On a warm Thursday evening, July 11th, 2024, the Park Life café in Harrow buzzed with excitement as residents gathered for the instalment of a groundbreaking medical talk series. This event, part of an ongoing partnership between Imperial College London and the café, showcased Prof. James Flanagan’s presentation on the innovative Cancer Loyalty Card Study (CLOCS).
The collaboration, spearheaded by Bipin Dattani, former Chairman of the Enderley Road Patients’ Association, aims to bridge the gap between world-class researchers and local residents. This initiative has been instrumental in bringing cutting-edge medical knowledge directly to the community, fostering a unique environment where research meets real-world application.
Prof. Flanagan’s talk centred on CLOCS, a pioneering project that leverages shopping data from partnerships with TESCO and Boots to detect early signs of ovarian cancer in women. By analysing consenting patients’ purchasing habits and medication records, researchers can identify trends potentially indicative of ovarian cancer, prompting timely health checks.
This presentation is the latest in a series of specialist talks that began in June 2023 with a discussion on strokes, which led to the implementation of the Bridging The Blues 12-week programme for Harrow residents. The success of these initiatives has sparked further community-driven health programmes, including the Diabetes Community Club, an 8-week course teaching participants to manage their condition through lifestyle changes. The Harrow Weald Health Hub, which supports these talks, plays a crucial role in improving local residents’ health and well-being.
Beyond hosting monthly specialist talks, the Hub runs Busby clubs to encourage social interactions and combat isolation and depression. Imperial College’s Public and Patient Involvement and Engagement (PPIE) approach, exemplified by these events, enhances research quality and impact. By engaging directly with the public, researchers ensure their work addresses real-world needs and concerns, leading to more effective and impactful outcomes.
Dr James Flanagan observed that the symptoms of ovarian cancer are often non-specific and not widely recognised by women, leading to delays in diagnosis. Common symptoms such as abdominal bloating, feeling full, pelvic pain and changes in bowel habits might prompt women to purchase medications like pain relievers or digestive aids. He hypothesised that analysing these purchasing behaviours through loyalty card data could reveal patterns indicative of early ovarian cancer symptoms, thus providing a window of opportunity for earlier intervention.
In 2019, the research team set about to test this idea using a case-control study recruiting women who have ovarian cancer (cases) and women who do not (controls). The study overcame a big obstacle as recruitment overlapped with the COVID pandemic but still managed to recruit 153 ovarian cancer patients and 120 control participants. From whom we could request purchasing data from loyalty card programs at the retailers Boots and Tesco. This provided data that goes back up to 6 years prior to enrollment in the study, so we were able to look at what women were buying from 2015 to 2021 before their ovarian cancer diagnosis.
Results from the study were incredibly interesting and hopeful: Ovarian cancer patients were buying products like pain and indigestion medication up to 8 months before their diagnosis date. Their first GP visits were, on average 3.5 months before their diagnosis. They found that 52% of people were willing to share their shopping data for health research.
These results show that patients were potentially managing their symptoms with over-the-counter medications about 4-5 months before they visited their GP. This also provides empirical evidence for when women start to experience symptoms of ovarian cancer. Finally, our job in the next few years is to convince more people of the value of this research so they will feel more comfortable contributing to it.
What are the CLOCS team doing next?
Using a similar approach, they have started a new study called CLOCS-2. However, in this new study, the team is focusing on other cancer types in addition to ovarian cancer, such as oesophageal, pancreatic and colorectal cancer. The study has picked these cancer types because some of the symptoms are non-specific and may be initially treated by patients with over-the-counter medications. An earlier diagnosis for some of these cancers is likely to greatly impact patient outcomes.
How have the discussions at Park Life Café helped the CLOCS team?
The discussion on Thursday 11th July 2024 at Park Life Café led to an interesting discussion about sharing data and some good questions about the study:
There were concerns regarding data sharing, which highlighted that as a team we will have to work on informing the public about data safety and security we have in place to conduct our research. We confirmed that the retailers will not know the health status of CLOCS participants.
What do you hope to achieve from this project?
To define a purchasing threshold as an “alert” about cancer symptoms where there is a difference in purchasing between people with cancer and those without. How people would like to receive that information is a matter for our new research project, and we hope to have some answers to that question very soon!