Prevention and Early Detection
Prevention and early detection is about combating cancer before the disease becomes too difficult to treat. Prevention is about understanding the causes of cancer, assessing cancer risk where possible and mitigating against the risks. Early detection relies on the ability to identify cancer in its infancy or in a pre-cancerous state, before the disease has spread and while it is still relatively easy to treat.
The ability to detect cancer sooner has a profound impact on patient outcome and survival. For instance, for UK patients diagnosed with lung cancer there is an 83% chance of one-year survival if the cancer is diagnosed at stage 1. However, this drops significantly to just 17% if the cancer is diagnosed in the latter stage 4.
Detecting potentially aggressive cancer in its earlier stages has been associated with better patient prognosis. While detection rates are increasing in many of the most common cancers such as breast, prostate and ovarian cancers, it is still the case that many are still only detected in the late stages of the disease. To detect cancer sooner, we need to find solutions to many current challenges. We need to identify multiple biological indicators that signal the development of the disease, and help us to develop smarter, more reliable screening methods to help locate cancers before they can spread throughout the body. We also need to make new strides in fields related to risk stratification in order to find those patients who are most at risk, offering precision prevention interventions as well as advancing diagnosis and modelling techniques.
Building on research heritage
Greater Manchester (GM) has a rich heritage in cancer prevention and early detection research. Professor Henry Kitchener was pivotal in progress in cervical cancer screening using HPV testing as a clinical and cost effective alternative to the cervical cytology smear test. He too played a role in the development of HPV vaccines for cervical cancer prevention
Professor Gareth Evans specialises in stratifying women for breast cancer risk and implementing prevention interventions to reduce their risk. Several studies led by Professors Evans and Tony Howell have resulted in changes to National Institute for Health and Care Excellence (NICE) chemoprevention guidelines and to modifications in the UK National Breast Screening programme.
The hugely successful Manchester Early Detection of Lung Disease (MEDLD) Pilot led by Dr Phil Crosbie and his team at Wythenshawe Hospital, where smokers, age 55-74, were invited to attend a community-based ‘Lung Health Check’ (LHC) in supermarket car parks in deprived areas of Manchester, resulted in NHS England announcing an £85 million investment in Lung Health Checks across England based on this Manchester model.
Further recent achievements include:
- In 2016, Manchester was awarded a ￡28.5m NIHR Biomedical Research Centre (BRC) including a Cancer Prevention and Early Detection Theme, one of seven within the Centre, with a specific aim to improve targeting of cancer prevention and early detection interventions.
- In 2019, The University of Manchester was made a founding member of the International Alliance for Cancer Early Detection (ACED), a new £55 million five-year partnership between Cancer Research UK, the Canary Center at Stanford University, The University of Cambridge, the Knight Institute at OHSU, University College London, and The University of Manchester.
Professor Gareth Evans is an international leader in cancer genetics, with a focus on neurofibromatosis and breast cancer. His research has led him to conclude that risk stratification offers the best way of targeting prevention and early detection (PED) approaches. Read about “Reducing the Risk” in this Cancer Futures article.
Driving changes in prevention and early detection strategy
The team aim to build on current strengths in GM leveraging the synergistic research power of a number of collaborative organisations using a Team Science approach. With support and funding from the NIHR Manchester BRC and ACED, PED research in GM is in a state of growth.
The team have an ambition to be world-leading in cancer PED research through interdisciplinary collaborations both locally and globally to leverage our capabilities and make the biggest impact.
The programmes of research will look to further develop and improve the accuracy of risk assessment models for priority cancers and provide effective risk reduction/early detection interventions. In collaboration with advanced materials facilities at The University of Manchester, researchers are investigating and modelling how cancer develops from a pre-cancerous cells to early stages of cancer. Exciting new areas of research include the early detection of gynaecological cancers through non-invasive methods, the number one priority for patients and public following the James Lind Alliance Priority Setting Partnership held in 2019.
In addition, researchers will explore new early biomarkers including epigenetics as a marker of risk, lifestyle interventions in multi-disease prevention and explore ways to engage young people with optimal lifestyle for cancer prevention later in life. A key priority is to engage with patients and the public at all stages of our research with a key objective to reduce health inequalities, improving connections and collaborations with community groups and patient, public involvement and engagement resource and expertise in Manchester, ensuring the right people are engaged with our research at the right time.
Where is our research performed?
Prevention and early detection researchers operate out of the following facilities across Manchester
- Cancer Research UK Lung Cancer Centre of Excellence
- Cancer Research UK Manchester Centre
- Centre for Health Economics
- Centre for Health Informatics
- Centre for Women’s Health
- Henry Royce Institute
- Institute for Population Health
- Lydia Becker Institute for Immunology and Inflammation
- Manchester Breast Centre
- Manchester Centre for Genomic Medicine
- Manchester Centre for Health Psychology
- Wellcome Centre for Cell Matrix Research