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Benton S.C.,Surrey Research Park | Benton S.C.,University of Surrey | Seaman H.E.,Surrey Research Park | Halloran S.P.,Surrey Research Park | Halloran S.P.,University of Surrey
Current Gastroenterology Reports | Year: 2015

Screening for colorectal cancer (CRC) reduces CRC mortality; many countries have implemented population-based CRC screening programmes and many more are poised to do so. Whilst several different CRC screening modalities are available, choice will be influenced by cost, available resources (e.g. high-quality colonoscopy) and acceptability of the test by the invited population. For CRC screening, no screening test has so far surpassed the practicality, affordability and effectiveness of tests for the presence of blood in faeces (faecal occult blood tests, FOBt). The results of several large FOBt-based randomised controlled trials provide the best clinical evidence to support their use in population-based CRC screening. This review considers the current options for CRC screening and the future for FOBt. © 2015, Springer Science+Business Media New York.


PubMed | Surrey Research Park, University of Surrey, Coventry University, Queen Mary, University of London and University of Warwick
Type: Journal Article | Journal: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland | Year: 2016

Worldwide, the guaiac faecal occult blood test (gFOBT) is being replaced with the more accurate faecal immunochemical test (FIT) for colorectal cancer (CRC) screening. From January 2016, the National Screening Committee in the UK has recommended a change from the gFOBT to the FIT following a successful Bowel Cancer Screening Programme pilot study with over 40000 participants. Although the test has shown improved uptake and the ability to detect significantly more colorectal cancers and advanced adenomas, the higher uptake and test positivity will challenge the capacity of colonoscopy services. One of the main advantages of the FIT is that it provides a quantitative haemoglobin concentration which has been shown to relate to the risk of CRC. Risk scoring systems which combine the FIT concentration with risk factor assessment have been shown to improve the sensitivity of the test. This individualized approach to screening could enable those at greatest risk to be referred for colonoscopy, optimizing resource use and ultimately patient outcomes.


PubMed | University of Nottingham, Queen Elizabeth Hospital, Imperial College London, Surrey Research Park and 7 more.
Type: Journal Article | Journal: British journal of cancer | Year: 2016

The NHS Bowel Cancer Screening Programme in England offers biennial guaiac faecal occult blood testing (gFOBt). There is a socioeconomic gradient in participation and socioeconomically disadvantaged groups have worse colorectal cancer survival than more advantaged groups. We compared the effectiveness and cost of an enhanced reminder letter with the usual reminder letter on overall uptake of gFOBt and the socioeconomic gradient in uptake.We enhanced the usual reminder by including a heading A reminder to you and a short paragraph restating the offer of screening in simple language. We undertook a cluster-randomised trial of all 168480 individuals who were due to receive a reminder over 20 days in 2013. Randomisation was based on the day of invitation. Blinding of individuals was not possible, but the possibility of bias was minimal owing to the lack of direct contact with participants. The enhanced reminder was sent to 78067 individuals and 90413 received the usual reminder. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation. Data were analysed by logistic regression with conservative variance estimates to take account of cluster randomisation.There was a small but statistically significant (P=0.001) increase in participation with the enhanced reminder (25.8% vs 25.1%). There was significant (P=0.005) heterogeneity of the effect by socioeconomic status with an 11% increase in the odds of participation in the most deprived quintile (from 13.3 to 14.1%) and no increase in the least deprived. We estimated that implementing the enhanced reminder nationally could result in up to 80 more people with high or intermediate risk colorectal adenomas and up to 30 more cancers detected each year if it were implemented nationally. The intervention incurred a small one-off cost of 78000 to modify the reminder letter.The enhanced reminder increases overall uptake and reduces the socioeconomic gradient in bowel cancer screening participation at little additional cost.


