While prevention of most female specific cancers (ovarian, breast, endometrial) has not progressed substantially in recent years, significant progress has been made with cervical cancer due to the accessibility of the cell of origin (cervical smear) and availability of a test for a causal agent (human papilloma virus); together these enable identification of high risk individuals and interventions in order to prevent infection or halt the progression to invasive cancer.
Our FORECEE (Female cancer prediction using cervical omics to individualise screening and prevention) consortium has developed an exciting opportunity to utilise clinically abundant cervical cells in tandem with a multi-omics enabled (genome, epigenome, metagenome) analysis pipeline to understand an individual's risk of developing all female specific cancers and to direct a personalised screening and prevention strategy. Cervical cells — currently collected within cervical cancer screening — provide an ideal window into other female specific cancers because they are (i) an excellent non-invasive source of high quality DNA, (ii) provide a readout for environmental exposure, (iii) are part of the Muellerian tract and (iv) are hormone sensitive, recording (via the epigenome) various hormonal conditions over a lifetime that trigger cancer development.
Our consortium comprises a multi¬disciplinary team of experts in clinical oncology, risk-benefit communication, omics technologies, decision analysis, health economics and public health. We will examine the effectiveness of the proposed cervical cell omics analysis method and investigate the legal, social, ethical and behavioural issues related to the implementation of the risk prediction tool, through direct interaction with stakeholder groups with a view to ensuring its rapid translation into clinical practice across Europe.
The FORECEE project is aligned with the novel concept of "P4 Medicine" (predictive, preventive, personalised, and participatory): it aims to develop a risk prediction tool and translate its output into personalised recommendations for screening and prevention of female cancers.