Improving survival rates for cancers of unknown primary (CUP) and reducing the proportion of Indigenous Australians diagnosed with CUP will be the focus of a new Flinders University-led project, which recently received a $2.4 million grant from the federal government.
Cancers of unknown primary are those that, despite a myriad of tests, doctors cannot determine where in the body the cancer started. As the primary site is unknown, site-specific treatment cannot be initiated, reducing the chance of survival.
While CUP only accounts for 1.6 percent of cases in Australia, among Indigenous Australians that incident is 2.1 times higher, with a 5-year survival rate of only 9 percent - almost half that of the non-Indigenous population.
Professor Chris Karapetis from the Flinders Health and Medical Research Institute will lead the project and says despite the availability of guidelines, or an 'optimal care pathway', for treating CUP they are yet to be universally implemented, impacting both Indigenous and non-Indigenous Australians.
"What we are currently seeing is people with suspected CUP may experience inappropriate or excessive tests, or the recommended tests aren't being used enough," says Professor Karapetis. "This can lead to delayed or inaccurate diagnosis, or a missed opportunity to identify a primary site, which then results in poorer outcomes.
"Our project aims to evaluate what impact adhering to the optimal care pathway has on patients diagnosed with CUP in South Australia and the Northern Territory."
Through this, the research team will look to better understand what improvements can be made to the care and survival outcomes of Indigenous Australians who present with suspected CUP.
"For Indigenous Australians a diagnosis of CUP can highlight the existing disparities in our health care system, including issues of remoteness, access to services and technology and the acceptance of invasive tests," says Professor Karapetis.
In a bid to improve treatment options and outcomes, the project will also investigate ways to improve identification of a cancer's primary site, including testing a tool that can identify the source of cancerous tissue.
"Previous studies have shown the tool is almost 100 percent accurate in identifying cancerous tissue from a primary site and 78 percent accurate when testing samples taken from cancer that has spread," says Professor Karapetis.
"Importantly, the tool can be used on archived tissue, meaning it can be made available for remote and regional areas without the need to collect new samples.
"Through this tool, we will also generate world-first data on tumour biology that may help inform the tumour response to therapy in Indigenous Australians compared to non-Indigenous Australians."
The research grant was awarded through the Medical Research Future Fund – EPCDR 2020 Improving Diagnosis in Cancers with Low Survival Rates Grant Opportunity.
Three Flinders University-led projects were awarded in the recent MRFF grant round, totalling $5.8 million. $2 million was awarded to investigate a blood test to help guide the treatment of gastrointestinal cancers while $1.4 million was awarded to the Partnership in iSupport Program
