Earlier and faster diagnosis of cancer: the opportunities for technology

This week the Health Foundry team attended a very interesting launch of the new SBRI competition focusing on cancer. SBRI Healthcare is an NHS England initiative, led by the Academic Health Science Network (AHSN), who aim to promote UK economic growth whilst addressing unmet health needs and enhancing the take up of known best practice. They have funding calls twice a year focusing on areas of need identified by the ASHN members.

The new funding call focuses on finding solutions with the ability to transform screening and facilitate both earlier and faster diagnosis of cancer. The launch event this week had a fantastically informative presentation by Professor Stan Kaye (with research from Dr. Michelle Chen) on the challenges with cancer but also where technology can provide opportunities for innovation and improving the patient pathway and ultimately saving lives.

The challenge

The problem with many cancers is that they are caught too late and have spread. A study recently quoted in the Guardian newspaper found that UK cancer survival rates lag behind those of other European countries and highlighted the need for earlier diagnosis and improved access to treatments. The factors underlying this state of affairs is two-fold: 1) delayed diagnosis and 2) sub-optimal treatment. The number of people being diagnosed with cancer is also increasing and it is predicted that by 2035, there will be over 500,000 people diagnosed with cancer in the UK each year, an increase of 40% compared to current levels.

The survival rates of different cancers also widely differs from testicular cancer with 98% of patients surviving more that 10 years to pancreatic cancer which only has a 1% 10 year survival rate. 

The government have set waiting time targets in England and Wales for treating cancer patients from GP referral to treatment. The national target is 62 days for the whole pathway and starting treatment no more than 31 days after the meeting at which you and your doctor agree the treatment plan. However, the 62 day target is only being met in 82.9% of cases with delays occurring in the front end of the pathway.

Prof. Kaye illustrated that there are some key areas where technology could make a real impact: better screening of the asymptomatic population (people who haven’t been diagnosed yet); earlier diagnosis of the symptomatic population; and faster diagnosis of the symptomatic population. 

As we saw in the diagram above on cancer survival rates, not all cancers are created equally. A cancer like colorectal cancer is actually fairly easy to spot early on with a blood in the stool test. However no such test exists for a cancer like pancreatic cancer so by the time a patient goes to their GP with symptoms, it’s too late. In the UK, there are currently national screening programmes in place for breast, bowel and cervical cancer. Screening programmes detect approximately 5% of all cancers, 10% of bowel cancers and 30% of breast cancer .

What if technology could identify new biomarkers (a measurable indicator of the severity or presence of some disease state) for hard to detect cancers eg pancreatic, ovarian?

The uptake of screening programmes also need to improve. With long waiting times for GP appointments, people don’t want to bother their GP with their worries so more people are getting diagnosed with cancer in the A&E.

What if technology could help people get screened early and in the community, for example in a local pharmacy? What if remote screening services were more widely available (e.g. self sampling methods)?

Prof. Kaye also spoke about the importance of risk stratification in screening programmes to identify high-risk asymptomatic individuals. The problem with generic screening programmes is that they will, at best, detect only 1 or 2 out of a 100 people rather than 20 out of 100 if the population was segmented.

What if technology was used to identify and screen high-risk individuals? What if we could diagnose patients with vague or non specific symptoms of cancer earlier and more effectively ?

The last opportunity for technology in cancer was around faster diagnosis and treatment (problems with the system itself.)

What if technology could combine diagnostics and initial treatment in a one-stop-shop environment? What if primary care was given access to new point of care diagnostics? What if technology could overcome Information Governance and IT integration issues, for example, in Multidisciplinary Meetings (MDTs).

The event ended with the team sharing some tips on what makes a great SBRI application:

  • Don’t spend too much time explaining the problem (they know it really well!). There is also a comprehensive brief here.
  • Don’t put hyperlinks in your application (they won’t be read) but you can attach documents and do reference any sources.
  • Make sure you demonstrate that you understand how to change a clinical pathway.
  • They will fund pure R&D ie technology not created yet but they will also fund technologies that come from other industries eg food that show promise for cancer.
  • The project needs to have an element of technological development. It can’t be just for market access or scaling.

To find out more about the call or to apply, please visit the competition website. Deadline for applications is noon, 6th September 2017.