PubMed | University of Nottingham, Queen Elizabeth Hospital, Imperial College London, Surrey Research Park and 6 more.
Type: | Journal: Gastroenterology research and practice | Year: 2016

Objective. To test the effectiveness of adding a narrative leaflet to the current information material delivered by the NHS English colorectal cancer (CRC) screening programme on reducing socioeconomic inequalities in uptake. Participants. 150,417 adults (59-74 years) routinely invited to complete the guaiac Faecal Occult Blood test (gFOBt) in March 2013. Design. A cluster randomised controlled trial (ISRCTN74121020) to compare uptake between two arms. The control arm received the standard NHS CRC screening information material (SI) and the intervention arm received the standard information plus a supplementary narrative leaflet, which had previously been shown to increase screening intentions (SI + N). Between group comparisons were made for uptake overall and across socioeconomic status (SES). Results. Uptake was 57.7% and did not differ significantly between the two trial arms (SI: 58.5%; SI + N: 56.7%; odds ratio = 0.93; 95% confidence interval: 0.81-1.06; p = 0.27). There was no interaction between group and SES quintile (p = 0.44). Conclusions. Adding a narrative leaflet to existing information materials does not reduce the SES gradient in uptake. Despite the benefits of using a pragmatic trial design, the need to add to, rather than replace, existing information may have limited the true value of an evidence-based intervention on behaviour.


News Article | November 1, 2016
Site: www.marketwired.com

GUILDFORD, UNITED KINGDOM--(Marketwired - Nov 1, 2016) - ANGLE plc ( : AGL) ( : ANPCY), the specialist medtech company, announces that a Notice of General Meeting (GM) has been distributed to shareholders. This notice comprises a special resolution in relation to a reduced level for the disapplication of statutory pre-emption rights, as noted in the RNS of 4 October 2016. The GM will be held at 2:00pm on Thursday 24 November 2016 at the 3 Frederick Sanger Road, Surrey Research Park, Guildford, GU2 7YD. The Notice of GM is available on the Company's website http://www.angleplc.com/investor-information/financial-reports/. ANGLE is a specialist medtech company commercialising a disruptive platform technology that can capture cells circulating in blood, such as cancer cells, even when they are as rare in number as one cell in one billion blood cells, and harvest the cells for analysis. ANGLE's cell separation technology is called the Parsortix™ system and it enables a liquid biopsy (simple blood test) to be used to provide the cells of interest. Parsortix is the subject of granted patents in Europe, the United States, Canada, China and Australia and three extensive families of patents are being progressed worldwide. The system is based on a microfluidic device that captures live cells based on a combination of their size and compressibility. Parsortix has a CE Mark for Europe and FDA authorisation is in process for the United States. ANGLE has established formal collaborations with world-class cancer centres. These Key Opinion Leaders are working to identify applications with medical utility (clear benefit to patients), and to secure clinical data that demonstrates that utility in patient studies. Details are available here http://www.angleplc.com/the-company/collaborators/ The analysis of the cells that can be harvested from patient blood with ANGLE's Parsortix system has the potential to help deliver personalised cancer care offering profound improvements in clinical and health economic outcomes in the treatment and diagnosis of various forms of cancer. The global increase in cancer to a 1 in 3 lifetime incidence is set to drive a multi-billion dollar clinical market. The Parsortix system is designed to be compatible with existing major medtech analytical platforms and to act as a companion diagnostic for major pharma in helping to identify patients that will benefit from a particular drug and then monitoring the drug's effectiveness. As well as cancer, the Parsortix technology has the potential for deployment with several other important cell types in the future. ANGLE stock trades on the AIM market of the London Stock Exchange under the ticker symbol AGL and in New York on the OTC-QX under the ticker symbol ANPCY. For further information please visit: www.angleplc.com


