Lethal versus non-lethal cancers

Challenge: Distinguish between lethal cancers that need treating, and non-lethal cancers that don't

This was a challenge in an earlier round, we are not currently accepting applications for this challenge.

Context

Current screening methods in breast and prostate cancer pick up cancers at an early stage, but lead to over-diagnosis and subsequent over-treatment.

Paradoxically, we don’t as yet have any tools to accurately diagnose other cancers at an early stage, leading to a high cancer-specific mortality (such as for cancers of the pancreas, brain, lung and oesophagus).

The premise of this challenge is that we need a thorough understanding of features that can distinguish a non-lethal growth from a potentially lethal malignant growth, to allow methods to be developed to specifically detect the cancers that require intervention.

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Barriers and opportunities

There are two aspects to this challenge: identifying changes that distinguish a non-lethal from a potentially lethal tumour and then determining how these changes would be detected accurately.

This might include (but would not be limited to) defining what distinguishing materials are shed from tumours into the bloodstream or bodily fluids that could be detected, working out how blood-based markers can be traced to a specific organ and determining how to detect the specific abnormalities that would then require intervention.

Vision and Impact

An advance in tackling this challenge could not only save lives from aggressive cancers by finding them earlier, but also reduce the harm caused by treating people with cancers that will never cause them any problems.

This, in turn, could lead to great improvements in how we screen for cancer, by helping us understand what to do with overdiagnosed cancers.

Plain language summary: Why lethal versus non-lethal cancers?

Our methods for detecting cancer simply aren’t good enough. We need to detect the disease at an early stage, but the diagnosis needs to be more sensitive and accurate too, otherwise we risk missing cancers that cause serious harm, and over-treating those that won’t.

It’s a hard concept to imagine, but not all of the things we call ‘cancer’ need to be treated. Some ‘cancers’ are temporary changes to cells that will reverse or disappear with time, and others are so slow-growing they’ll never cause any problems.

For some cancers, over-diagnosis leads to unnecessary treatment and avoidable side effects. In others, we desperately need to be able to detect the disease earlier – but do so in a more accurate way.

In lung cancer, for example, X-ray scans can’t distinguish between spots where there is nothing to worry about, or the early stages of an aggressive cancer that needs prompt treatment.