Cancer Research Wales at the Early Diagnosis Conference 2024

Inequalities

Reducing cancer inequalities is one of the key strategic aims of Cancer Research Wales, so seeing such a strong focus on this topic throughout the conference was fantastic.

It is an established fact that the burden of cancer is not shared equally, with factors including ethnicity, socioeconomic status and education all impacting the risk of developing and dying from cancer. The combination of these various factors and how they interact (known as intersectionality) is vitally important to understanding where the greatest inequalities lie and to beginning to address the issues.

A real highlight of the conference was a series of talks from PPI (Patient and Public Involvement) representatives, spelling out their experiences of obstacles to early cancer diagnosis. These included cultural barriers related to traditional beliefs, stigma and gender roles, as well as barriers related to living in a rural community and being a mother. Hearing first-hand how the lived experiences of individuals differ from what would be considered ‘best practice’ was eye-opening and powerful, inspiring everyone in attendance to increase efforts to achieve equitable healthcare for all.

From a Welsh perspective, Prof Dean Harris presented the results of work investigating the acceptability of the Cancer Research Wales funded Raman Blood Test among ethnic minority and homeless people in South Wales. Bowel cancer mortality rates are 83% higher in the most deprived communities in Wales, but these groups are also the least likely to take part in bowel cancer screening, which uses the FIT (faecal immunochemical test).

The recent study, which involved collaboration with organisations including Muslim Doctors Cymru, found that there were significant cultural and practical barriers that helped to explain the low uptake of FIT screening in certain communities. Importantly, the option to have a blood test instead was found to be much more acceptable, with significant enthusiasm for the idea particularly if it could be combined with other healthcare activities such as vaccinations. These findings demonstrate that innovations such as the Raman Blood Test have the potential to significantly reduce inequalities in screening, which would begin to address disparities in cancer mortality.

Tools to Assess Cancer Risk

There was a recurring theme across the conference of using new tools to understand a patient’s risk of developing cancer, to help guide screening and diagnostic decision making.

With huge and increasing demand on the NHS, waiting lists and delays are lengthening and patient outcomes are the victims. Using innovation to better direct testing and care to those in greatest need, as well as avoiding unnecessary procedures for those who don’t need them, offers a solution to relieve some of the burden on our health systems. A number of different research areas in this field were presented at the conference, with the potential to better target screening programmes and improve early cancer diagnosis.

One study of particular interest explored patients’ blood test results over time to look for patterns. For patients who went on to develop cancer, there were often trends in their test results in the months leading up to their diagnosis, even though individually the results were in the normal range and wouldn’t cause alarm. These findings suggest cancer could be diagnosed months earlier in some patients, without the need for any new tests, which would help to improve patient outcomes.

There were also studies showing how different combinations of non-specific symptoms could predict the type of cancer that patients went on to be diagnosed with, allowing GPs to provide more accurate referrals, and how high platelet counts can predict an increased risk of cancer.

Of relevance to Cancer Research Wales funded research was a study investigating the use of the PSA (prostate-specific antigen) test for prostate cancer. The PSA test has been used for a number of years, but is known to not be very accurate for diagnosing prostate cancer. The new research presented at the conference showed that the level of PSA which indicated a high risk of advanced prostate cancer varied depending on the patient’s age, and the referral thresholds used by GPs did not reflect this.

The above study highlights the need for improved tests for prostate cancer, that can accurately diagnose patients and provide information about the aggressiveness of the disease to clinicians. Cancer Research Wales is funding a project at Swansea University aiming to deliver exactly such a test, which can diagnose prostate cancer based on changes detected in extracellular vesicles (tiny bubbles of fat released by cells) in blood samples. This would represent a brilliant new tool for doctors to use for this very common cancer type (read more in a previous blog here).

This year’s Early Diagnosis Conference was a fantastic event and a real showcase for the research happening both in Wales and across the UK. Unfortunately there was plenty of less positive news as well, with NHS pressures and budget deficits, health inequalities and lack of real world data all receiving numerous mentions. The hope is that the innovations and evidence presented at the conference can ultimately start to address the huge difficulties being faced and really improve outcomes for the cancer patients of the future.

At Cancer Research Wales, we are very optimistic about the role our funded projects can play in driving these improvements. There is lots more work to be done and we will continue to need the generous support of the people of Wales to help us achieve our goal.

To learn more about our funded research projects, click here.