Identifying genetic variation of prostate cancer in Kenya
A move towards healthcare equality
Some cancers vary in their prevalence and aggressiveness through different populations across the globe. Prostate cancer is more common in different ethnicities; on average, one in four Black men will be diagnosed with the cancer compared with one in eight men from other ethnic backgrounds, according to Prostate Cancer UK. With the majority of research having been carried out in developed countries, primarily on White Europeans, it is currently unclear why varying patterns of mutations occur in different ethnic groups.
It is really important that we have equal attention paid to different ethnic groups within the UK, as well as overseas, because the development of cancer is actually different in different ethnic groups. (...) Nearly all genetic research in cancer has been carried out in developed countries and primarily on White populations, which leaves a massive gap in research
Professor David Wedge
David Wedge, Chair in Cancer Genomics and Data Sciences at The University of Manchester, is carrying out prostate cancer research to ascertain what mutations occur in prostate cancers in Kenyan men. He explains the global and local impacts he envisages this research having.
In partnership with researchers at the University of Nairobi, David and his team are collecting prostate cancer samples from Kenyan men, extracting and sequencing the DNA from the tumours.
As part of a large global consortium, the researchers will compare the patterns of mutations in prostate cancers from a series of different populations, with the aim of identifying which mutations are causing differences in the nature of the cancer, and to ascertain if these mutations are caused primarily by environmental factors or inherited genetics.
“Nearly all genetic research in cancer has been carried out in developed countries and primarily on White populations, which leaves a massive gap in research.
“We want to improve equality and access to good health care, but also to improve equality in terms of contributions to science.
“We also want to benefit scientists and clinicians in Kenya to spread the knowledge and the skills in terms of research,” David said.
Tumours arise through mutations within different genes and can be caused by various factors. Researchers have carried out previous studies looking at different subtypes of prostate cancer and have discovered that prostate cancers can be separated into two distinct groups based on the patterns of their mutations.
David explained: “If we do find unique mutation patterns, it would mean that we could very early on identify the key markers. These would be mutations in particular genes that are driving cancer growth within specific populations.
“If a pattern of mutations was unique to a particular ethnic group, or maybe was more common in a particular ethnic group, then it might become possible to tailor treatment towards that group.
“We think there may be some treatments which are more effective with some ethnic groups than others.
“So, we are moving towards more personalised cancer treatments, that might be partially directed by inherited genetics.”
Global and local impacts
The Kenyan population is a separate ethnic group to research populations that have been studied previously, and patterns of mutations will be compared with those from men from South Africa and other developing countries.
David hopes this ongoing collaboration will have a wider international impact, not only benefitting different ethnic groups globally, through greater understanding of individual cancer genetics, but also focusing on ethnic minorities within the population of Greater Manchester and engaging with local communities.
In this sense, developing an understanding of tumour development within different populations would act to inform the basis on which certain treatments were allocated to different ethnic groups.
“One of the biggest challenges is getting into the local communities and speaking to people and identifying what their concerns are and hopefully convincing people of the benefits of participating in our research programmes.”
“If we were tailoring the risk predictors to different ethnic groups and giving accurate estimates then we could get into communities and explain we do now have a test which is effective in different ethnic groups – that could be a driver for getting more equal access to screening.
“An important aim is to move towards much more equal access to health care, equal uptake of screening and equal access to early treatment because what we know about cancer is that the earlier it’s detected the better outcomes for the patients,” David suggested.
With an ethnically diverse population in Greater Manchester and a strong backbone of cancer research, particularly around genetics, David hopes to see research carried out equally on different ethnic populations to minimise healthcare inequalities and develop personalised treatments tailored to an individual’s cancer.