World Cancer Research Day – Addressing poor survival rates through earlier diagnosis

Early diagnosis is one of our four pillars of research, because when cancer is diagnosed earlier, it’s easier to treat, manage and cure. In turn this will lead to better outcomes for cancer patients and help ensure that those we love the most are given a longer and better quality of life.

We are committed to finding solutions that detect cancer at the first point of contact, solutions that increase the accuracy of diagnosis, and remove any barriers to early access to the right healthcare.

This month, researchers supported by Cancer Research Wales have published the initial results of a study assessing a new blood test, which has shown remarkable accuracy in detecting bowel cancer. Known as the Raman project, this Cancer Research Wales funded study is set to change the landscape of the diagnosis of bowel cancer in Wales and further afield.

Bowel cancer, also known as colorectal cancer, is one of the most common types of cancer in Wales, with around 2300 cases diagnosed every year. Unfortunately, bowel cancer is often diagnosed late, with over a quarter of cases diagnosed at Stage 4, the most advanced stage. This represents a major problem for health services and there is an urgent need for better methods of detecting bowel cancer earlier.

The gold standard diagnostic test for bowel cancer is a colonoscopy, but services are struggling to cope with demand. This problem has been exacerbated by the Covid-19 pandemic, during which many services were shut down leading to a large backlog of patients. The number of patients on the colonoscopy waiting list today is almost 8000, more than double the 3200 patients pre-pandemic. The figures above demonstrate a clear need for new ways to reduce the burden on colonoscopy services and a need to tackle the unacceptable delays facing patients.

Faecal immunochemical testing (FIT), which looks for the presence of haemoglobin in faeces, was introduced in 2017 for use in patients with low-risk symptoms and has proven a useful tool for GPs. However, FIT is unpleasant to conduct and so has a poor uptake rate with patients, as well as not being cancer specific, so there is obvious potential for a more acceptable and more specific test to be developed.

Supported by Cancer Research Wales from its initial conception as a PhD project through to the current study, the Raman blood test is the product of the research group of Professor Dean Harris and Professor Peter Dunstan at Swansea University. The test uses a technique called Raman spectroscopy to analyse a blood sample taken from the patient - this generates a ‘biochemical fingerprint’ which is assessed by artificial intelligence to determine the likelihood of bowel cancer being present.

In the new study, published in the British Journal of General Practice Open, over 500 patients with suspected bowel cancer were recruited from primary care to have the Raman blood test as well as the gold standard colonoscopy, allowing the accuracy of the Raman blood test to be assessed. From this group of patients, the Raman blood test correctly detected bowel cancer an impressive 96% of the time. For those patients with advanced bowel cancer (Stages 3 and 4) this was 100%, compared to around 80% for FIT.

These results show that the Raman blood test has the potential to be highly effective in prioritising patients for colonoscopy, ensuring those who have cancer can receive a confirmed diagnosis as quickly as possible. The test also has the potential to significantly reduce the burden on colonoscopy services. Currently only around 1 in 10 colonoscopies actually lead to a bowel cancer diagnosis – by using the Raman blood test, those patients with a negative result can avoid having an unnecessary colonoscopy, freeing up capacity to help deal with the demand.

The results here represent a pilot study, and a follow-up study with much larger numbers of patients is ongoing. The nature of this work, which replicates how the test would work in a primary care setting, gives it the best chance of being embedded into NHS practice. It is hoped that the accuracy of the Raman blood test, both in detecting and ruling out bowel cancer, will continue to improve as the artificial intelligence analyses more patient samples and becomes better at recognising the ‘biochemical fingerprint’ of cancer. If so, the test promises a fast, simple and highly accurate tool for GPs that will ensure future bowel cancer patients can be diagnosed earlier.

It is well known that the sooner cancer can be diagnosed, the better the outcome is likely to be. The work of Professor Harris and Professor Dunstan is a perfect example of the kind of innovative research that is happening, both in Wales and around the world, to find new ways of detecting cancer earlier. This, World Cancer Research Day, let’s come together to support life-saving research that offers hope to cancer patients of the future.