusions: This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes.

Read the full article here

Significant variation in A&E cancer diagnoses across England

Cancer diagnosis in accident and emergency departments are three times more likely in some parts of England than others | HSJ

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Public Health England data shared with HSJ shows the number of cancer diagnoses in emergency care, often when a patient has attended for another reason, vary from 11 per cent of all cancer diagnoses in one clinical commissioning area to 33 per cent in another.

The figures indicate which areas are better at detecting cancers at an early stage and in primary care services. The percentage of cancer cases diagnosed during an emergency visit to hospital is recognised as a proxy for the effectiveness of primary care.

The national average according to the most recent available data, for quarter three of 2015-16, is 20 per cent of cancer cases being diagnosed in A&E.

In the same period, South Manchester CCG had the highest rate of 33 per cent, compared to 11 per cent for North Somerset CCG, which was the lowest.

Read the full article here

Guide to cancer early diagnosis

This WHO Guide to cancer early diagnosis aims to help policy-makers and programme managers facilitate timely diagnosis and improve access to cancer treatment for all | WHO

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Image source: WHO

Detecting cancer early can effectively reduce the mortality associated with cancer.In resource-poor settings, cancer is often diagnosed at a late-stage of disease resulting in lower survival and potentially greater morbidity and higher costs of treatment. Even in countries with strong health systems and services, many cancer cases are diagnosed at a late-stage. Addressing delays in cancer diagnosis and inaccessible treatment is therefore critical in all settings for cancer control.

Early diagnosis strategies improve cancer outcomes by providing care at the earliest possible stage and are therefore an important public health strategy in all settings. The barriers that delay cancer diagnosis must first be identified and assessed, and these factors may originate from patients to carers to health systems. Effective programmes can then be implemented at various levels that include community engagement to address patient behaviour, improving diagnostic and referral capacity and ensuring access to timely, high-quality treatment.

Read the full report here

Immediate chest X-ray for patients at risk of lung cancer presenting in primary care

Neal, R.D. et al. (2017) British Journal of Cancer. 116, pp. 293-302

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Image source: Anthea Sieveking – Wellcome Images // CC BY-NC-ND 4.0

Background: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation.

Conclusions: We have demonstrated the feasibility of individually randomising patients at higher risk of lung cancer, to a trial offering urgent investigation or usual care.

Read the full abstract here

Cancer diagnosis in GP surgeries

Better GP access to cancer diagnostic tools would benefit doctors and patients, says RCGP |via OnMedica

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The Royal College of GPs has welcomed a £5 million grant aimed at giving GPs better access to cancer diagnostic tools. Cancer Research UK (CRUK), which is funding the research project, said having more effective ways to diagnose cancer in GP surgeries would save both doctors’ and patients’ time, and reduce anxiety for patients.

The charity announced its £5 million funding for the “revolutionary” CanTest project as part of its Catalyst Award, which it said “aims to help researchers from around the world deliver trailblazing progress in their field with long-lasting results”. CanTest will investigate and develop new ways for GPs, physician’s assistants and nurse practitioners to diagnose cancer in GP surgeries. It will assess the accuracy, cost effectiveness and suitability of a range of diagnostic methods and tools, with the aim of cutting both the wait for diagnosis and the number of referrals.

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