Early Cancer Detection: New Algorithms Revolutionize Primary Care

Two groundbreaking predictive algorithms have been developed to help General Practitioners (GPs) identify patients who may have undiagnosed cancer, including hard-to-detect liver and oral cancers. These advanced models use information about a patient’s health conditions and simple blood tests to accurately predict their chances of having an undiagnosed cancer.

The National Health Service (NHS) currently uses algorithms like the QCancer scores to combine relevant patient data and identify individuals at high risk of having undiagnosed cancer, allowing GPs and specialists to call them in for further testing. Researchers from Queen Mary University of London and the University of Oxford have created two new algorithms using anonymized electronic health records from over 7.4 million adults in England.

The new models are significantly more sensitive than existing ones, potentially leading to better clinical decision-making and earlier cancer diagnosis. Crucially, these algorithms incorporate the results of seven routine blood tests as biomarkers to improve early cancer detection. This approach makes it easier for patients to receive treatment at much earlier stages, increasing their chances of survival.

Compared to the QCancer algorithms, the new models identified four additional medical conditions associated with an increased risk of 15 different cancers, including liver, kidney, and pancreatic cancers. The researchers also found two additional associations between family history and lung cancer and blood cancer, as well as seven new symptoms of concern (itching, bruising, back pain, hoarseness, flatulence, abdominal mass, dark urine) associated with multiple cancer types.

The study’s lead author, Professor Julia Hippisley-Cox, said: “These algorithms are designed to be embedded into clinical systems and used during routine GP consultations. They offer a substantial improvement over current models, with higher accuracy in identifying cancers – especially at early, more treatable stages.”

Dr Carol Coupland, senior researcher and co-author, added: “These new algorithms for assessing individuals’ risks of having currently undiagnosed cancer show improved capability of identifying people most at risk of having one of 15 types of cancer based on their symptoms, blood test results, lifestyle factors, and other information recorded in their medical records.”

In a bid to improve bowel cancer outcomes, Australia has lowered its starting age for screening from 50 to 45 years old. While this move is expected to lead to better results, it will also put additional pressure on an already strained healthcare system.

Flinders University researchers have sounded the alarm, warning that the expanded screening program could lead to a surge in younger adults requiring ongoing surveillance with regular colonoscopies. In response, the team has reviewed current clinical guidelines for at-risk individuals and explored alternative approaches to better meet their needs.

A new study led by Flinders University reveals a shift in how bowel cancer surveillance might be approached using faecal tests. This approach could provide extra peace of mind for those at risk, particularly younger adults who are more concerned about bowel cancer despite it being traditionally viewed as an “older person’s disease”.

The researchers surveyed almost 300 people at risk for bowel cancer and found that most participants, regardless of age, wanted more frequent bowel cancer surveillance than what is currently recommended. A significant percentage preferred more frequent colonoscopies, with many supporting the incorporation of faecal tests between surveillance colonoscopies.

The study highlighted the role of fear in influencing surveillance preferences, with younger adults reporting higher levels of fear regarding bowel cancer and a preference for more frequent monitoring. This suggests that healthcare providers might want to consider this psychological aspect when providing care for younger adults at risk.

The researchers proposed adding faecal tests into existing colonoscopy-based surveillance protocols to allow for personalized strategies that extend the time between colonoscopies for those with negative results. Such an approach could meet the needs of patients wanting closer monitoring while also optimizing resource use in healthcare systems.

As early-onset bowel cancer continues to rise, this study reinforces the urgent need to adapt and update surveillance strategies to suit younger adults. Traditional guidelines often do not address the specific concerns and preferences of this demographic, which is becoming increasingly significant as screening eligibility ages are lowered.

By tailoring bowel cancer surveillance to individual needs, healthcare providers can improve patient outcomes while also optimizing resource use in a changing healthcare landscape.

The article highlights a substantial decrease in breast cancer deaths among young women between 2010 and 2020. Analyzing data from the Surveillance, Epidemiology, and End Results (SEER) registry, researchers found that incidence-based mortality declined from 9.70 per 100,000 women in 2010 to 1.47/100,000 in 2020 across all subtypes and racial/ethnic groups.

Luminal A had the most pronounced decline among the four subtypes, with a notable drop in 2017 (-32.88% annual percent change). Triple-negative breast cancer also showed a similar trend, with its largest decline in 2018 (-32.82% APC).

The analysis revealed that the declines became more pronounced after 2016, likely reflecting advancements in treatment options and greater access to care and screening. The study’s findings suggest that there are opportunities for further improvement, particularly in reducing disparities.

However, the research also identified some unexpected trends. Among women aged 20-39, luminal A had lower 10-year survival rates than luminal B, which was unexpected as luminal A is generally considered the least aggressive subtype with the most favorable prognosis.

The study’s limitations include a follow-up time limited to 10 years and a relatively smaller number of breast cancer deaths in some racial/ethnic groups. Despite these limitations, the research provides valuable insights into recent trends in mortality rates among young women and highlights the need for further investigation into understanding tumor biology and molecular mechanisms driving carcinogenesis and treatment response in younger women.

The article concludes by emphasizing the importance of continued research to ensure further reduction in breast cancer mortality, including research into population-based screening in women aged 40-49 and targeted screening in younger high-risk women. Additionally, it advocates for access to high-quality treatment and care for all women.