Stratified screening for cancer
Population screening for breast, bowel and cervical cancers typically targets older age groups at higher risk of developing cancer. However, screening younger individuals could have significant benefits for early detection and intervention. By designing a process of risk stratification to identify high risk individuals, there is potential to transform healthcare through earlier diagnosis and more effective prevention of disease
Recent advances in genomics promise targeted or personalized approaches to population screening through a process of risk stratification. This type of stratified screening to identify high risk individuals has the potential to transform healthcare through earlier diagnosis and more effective prevention of disease. The findings of the European Collaborative Oncological Gene-Environment Study suggest that the combination of polygenic risk stratification and a personalized approach can significantly increase cancer detection in younger individuals, and limit the inappropriate use of investigations, over-diagnosis and unwarranted invasive treatments.
Our work aims to develop a new cancer screening program that incorporates comprehensive genomic, lifestyle and family history data to identify individuals at high risk. The ability to stratify individuals at higher risk based on these factors can lead to better treatment, improved prognosis and lower healthcare costs. Initially, our research program will design a stratified risk approach for colorectal cancer as a proof of principle, before expanding to other cancers (breast, cervical, prostate). We will collate epidemiological data on genomic and lifestyle risk factors describing disease occurrence in the WA population, and evaluate the benefits, harms and costs of using different interventions at different levels of genetic risk.
This work involves experts in genomics, bioinformatics, population screening, cancer services, epidemiology, economic modelling, cancer genetics and community engagement. It is a multi-institutional collaborative effort by researchers from UWA, Curtin, University of Melbourne, KEMH and Sir Charles Gairdner Hospital.
- Cancer Council of Western Australia Capacity Building & Collaboration Grant [2014-2016]: $1,200,000. “Integrating personalised genomics into risk stratification models of population screening for cancer”
CIA Eric Moses, CIB Iris Lansdorp-Vogelar, CIC Hooi Ee, CID Robert Donovan, CIE David Preen, CIF Delia Hendrie, CIG Jack Goldblatt, CIH Mark Jenkins, CII Peter O’Leary
- Cenin, D., P. O’Leary, I. Lansdorp-Vogelaar, D. Preen, M. Jenkins and E. Moses (2017). “Integrating personalised genomics into risk stratification models of population screening for colorectal cancer.” Aust N Z J Public Health 41: 3-4. [link]
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