Home urine tests studied to boost early detection of lung cancer
Researchers are investigating whether simple urine tests could help improve early diagnosis and survival rates for lung cancer.
Over the last four months, one thousand people across Southampton have been sent urine collection kits to trial in their own homes.
The UH-CAN Lung study is evaluating whether this approach could help to screen more people at high risk of lung cancer.
The study is sponsored by University Hospital Southampton (UHS) and run by the Southampton Clinical Trials Unit (SCTU).
It comes at a time when the Government’s recent 10 Year Cancer Plan aims to increase early detection rates. The intention is to achieve this using routine testing, including urine samples.
Preventing cancer deaths
Lung cancer is the third most common cancer in the UK, with over 50,000 people diagnosed each year. It is the most common cause of cancer death.
Almost 70 percent of cases are diagnosed at a later stage (three or four), when the chances of successful treatment are much lower.
Dr Victoria Goss is Associate Professor of Early Diagnosis and Translational Research at the SCTU.
“Earlier diagnosis of lung cancer can improve outcomes for patients, by identifying the disease when it is at a stage where treatment options are more effective,” she said.
“But lung cancer can be difficult to detect in its early stages, as symptoms can be vague. We need better, more accessible screening methods that can help spot the early signs of the disease in people who are at a high risk for this cancer.”
It is estimated more than three quarters of lung cancer diagnoses in the UK are preventable. Two of the biggest risk factors for the disease are age and smoking. Over 70 percent of cases occur in people with a history of smoking.
Catching lung cancer earlier
In 2019, NHS England launched the Targeted Lung Health Check programme. This is now called the Lung Cancer Screening (LCS) programme.
Through this initiative, people aged 55 to 74 with a history of smoking are invited for a CT scan in a mobile scanning unit near to where they live.
“The LCS programme has been revolutionary for lung cancer screening,” said Dr Goss.
“Since its launch, over 3.3 million people have been invited for a lung health check, with over ten thousand cases of lung cancer detected. More than three quarters of those were caught in the early stages.
“However, nationally around half of people invited do not attend a LCS appointment. This may be because they cannot get to the mobile unit, are fearful of the scan, or simply do not have the time.
"Screening can only help if people take part, so improving participation is key.”
Trialling a new approach
The SCTU Early Diagnosis team has been working with Elypta AB. This is a Swedish company developing a urine-based test for the earlier diagnosis of lung cancer.
Hannah Warming is Trial Manager for the UH-CAN Lung study at the SCTU.
“Urine tests have already been shown to be an acceptable sampling method for some other cancers,” she says. “There is, however, very limited data on the uptake rate in people who don’t respond to other cancer screening invites.
“UH-CAN LUNG is a feasibility study to understand if LCS non-responders will be willing to return a urine sample collected at home, to be analysed as part of a laboratory test.
“If we can show that people are willing to engage with this method, then we can conduct further larger studies to evaluate the test and see whether it can improve early diagnosis rates.
“We hope that home-based collection can help to remove barriers that stop many people from engaging with cancer screening.”
One thousand kits have now been sent out across Southampton, along with a short participant questionnaire.
The questionnaire seeks to understand how easy a urine home collection kit was to use, and whether this is an acceptable form of test. It also asks about the reasons why they did not engage with the LCS screening programme before.
The UH-CAN Lung study is funded by the Jon Moulton Charity Trust and supported by Wessex Health Partners.
Professor Simon Crabb is Chief Investigator for the study. He is Professor of Experimental Cancer Therapeutics at the University of Southampton and an Honorary Consultant in Medical Oncology at UHS.
“The UH-CAN Lung feasibility study is helping us to understand more about ways in which we can increase cancer screening uptake among people who may not be able to access traditional screening programmes,” he said.
“We know that at-home bowel cancer screening has had a huge impact on the number of cancer cases being detected and the number of people being successfully treated.
“Our hope is that home urine collection kits can eventually provide a similar early detection test for those at risk of lung cancer, and possibly other cancers in the future.”