Detect

Early detection of cancers can help to significantly improve prognosis of patients and reduce mortality. This is particularly pronounced for cancers that, despite advances in diagnostic procedures, are still only detected late.

Ovarian cancer is often detected at advanced stages and as a result has a five-year survival rate of less than 40%.
Womb cancer is the fourth most common cancer in women and its prevalence is increasing. No screening exists for endometrial cancer and the lead symptom is abnormal uterine bleeding. Many women present with abnormal uterine bleeding, but most do not have cancer. Current imaging methods for detecting cancer in women with symptoms are suboptimal.
Cervical cancer screening is routine in many countries and saves lives. Nevertheless, current strategies for triaging women at risk following an HPV test could be improved.

Our work focuses on the early detection of all of these cancers.

WID™-qEC – womb cancer detection test

Abnormal uterine bleeding is a symptom of endometrial (womb) cancer, but most women with abnormal bleeding do not have womb cancer.

Simpler and more accurate methods to detect cancer in women with abnormal bleeding are urgently needed. Our new molecular WID™-qEC test detects endometrial cancer quickly and with high accuracy using a cervical smears or a vagina swab. The test offers many advantages over currently used methods of early detection, such as ultrasound. In the future, with this easy-to-perform test, many women with suspected endometrial cancer could be spared very stressful hysteroscopies and biopsies.

The test is currently being assessed in a prospective, observational cohort study in London. Details of the study can be found here.

Herzog et al. A Simple Cervicovaginal Epigenetic Test for Screening and Rapid Triage of Women With Suspected Endometrial Cancer: Validation in Several Cohort and Case/Control Sets. Journal of Clinical Oncology 2022; 40(33):3828-3838. DOI: 10.1200/JCO.22.00266

Schreiberhuber et al. The WID™-qEC test – performance in a hospital-based cohort and feasibility to detect endometrial and cervical cancers. International Journal of Cancer. 2023; 152(6):1269-1274. doi: 10.1002/ijc.34275.

WID™-qCIN – cervical (pre)cancer detection test

In many countries, screening programmes for cervical (pre)cancer detection use primary human papilloma virus (HPV) testing followed by cytology for those found to be HPV positive.

Cytology as triage for colposcopy referral suffers from several shortcomings. HPV testing overcomes some of these but lacks specificity in women under 30.

We have developed and validated an automatable three-marker PCR-based triage test that is highly sensitive and specific and predicts progression to CIN3+ in HPV+ patients. The EUTOPS team is currently validating the markers in samples from a large population-based cervical cancer screening cohort.

Herzog et al. DNA methylation-based detection and prediction of cervical intraepithelial neoplasia grade 3 and invasive cervical cancer with the WID™-qCIN test. Clin Epigenetics 14, 150 (2022). doi: 10.1186/s13148-022-01353-0.

EpiFemCare – Ovarian cancer detection

By assessing methylation in prospectively collected samples, we were able to develop a tool for early blood-based detection of ovarian cancer, which was highly specific and may have the potential to detect a proportion of ovarian cancers up to two years in advance of diagnosis.

Identifying more sensitive and specific blood-based bioassays for the detection of ovarian and breast cancer

The EpiFemCare project was a European Commission funded programme running from November 2012 to April 2016 with the aim of identifying more sensitive and specific blood-based bioassays for the detection of ovarian and breast cancer. We employed the epigenome as a stable target molecule reflective of the disease.

Prof Martin Widschwendter was the Coordinator and Principal Investigator of the EpiFemCare project and led an international consortium comprising clinicians, academics, and small- to medium enterprises (SMEs). By assessing methylation in prospectively collected samples, we were able to develop a tool for early blood-based detection of ovarian cancer, which was highly specific and may have the potential to detect a proportion of ovarian cancers up to two years in advance of diagnosis.

Key publications

Widschwendter M, et al. Methylation patterns in serum DNA for early identification of disseminated breast cancer. Genome Med. (2017); 9(1):115. doi: 10.1186/s13073-017-0499-9.

Widschwendter M,et al. The potential of circulating tumor DNA methylation analysis for the early detection and management of ovarian cancer. Genome Med.(2017); 9(1):116. doi: 10.1186/s13073-017-0500-7.