New approaches to cancer diagnostics, from bench to primary care

Programme stream(s): Early detection / diagnosis and prognosis
Programme session type(s): Specialist session

Chair: Fiona Walter, University of Cambridge, UK
Speaker: Richard Neal, University of Leeds, UK
Speaker: Steve Pereira, University College London, UK
Speaker: Jon Emery, University of Melbourne, Australia

14:00-16:00

Room: Alsh

Testing for cancer has largely been the province of specialist care, and services are under considerable strain. As most UK patients initially present in primary care, it is logical to make this the setting for most testing activity, although the feasibility, acceptability, safety and cost-effectiveness of many existing and innovative tests and diagnostic approaches need to be proven. The speakers will discuss recent advances in the development, evaluation and delivery of investigations within a community setting to provide a more timely provisional diagnosis (or exclusion of) cancer. Participants will gain an understanding of new approaches to cancer diagnostics and their evaluation for use in a community setting.

Applying genomics to tailor colorectal cancer screening in primary care
Speaker: Jon Emery
Affiliation: Centre for Cancer Research and Department of General Practice, University of Melbourne

Abstract:

In the era of precision medicine it is increasingly recognised that a more tailored approach could be applied to cancer screening and early detection. In primary care, the assessment of cancer risk to determine who is most likely to benefit from invasive, expensive diagnostic tests can be applied both to symptomatic and asymptomatic populations.  There is large variation in individual lifetime risk of colorectal cancer due to differences in external factors (lifestyle and environment) and genetic susceptibility. Recent genome wide association studies have begun to identify multiple common single nucleotide polymorphisms (SNPs) which increase risk of colorectal cancer and could be used to stratify colorectal cancer screening. In this presentation I will present data on a 45 SNP panel for colorectal cancer risk prediction. This will include modelling its potential impact on colorectal cancer screening programs and recent implementation research to study issues of feasibility, acceptability and impact on patient and clinician decision-making in primary care. I will compare this approach with alternative methods of risk assessment based on electronic risk assessment tools currently being evaluated in the CRISP Trial.