What’s next for early cancer detection?

Cancer is often a gradual process

The conference opened with a keynote lecture from Professor Sam Janes (University College London), who discussed the early detection of lung cancer. His research aims to understand why rates of lung adenocarcinoma, the most common subtype of lung cancer, continue to rise while rates of squamous cell carcinoma are declining.

One fascinating finding was that some lung cells damaged by smoking can recover after smoking cessation. The research showed that squamous cells may be able to return to a healthier state once smoking stops, whereas basal cells appear less capable of doing so. This may explain the increase in the proportion of the adenocarcinoma subtype.

Professor Janes also highlighted that, even in people who have never smoked, lung cells accumulate an average of around 22 genetic mutations each year. Most of these mutations are harmless, but on rare occasions they can contribute to the development of cancer.

The data presented reinforced how cancer is often a gradual process that begins many years before a diagnosis is made. Understanding these earliest changes could help researchers identify opportunities for intervention long before symptoms appear.

The ‘golden triangle’ for clinical trials

During the afternoon panel session on inequalities in cancer early detection, a statement from patient representative Dave Kelsall particularly stood out. He highlighted that patients living within the M25 are often more likely to be offered opportunities to take part in clinical trials. Similar challenges can exist in Wales, where geography can create additional barriers to research participation. For example, brain tumour patients in North Wales may have to travel to Cardiff to take part in clinical trials.

Mr Kelsall’s comments prompted me to reflect on the role that we, as research funders, can play in addressing these challenges. Research-intensive centres such as London, Cambridge and Oxford have established infrastructure and strong track records that naturally attract significant investment. Institutions within this so-called ‘golden triangle’ received a significantly higher and disproportionate share of clinical trial funding from other UK-wide funding organisations in 2025/26. While these centres help drive scientific progress, as a research community we must also consider how to ensure that the benefits of research are accessible to all patients, regardless of where they live.

This is not only a question of fairness but also of scientific quality. If the patients taking part in clinical trials do not reflect the wider diversity of our population, it becomes more difficult to understand how new diagnostics, treatments or interventions will perform in real-world settings. Improving access to research opportunities across different regions and communities is therefore essential if we are to develop innovations that benefit everyone affected by cancer.

Europe accounts for 20% of worldwide cancer cases

The second day began with a thought-provoking session on emerging trends in cancer risk. Professor Freddie Bray from the International Agency for Research on Cancer (IARC) highlighted the growing global burden of cancer, noting that although Europe is home to just 9% of the world’s population, it accounts for more than 20% of all cancer cases worldwide.

My personal highlight of the day was a presentation by Dr Karl Smith Byrne, who offered a unique perspective as both a cancer researcher at the University of Oxford and a survivor of stage IV early-onset colorectal cancer. Dr Smith Byrne shared insights from his work on circulating proteins in the blood and how they could be used to improve the early detection of prostate cancer. His personal experience brought an added dimension to the presentation, serving as a powerful reminder of the real-world impact of cancer research.

Environmental exposures and cancer risk

The afternoon featured a fascinating presentation from Associate Professor Trang VoPham of the Fred Hutchinson Cancer Center in Seattle, whose research explores the relationship between environmental exposures and cancer risk. As a specialist in geospatial science, Professor VoPham has investigated how climate change-related factors, including increasingly frequent wildfires in the United States, may contribute to rising cancer incidence.

Her work also examines a range of other potential risk factors, including pesticide exposure and early-onset colorectal cancer, so-called ‘forever chemicals’, ultra-processed foods and, more recently, the impact of solar jet lag on liver cancer risk.

98% accuracy of detection

The standout presentation of the final day came from biomedical engineer Dr Daniel Heller of the Memorial Sloan Kettering Cancer Center. Dr Heller’s team has developed an innovative array of nanosensors capable of detecting proteins and other small molecules in blood plasma samples. The data generated by these nanosensors are then analysed using machine learning to produce a unique molecular ‘fingerprint’.

To date, the approach has been tested on more than 600 samples from both healthy individuals and patients with brain cancer. Remarkably, the test was able to identify the presence of brain cancer with an accuracy of 98%, although distinguishing between different brain tumour types remains more challenging. While further validation will be needed before tests like this can move into routine clinical use, the technology offered an exciting glimpse into what the future of cancer detection might look like.

Equally intriguing was the discovery that the molecular signals underpinning this brain cancer fingerprint extended beyond those already known to be associated with the disease. The nanosensor array also detected molecules involved in processes such as stress responses, immune activity and remodelling of the extracellular matrix, the network of proteins and other molecules that surrounds cells. These findings suggest that the test captures changes occurring across the wider tumour ecosystem, rather than focusing solely on the cancer cells themselves. This broader view could offer valuable new opportunities for detecting cancer at an earlier stage.

A commitment to improving patient outcomes

Although the topics covered during the conference were incredibly diverse, a common theme emerged: the future of early detection is likely to depend on bringing together multiple disciplines. Clinicians, laboratory scientists, engineers, data scientists and patients all have an important role to play in developing tools that are not only scientifically robust but also accessible to the people who need them most.

Attending the conference was a valuable opportunity to learn about the latest advances in early cancer detection and to connect with researchers from across the world who share a commitment to improving patient outcomes. I left Edinburgh with plenty of new ideas and insights to bring back to Cancer Research Wales. I hope that in future years we will see more Welsh researchers sharing their work and contributing to these discussions on the international stage.