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Professor Julia Hippisley-Cox and the QResearch electronic health records database are to contribute to a prestigious Cancer Research UK-funded programme to research the earlier detection of hepatocellular carcinoma.

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The Early Detection Programme Award, worth £2.5million over five years, brings together a multidisciplinary team from across the University of Oxford to understand more about the changes in the liver as cancer develops. The researchers will use this to inform new, more sensitive diagnostic tests with the ambition of detecting liver cancer earlier.

Liver cancer is the fastest rising cause of cancer death in the UK, with more than 5,000 deaths per year. Diagnosing liver cancer earlier, when current treatments are more effective, is critical for improving survival. However, this is challenging because symptoms are vague and late-presenting, and are frequently masked by co-occurring liver disease, such as cirrhosis. There are a number of conditions that increase the risk of liver cancer, including viral hepatitis, obesity and alcohol, leading to liver inflammation and cirrhosis. Surveillance of people at higher risk can reduce mortality but effectiveness is limited by the low sensitivity of current detection methods.

In this research programme, scientists aim to learn more about the origins of liver cancer and develop more sensitive detection tests. The Oxford-led team will investigate people with and without cancer to identify factors that will enable better risk assessment and earlier cancer detection. Their research will include analysis of molecular profiles in both the liver tissue and the blood, and advanced liver imaging.

Hosted within the Nuffield Department of Primary Care Health Sciences, QResearch (www.qresearch.org) is a large consolidated database derived from the anonymised health records of over 35 millions patients in the UK, with data from around 1500 general practices linked to cancer registry, mortality and hospital data.

We are delighted to be part of this innovative award. We will use QResearch to develop a new computerised risk prediction tool which will help identify patients in primary care who are at highest risk of liver cancer so that patients can be identified at the earliest possible opportunity to help speed up the diagnosis and treatment for people with liver cancer. This will be on existing Qcancer tool which is already widely used across the NHS.
Professor Julia Hippisley-Cox, Director of QResearch and Professor of Clinical Epidemiology and General Practice

Professor Ellie Barnes, Nuffield Department of Medicine and the Chief Investigator for this programme, said “We are delighted to receive funding from CRUK for this research programme. With the support of a world-class team, I believe that this award will allow us to make an important step change in the UK for both HCC detection and the scientific understanding of cancer initiation, with the aim of improving survival of this increasingly prevalent disease.”

Dr Alexis Webb, Cancer Research UK's Early Detection Senior Research Funding Manager, said "At the moment, liver cancer is often diagnosed too late for treatment to be effective. But by developing better techniques to diagnose the disease earlier, a greater number of patients will have more treatment options available to them and a better chance of survival. There is great potential in early detection research, which is why studies like these are so important to help more people survive cancer."

This multidisciplinary team has expertise in cancer biology, clinical hepatology, inflammation and infection, liquid biopsy technologies, multiparametric liver imaging, big data science, primary care health science, and health economics. The team involves many Oxford researchers from the Nuffield Department of Clinical MedicineRadcliffe Department of MedicineDepartment of OncologyNuffield Department of Primary Care Health SciencesBig Data InstituteDepartment of Chemistry, and the Department of Statistics. The consortium also includes: researchers from Nottingham University, Newcastle University, Glasgow Caledonian University, the University of Bristol, the London School of Hygiene and Tropical Medicine and Aarhus University (Denmark); industry partners Roche DiagnosticsPerspectum DiagnosticsOncImmune and IPDx; and charity partners the British Liver Trust and the Hepatitis C Trust.