Bowel cancer home testing

A major NHS England funded study is expected to almost halve the number of invasive procedures by 2020 by improving the accuracy of home-testing kits that detect bowel cancer from invisible amounts of blood.

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New device accurately identifies cancer in seconds

Handheld device can identify cancerous tissue in 10 seconds, with 96% accuracy. | story via ScienceDaily

A team of scientists at The University of Texas has invented a handheld device that quickly and accurately identifies cancerous tissue during surgery, delivering results in about 10 seconds. The MasSpec Pen is a handheld instrument that gives surgeons precise diagnostic information about what tissue to cut or preserve, helping improve treatment and reduce the chances of cancer recurrence.

In tests on tissues removed from 253 human cancer patients, the MasSpec Pen took about 10 seconds to provide a diagnosis and was more than 96 percent accurate. The technology was also able to detect cancer in marginal regions between normal and cancer tissues that presented mixed cellular composition. The team expects to start testing this new technology during oncologic surgeries in 2018.

Full story at ScienceDaily

See also: BBC News: ‘Pen’ identifies cancer in 10 seconds

Full reference: Zhang, J. et al. Nondestructive tissue analysis for ex vivo and in vivo cancer diagnosis using a handheld mass spectrometry system  Science Translational Medicine 06 Sep 2017: Vol. 9, Issue 406

 

Common evidence gaps in point-of-care diagnostic test evaluation

The authors used Oxford Diagnostic Horizon Scan Programme reports to determine the sequence and timing of evidence for new point-of-care diagnostic tests and to identify common evidence gaps in this process | BMJ Open

We extracted data from 500 primary studies. Most diagnostic technologies underwent clinical performance (ie, ability to detect a clinical condition) assessment (71.2%), with very few progressing to comparative clinical effectiveness (10.0%) and a cost-effectiveness evaluation (8.6%), even in the more established and frequently reported clinical domains, such as cardiovascular disease. The median time to complete an evaluation cycle was 9 years (IQR 5.5–12.5 years). The sequence of evidence generation was typically haphazard and some diagnostic tests appear to be implemented in routine care without completing essential evaluation stages such as clinical effectiveness.

Evidence generation for new point-of-care diagnostic tests is slow and tends to focus on accuracy, and overlooks other test attributes such as impact, implementation and cost-effectiveness. Evaluation of this dynamic cycle and feeding back data from clinical effectiveness to refine analytical and clinical performance are key to improve the efficiency of point-of-care diagnostic test development and impact on clinically relevant outcomes. While the ‘road map’ for the steps needed to generate evidence are reasonably well delineated, we provide evidence on the complexity, length and variability of the actual process that many diagnostic technologies undergo.

Full reference: Verbakel, J.Y. T et al. (2017) Common evidence gaps in point-of-care diagnostic test evaluation: a review of horizon scan reports. BMJ Open 7:e015760.

Can search engine data save lives from pancreatic cancer?

Gerd Gigerenzer discusses how search engines use big data analytics to “diagnose” your state of health | BMJ Opinion

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Image source: NIH Image Gallery – Flickr // CC BY-NC 2.0

Image shows pancreatic desmoplasia. Pancreatic cancer is associated with a vast desmoplastic reaction in which the connective tissue around the tumor thickens and scars. 

Imagine this warning popping up on your search engine page: “Attention! There are signs that you might have pancreatic cancer. Please visit your doctor immediately.” Just as search engines use big data analytics to detect your book and music preferences, they may also “diagnose” your state of health.

Microsoft researchers have claimed that web search queries could predict pancreatic adenocarcinoma. A retrospective study of 6.4 million users of Microsoft’s search engine Bing identified first-person queries suggestive of a recent diagnosis, such as “I was told I have pancreatic cancer, what to expect.” Then the researchers went back months before these queries were made and looked for earlier ones indicating symptoms or risk factors, such as blood clots and unexplained weight loss. They concluded that their statistical classifiers “can identify 5% to 15% of cases, while preserving extremely low false-positive rates (0.00001 to 0.0001)”, and that “this screening capability could increase 5-year survival.” The New York Times reported: “The study suggests that early screening can increase the five-year survival rate of pancreatic patients to 5 to 7 percent, from just 3 percent.”

Read the full blog post here

Prescription history could help GPs diagnose cancer earlier

“We want to develop a tool that helps GPs diagnose cancer earlier in the hope of saving more lives.”– Dr Jem Rashbass 

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Cancer Research UK-funded scientists are to examine whether identifying patterns in medication given to patients before they develop cancer could improve early diagnosis.

Looking for patterns in prescriptions and other data could help guide GP referrals, especially in patients with non-specific symptoms that don’t obviously indicate cancer.

Only about half of those with the most common cancers have “red-flag” symptoms. And this is even lower in cancers with poor survival rates such as pancreatic, stomach, ovarian and brain cancer.

This research is being led by Health Data Insight which has received funding through Cancer Research UK’s Pioneer Awards scheme. Together with Public Health England and the NHS Business Services Authority they have created an anonymous dataset of nearly all the primary care prescription data – approximately 80 million medications being prescribed each month.

The researchers will then link this information to data in the National Cancer Registration and Analysis Service to look for trends in medications given to patients before they were diagnosed with cancer.

Read more at Cancer Research UK

Cheap blood test could boost prostate cancer treatment

A cheap genetic test costing less than £50 has been developed that could help target treatment for men with advanced prostate cancer and help offset side effects from ineffective treatments | OnMedica

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Cancer researchers across Europe, including doctors from the Institute of Cancer Research (ICR) in London, analysed blood from 265 men with the disease and found those with multiple copies of a particular gene did not respond to abiraterone and enzalutamide – drugs commonly used to treat advanced cases.

About 46,000 men are diagnosed with prostate cancer in the UK every year, one in four of them at an advanced stage. For the study,* published in the journal Annals of Oncology, scientists took blood samples from patients taking part in three different clinical trials.

The team says that more trials are needed but they hope the test could prevent thousands of men undergoing unnecessary treatment and allow more personalised care. The drugs abiraterone and enzalutamide are given to men whose cancer is no longer responding to traditional hormone therapy and has started to spread.

Read the full commentary via OnMedica here

Read the full original research article here

 

Guide to cancer early diagnosis

This WHO Guide to cancer early diagnosis aims to help policy-makers and programme managers facilitate timely diagnosis and improve access to cancer treatment for all | WHO

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Image source: WHO

Detecting cancer early can effectively reduce the mortality associated with cancer.In resource-poor settings, cancer is often diagnosed at a late-stage of disease resulting in lower survival and potentially greater morbidity and higher costs of treatment. Even in countries with strong health systems and services, many cancer cases are diagnosed at a late-stage. Addressing delays in cancer diagnosis and inaccessible treatment is therefore critical in all settings for cancer control.

Early diagnosis strategies improve cancer outcomes by providing care at the earliest possible stage and are therefore an important public health strategy in all settings. The barriers that delay cancer diagnosis must first be identified and assessed, and these factors may originate from patients to carers to health systems. Effective programmes can then be implemented at various levels that include community engagement to address patient behaviour, improving diagnostic and referral capacity and ensuring access to timely, high-quality treatment.

Read the full report here