The end of January marked the end of the second Integrative Cancer Epidemiology Programme (ICEP). This five-year Cancer Research UK (CRUK)-funded programme had a particular focus on understanding cancer risks to improve prevention and early detection of cancer, especially less common cancers, using a range of cutting-edge genetic epidemiology approaches.

The programme was responsible for 176 papers, with more still in progress, and nine systematic reviews. ICEP researchers collaborated with researchers from 49 countries and developed a vast wealth of open data for other researchers to use and build on.

Making a difference

But the impact goes beyond academic outputs. Since the inception of ICEP, our research has provided a better understanding of biological pathways leading to cancer. We have developed software for global use and identified opportunities to repurpose drugs developed for other purposes to the fight against cancer.

The programme has also helped integrate biomarkers into cancer screening programmes. One key example is in the area of lung cancer screening. In the UK, only 15% of people diagnosed with lung cancer will still be alive five years later. This rate decreases for people living in deprived areas. This very low rate is partly because lung cancer is often diagnosed at an advanced stage. Questionnaires and scans increase survival rates but many cancers are still missed, and many patients suffer misdiagnoses.

Researchers in ICEP found that DNA methylation provides a biomarker for lung cancer risk. They are now developing a test in collaboration with the NHS Targeted Lung Health Check, an NHS scheme that is forming the basis of a national screening programme. If our test performs as expected, it can be seamlessly incorporated into this standard clinical practice, helping more lung cancer cases to be spotted earlier and improving survival rates.

ICEP has also done trials and feasibility studies for behavioural interventions. For example, researchers found that using smartwatches can help people quit smoking and drinking alcohol. Another part of the programme found that using e-bikes to increase physical activity can help people recovering from prostrate cancer.

All of this work has also influenced policy recommendations. For example, researchers from ICEP fed into a recent House of Lord consultation on the health impacts of obesity.

ICEP researchers have also helped shape policies around dissuading young people from vaping. In developing a range of new policies, the UK Parliament discussed and cited evidence from ICEP research. The Government also changed their tax policy in line with our consultation recommendations. Instead of having a tiered tax rate dependent on the amount of nicotine in a vape (which could mislead people into thinking nicotine itself is harmful) they have chosen to introduce a flat rate tax.

Throughout ICEP, our patient and public involvement and engagement (PPIE) group has provided valuable insight into current and planned work. This involvement has also helped us all learn about how to do PPIE effectively in complex, non-clinical research. The group led on producing a poster to share some of our learning.

Find out more about ICEP in videos from our end-of-programme celebration event.

New programme with obesity focus

So, what next? As one CRUK-funded programme ends, another begins. The start of February marks the start of the Obesity-related Cancer Epidemiology Programme (OCEP). This programme will build on the foundations of our previous work with a particular focus on obesity. Obesity is a risk factor in at least 13 cancers but there is a gap in understanding the underlying biology.

OCEP hopes to halt the rising trend of obesity-related cancers by investigating: 1) why obesity causes cancer; 2) who would most benefit from risk-reducing measures; and 3) what the most effective measures are.

By improving understanding of the biological mechanisms, the programme will greatly improve our understanding of how we can prevent obesity-related cancers. Its findings will inform the development of prevention trials that will test better ways to prevent obesity-related cancer, especially for those at higher risk. In the longer-term these findings will help shape policy initiatives, leading to better public health and prescribing guidance for preventing obesity-related cancers.

A wider partnership

OCEP is one part of a wider set of epidemiology research on cancer at University of Bristol and beyond. At the end-of-ICEP celebration event we asked the team – researchers, professional services team and public contributors – what they valued about being part of ICEP. Overwhelmingly, the responses focused on the wider culture of teamwork and collaboration.

“… a great, inclusive and collegiate culture … working with amazing group of people … relationships, collaborations and friendships formed along the way  … friendly colleagues … fabulous people  … commitment and team work … working with so many enthusiastic researchers …”

Alongside this, people valued opportunities to learn from each other and develop new skills.

“ … capacity building pipeline  … hearing experience of people in public engagement group …  festivals … going on BBC news … encouragement to pursue my own research ideas (as an early-career researcher) …”

This collaborative spirit will not end with the end of the Integrative Cancer Epidemiology Programme. OCEP and all our cancer epidemiology work will sit within a wider Integrative Cancer Epidemiology Partnership – a new ICEP. This will be part of the University of Bristol’s grand challenge cancer theme and involve work with partners around the world. We look forward to working together to continue to understand cancer biology and help more people survive cancer.