Stratified screening for cancer is a radical new population approach to cancer prevention with the potential to transform healthcare through earlier diagnosis and more effective prevention.
Population screening for breast, bowel and cervical cancers targets certain age groups. While screening younger individuals could have significant benefits for early detection and intervention, it is simply not cost-effective. This project, 'Integrating personalised genomics into risk stratification models of population screening for cancer', will develop a screening program for cancer using lifestyle, genetics and family history data to identify individuals at high risk, which will lead to better treatment, improve prognosis and lower healthcare costs.
Recent advances in genomics promise targeted or personalized approaches to population screening through a process of risk stratification. 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, overdiagnosis and unwarranted invasive treatments. This research will evaluate the impact of stratifying risk in the population by incorporating comprehensive genomic and lifestyle and family history data to improve cancer screening. Assessment of the appetite of providers and consumers for adopting a genomic risk stratification model is a fundamental component of the ethical, legal and social theme of this research program.
This strong multi-institutional collaboration involves experts in genomics, bioinformatics, population screening, cancer services, epidemiology, economic modelling, cancer genetics and community engagement.
Our research program will begin with a stratified risk approach for colorectal cancer, as a proof of principle and then expand to other cancers (breast, cervical, prostate).
The specific aims of this project are to:
- Assemble epidemiological data on genomic and lifestyle risk factors describing disease occurrence in the WA population.
- Incorporate lifestyle and other risk factors to identify individuals who will benefit from early detection and earlier interventions.
- Evaluate the benefits, harms and costs of using different interventions at different levels of genetic risk.
- Engage the community in regards to the acceptability of genetic stratification over the population.
- Integrate the model into healthcare and public health systems.
This project is a collaborative effort between GOHaD, The University of Western Australia, Curtin University, King Edward Memorial Hospital, Sir Charles Gairdner Hospital and the University of Melbourne:
- Prof Eric Moses, GOHaD, UWA
- Dr Iris Lansdorp-Vogelaar, Erasmus MC
- Dr Hooi Ee, SCGH
- Prof Rob Donovan, , Centre for Behavioural Research in Cancer Control, Curtin University
- Prof David Preen, School of Population Health, UWA
- Dr Delia Hendrie, School of Public Health, Curtin University
- Prof Jack Goldblatt, Familial Cancer Program, KEMH
- Prof Mark Jenkins, University of Melbourne
- Prof Peter O'Leary, Faculty of Health Sciences, Curtin University
- Travis Endersby, GOHaD, UWA
- Dr Sarah Ward, GOHaD, UWA
- Suzy Maxwell, Faculty of Health Sciences, Curtin University
- Dr Gemma Cadby, GOHaD, UWA
- Dr Geoffrey Jalleh, Centre for Behavioural Research in Cancer Control, Curtin University
- Prof Lin Fritschi, Epidemiology and Biostatistics, Curtin University
- Dr Tegan McNab, GOHaD, UWA
- Prof Ryan Lister, Plant Energy Biology, ARC Centre of Excellence, UWA
- CIA - Prof Eric Moses
- CIB - Dr Iris Lansdorp-Vogelaar
- CIC - Dr Hooi Ee
- CID - Prof Rob Donovan
- CIE - Prof David Preen
- CIF - Delia Hendrie
- CIG - Prof Jack Goldblatt
- CIH - Prof Mark Jenkins
- CII - Prof Peter O'Leary