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New Gene Test Detects Risk of Oral Cancer

Researchers create “malignancy index” (Oct. 4)

According to an October 4 announcement, researchers at Queen Mary, University of London in the U.K. have developed a new gene test that can detect precancerous cells in patients with benign-looking mouth lesions. The test could potentially allow at-risk patients to receive earlier treatment, significantly improving their chances of survival.

The study, published in the International Journal of Cancer, showed that the quantitative Malignancy Index Diagnostic System (qMIDS) test had a cancer detection rate of 91% to 94% when used on more than 350 head-and-neck tissue specimens from 299 patients in the U.K. and Norway.

Mouth cancer affects more than half a million people worldwide, with global figures estimated to exceed 1 million a year by 2030. Most cases are caused by smoking or chewing tobacco and by drinking alcohol.

An estimated 5% to 30% of mouth lesions may turn into cancers. If detected in the early stages, treatment can be curative, but until now no test has been able to accurately detect which lesions will become cancerous.

The current diagnostic gold standard is histopathology, in which biopsy tissue taken during an operation is examined under a microscope by a pathologist. This is a relatively invasive procedure, and many mouth cancers are being diagnosed at later stages when the chances of survival are significantly reduced. For patients presenting with advanced disease, survival rates are poor (10% to 30% at 5 years).

“A sensitive test capable of quantifying a patient’s cancer risk is needed to avoid the adoption of a wait-and-see intervention,” said lead investigator Dr. Muy-Teck Teh. “Detecting cancer early, coupled with appropriate treatment, can significantly improve patient outcomes, reduce mortality, and alleviate long-term public healthcare costs.”

The qMIDS test measures the levels of 16 genes, which are converted via a diagnostic algorithm into a “malignancy index” that quantifies the risk of the lesion becoming cancerous. The test is less invasive than the standard histopathology methods as it requires only a 1- to 2-mm piece of tissue (less than half a grain of rice), and it takes less than 3 hours to get the results, compared with up to a week for standard histopathology.

Clinical trials are needed to evaluate the long-term benefits of the test.

For more information, visit the Queen Mary, University of London Web site.

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