By Dr Jon Krell, Principal Investigator within the Ovarian Cancer Action Research Centre (OCARC), a collaborative, multi-disciplinary team of clinicians and scientists, focused on translational research to improve outcomes for women with ovarian cancer.
March is Ovarian Cancer Awareness Month, and an opportunity to highlight a key part of our Centre’s research programme aimed at improving early diagnosis and identifying risk factors.
Most ovarian cancers are diagnosed late and have poor prognosis, an outcome that has not changed significantly over the last 30 years. Existing screening modalities for ovarian cancer do not appear to reduce mortality, and at present there is no national ovarian cancer screening programme. Furthermore, personalising eligibility for cancer screening programmes through genetic markers, or family history, is very limited.
The identification of screening tools with higher sensitivity and specificity would change this, as at present the best chance to reduce mortality from ovarian cancer is prevention and the ability to identify women at high risk. The use of genetic testing to select patients for screening programmes, or to guide individualised screening strategies, has the potential to complement current cancer prevention and screening practices, augment their impact and efficiency, and allow for a paradigm shift away from aged-based selection.
As part of a dedicated programme at the OCARC, we are looking to address this need through the development of a clinical study, called PROGRESS, funded by Ovarian Cancer Action, which will start to recruit patients from mid-2017 onwards.
The purpose of the PROGRESS study is to better understand the public’s perception of genetic testing and to determine the feasibility of using a cancer risk algorithm that we have developed to guide the personalisation of cancer screening programmes and disease prevention behaviour.
The potential applications of this work are broad, and while we will initially focus on ovarian and breast cancer risk, the approach could be adapted to other cancers and diseases. The test to assess polygenic risk is conducted using a saliva sample, and so there are potential improvements in efficiency from a health economics perspective once appropriate infrastructure is in place, with the cost being affordable for use in both developed and developing countries.
Disease prevention is paramount to improving public health and quality of life throughout the world. Whilst significant progress is being made in disease therapeutics, global cancer prevention strategies require significant development and we remain committed to improving this through collaborative research, and public and political engagement. It is our hope that outcomes from the PROGRESS study will feed the debate on current public health policy with respect to disease screening and prevention and the regulation of genetic testing.