When cancer is detected at an early stage, the rates of survival increase drastically, but today only a few cancer types are screened for. An international study led by researchers from Chalmers University of Technology, Sweden, shows that a new, previously untested method can easily find multiple types of newly formed cancers at the same time – including cancer types that are difficult to detect with comparable methods.

Cancer is one of the deadliest diseases in the world and is more difficult to cure when detected at a late stage.

Finding effective methods for early detection of several types of cancer at the same time, so-called Multi-Cancer Early Detection (MCED), is an emerging research area. Today's established screening tests are cancer type-specific, which means that patients need to be tested for each cancer type separately. Emerging MCED tests under development are usually based on genetics, for example measuring DNA fragments from tumours circulating in the blood. But DNA-based methods can only detect some types of cancer and have limited ability to find tumours at the earliest stage, so called stage I.

New method based on human metabolism

Now, in an international collaboration, researchers from Chalmers have developed a new method for multi-cancer early detection that is instead based on human metabolism. The results, which have been published in the scientific journal PNAS, uncover new opportunities for cheaper and more effective cancer screening. In a study totalling 1 260 participants, the researchers first discovered that the new method could detect all 14 cancer types that were tested. Next, they showed that twice as many stage I cancers in asymptomatic healthy people can be detected with the new method compared to the emerging DNA-based MCED tests.

"This is a previously unexplored method, and thanks to the fact that we have been able to test it in a large population, we can show that it is effective in finding more stage I cancers and more cancer types. The method makes it possible to find cancer types that are not screened for today and cannot be found with DNA-based MCED tests, such as brain tumours and kidney cancer," says Francesco Gatto, who is a visiting researcher at the Department of Biology and Biological Engineering at Chalmers and one of the study's authors.

Cheaper and more practical tests

The method is based on a discovery by Dr. Francesco Gatto and Prof. Jens Nielsen at Chalmers almost ten years ago: that so-called glycosaminoglycans – a type of sugar that is an important part of our metabolism – are excellent biomarkers to detect cancer noninvasively. The researchers developed a machine learning method in which algorithms are used to find cancer-indicating changes in the glycosaminoglycans. The method uses comparatively small volumes of blood or urine, which makes them more practical and cheaper to use.

"The fact that the method is comparatively simple means that the cost will be significantly low, ultimately enabling more people to have access to and take the test," says Francesco Gatto.

Important step towards effective multi-cancer tests
In the next step, the researchers hope to be able to conduct a study with even more participants to further develop and confirm the method’s potential for screening use.

"This is a ground-breaking study that gives us hope that one day society will be able to create screening programmes that can detect all cancer types early,” says Francesco Gatto.

"To be able to find more cancer cases early, we know that new tools are needed. These results are very promising because of the demonstrated higher sensitivity across more types of cancer at stage I, using a cost-efficient and accessible technology," says Dr. Eric Jonasch, MD, Professor at The University of Texas MD Anderson Cancer Center and co-author of the study.

The article "Non-invasive multi-cancer early detection using glycosaminoglycans" has been published in the scientific journal Proceedings of the National Academy of Sciences (PNAS).

The study has been led by researchers from Chalmers in collaboration with over 30 partners at 10 different universities and research institutes in Sweden and internationally. These are:  Lund University, Sweden, Uppsala University, Sweden, Sahlgrenska Academy at University of Gothenburg, Sweden, Karolinska Institute, Sweden, Vancouver Prostate Centre, Canada, University of British Columbia, Canada, Università Vita-Salute San Raffaele, Italy, University of Modena and Reggio Emilia, Italy, University of Texas MD Anderson Cancer Center, USA, and University of Copenhagen, Denmark.
The method has already taken the step into society through the start-up company Elypta, which is one of Chalmers Ventures' portfolio companies. Elypta is based on the research presented in the scientific study and focus on developing and commercialising MCED testsas well as a test for recurrent kidney cancer. In addition, Elypta has developed the measurement methods used to support the study analysis.

More about the research

The study shows that a method based on analysing changes in glycosaminoglycans – a type of sugar that is an important part of our metabolism – can be used to detect several different cancer types at an early stage from the same blood and urine sample, even cancer types that are difficult to detect with other methods.  The researchers chose to test 14 different cancer types, representing the majority of newly diagnosed cancers, and all 14 types could be detected with the new method. 1 260 people participated in the study, both healthy and previously diagnosed with cancer.  With this new method of multi-cancer early detection (MCED), twice as many cases of cancer at its earliest stage (stage I) in otherwise asymptomatic healthy people could be detected compared to other DNA-based MCED tests under development.

About Chalmers University of Technology

Chalmers University of Technology in Gothenburg, Sweden, conducts research and education in technology and natural sciences at a high international level. The university has 3100 employees and 10,000 students, and offers education in engineering, science, shipping and architecture.

With scientific excellence as a basis, Chalmers promotes knowledge and technical solutions for a sustainable world. Through global commitment and entrepreneurship, we foster an innovative spirit, in close collaboration with wider society.The EU’s biggest research initiative – the Graphene Flagship – is coordinated by Chalmers. We are also leading the development of a Swedish quantum computer.

Chalmers was founded in 1829 and has the same motto today as it did then: Avancez – forward.