Highlights from NCRI 2018 – part 2

This week on the blog, we’re sharing our highlights from the annual NCRI cancer conference.

Read the first part of our NCRI blog here

As well as talks showcasing new discoveries in cancer biology and evolution, many sessions at this year’s conference shone a light on public health and cultural factors in cancer prevention, diagnosis and treatment.

‘Why is behaviour change so difficult?’ asked Professor Theresa Marteau during her talk. We already know that public health messaging based on information and raising awareness of risk isn’t very effective, even if that risk information is personalised (for example, using genetic risk factors). Professor Marteau hypothesised that risk information does not work well as a prevention tool because the perception of threat is just not big enough to create change. Even if we are motivated to change, we are influenced by our current environment just as much as we are influenced by our own intentions. In one study, for example, just increasing the size of glasses used to serve wine at a bar (not the size of the wine serving itself!) led to a 9.8% increase in wine consumption. So, effective prevention strategies should focus on changing our environments in order to change minds and subsequent behaviour. However, this kind of intervention by government is typically considered too invasive, so there is a balance to strike between what can be accepted and what is most effective.

Sticking with the theme of cancer prevention, we learned about risks posed by tobacco, air pollution and carbon nanotubes in a session dedicated to environmental exposure. Dr Lion Shabab spoke about the challenges of assessing the impact of e-cigarettes, due to a lack of long-term data and the fact that the majority of e-cigarette users are also former smokers. Nevertheless, the available data does suggest that e-cigarettes are up to 95% less harmful than conventional cigarettes, but not completely without risk.

We were also interested to attend a session that examined the culture of population cancer screening. Of course, any screening programme is a balance of benefits, harms and affordability. Screening currently detects around 5% of cancers in the UK but in some cases, screening can have unintended costs to both individuals and the wider health system. For example, for every 1 life saved from breast screening, it is estimated that 3 are diagnosed with a cancer that would never become life threatening. Further, around ¼ of women who had a low grade abnormal cervical smear result scored in the clinically significant range for anxiety in one study. Learning from this research to refine and improve screening programmes will be beneficial to individuals, society and the healthcare system going forward.

Naturally, many talks at the conference tried to examine ways that we can ‘future-proof’ and do better at managing the burden of cancer. In one session, we heard about new diagnostic approaches in pancreatic, colorectal and lung cancers. These included urine tests and blood tests, as well as adaptive screening programmes that are stratified according to genetic and lifestyle risk factors. Common among many approaches was the use of big data and computational power, as well as integrating diagnostic models into clinical practice and point of care testing.

Elsewhere, in a specialist session about data driven technologies, the rise of ‘big data’ was described as the 4th industrial revolution. The NHS collects a huge amount of data during a patient’s cancer journey and scientists are increasingly trying to harness this to learn more about cancer progression. For example, statistics show that a greater number of elderly patients die from bowel cancer close to diagnosis compared to younger patients. But, what happens in the intermediate time? By linking cancer registry data with other available data (e.g. histopathology, patient reported statistics, prescribing data etc), we may be able to connect the dots to understand more about the cancer pathway from diagnosis through treatment and beyond. Looking forward, it is possible to envisage digital transformation as a catalyst for change in the healthcare system.

 

As we return from the NCRI, we begin the tasks of administration for our next round of grant applications. It is fantastic to visit these conferences and learn more about breakthroughs and discoveries across the cancer field, and so often to see our scientists presenting their own work among their peers. We are excited to see how our existing projects and newly funded scientists will expand on these findings to develop world-class research projects across Wales. Stay tuned!