Carroll M.R.,Surrey Research Park
Clinical biochemistry | Year: 2014

Worldwide, colorectal (CRC) is the third most common form of cancer, after lung and breast cancer, and the fourth most common cause of cancer death, although in developed countries CRC incidence is higher and it accounts for an even higher proportion of cancer deaths. Successful treatment of early-stage CRC confers substantial survival advantage, and there is now overwhelming evidence that screening average-risk individuals for CRC reduces the incidence and disease-specific mortality. In spite of considerable research for new biomarkers for CRC, the detection of blood in faeces remains the most effective screening tool. The best evidence to date for population-based CRC screening comes from randomised-controlled trials that used a guaiac-based faecal occult blood test (gFOBt) as the first-line screening modality, whereby test-positive individuals are referred for follow-up investigations, usually colonoscopy. A major innovation in the last ten years or so has been the development of other more analytically sensitive and specific screening techniques for blood in faeces. The faecal immunochemical test for haemoglobin (FIT) confers substantial benefits over gFOBt in terms of analytical sensitivity, specificity and practicality and FIT are now recommended for CRC screening by the European guidelines for quality assurance in colorectal cancer screening and diagnosis. The challenge internationally is to develop high quality CRC screening programmes for which uptake is high. This is especially important for developing countries witnessing an increase in the incidence of CRC as populations adopt more westernised lifestyles. This review describes the tests available for CRC screening and how they are being used worldwide. The reader will gain an understanding of developments in CRC screening and issues that arise in choosing the most appropriate screening test (or tests) for organised population-based screening internationally and optimising the performance of the chosen test (or tests). Whilst a wide range of literature has been cited, this is not a systematic review. The authors provide FOBT CRC screening for a population of 14.6 million in the south of England and the senior author (SPH) was the lead author of the European guidelines for quality assurance in colorectal cancer screening and diagnosis and leads the World Endoscopy Organization Colorectal Cancer Committee's Expert Working Group on 'FIT for Screening'. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.


Molloy C.,Surrey Research Park
American Laboratory | Year: 2013

Translational medicine research (TransMed) is a new environment in which groups of stakeholders come together to review increasingly complex data with the goals of improving outcomes, getting more value from health-care spending, and developing precision therapeutics. The modern generation of electronic laboratory notebooks (ELNs) offer not just transactional efficiency, but enable TransMed. The modern ELN is an enterprise data system with configurable user interfaces, analytics, and process control. The ELN needs process execution to govern the wet work and (even) drive LIMS to manage samples and generate the data. It needs to enable all researchers to orchestrate and capture the output from bioanalytical work flows written and optimized by bioinformaticians. It also must store sample-centric 'omics data and patient-centric clinical data in data stores that are built to house them. In addition, the ELN should allow secure yet easy data searching, review, and sharing. Last, it must be able to work in regulated and unregulated environments and provide an audit trail for all data items.


Chen S.,Ovarian and Prostate Cancer Research Trust Laboratory | Corteling R.,Surrey Research Park | Stevanato L.,Surrey Research Park | Sinden J.,Surrey Research Park
Biochemical and Biophysical Research Communications | Year: 2012

Indoleamine dioxygenase (IDO) is a heme- containing enzyme that catalyzes the oxidation of tryptophan to N-formylkynurenine, kynurenine and the downstream quinolinic acid. Though IDO is physiologically important in maintaining tissue integrity, aberrant IDO expression represses T cell function and promotes regulatory T cells (Treg) in cancer. It additionally exacerbates Alzheimer, depression, Huntington and Parkinson diseases via quinolinic acid. Inhibition of IDO has thus been recently proposed as a strategy for treating cancer and neuronal disorders. In the present study, we have developed a cell-based assay to evaluate the suppressive effect of anti-inflammatory phytochemicals on the enzyme. When stimulated by INF-γ, profound high expressions of IDO-1 mRNA as well as the protein were detected in human neural stem cells (hNSC) and verified by real-time retro-transcribed PCR and western blot analysis, respectively. The protein activity was measured by kynurenine concentration and the assay was validated by dose-responsive inhibition of IDO-1 antagonists including 1-methyltryptaphan, indomethacin and acetylsalicylic acid. Among the tested compounds, apigenin, baicalein, chrysin, and wogonin exhibit a potent repressive activity with IC50s comparable to that of indomethacin. The inhibition was further found to be independent of gene expression and protein translation because of the unaltered levels of mRNA and protein expression. Although curcumin displayed a potent inhibitory activity to the enzyme, it appeared to be cytotoxic to hNSCs. Morphological examination of hNSC revealed that baicalein and wogonin at the inhibitory concentrations induced neurite outgrowth. In conclusion, our data shows that certain phytochemicals with 2-phenyl-1-benzopyran-4-one backbone (flavones) attenuate significantly the IDO-1 protein activity without harming hNSCs. The inhibitory activity might have partially contributed to the anti-cancer and neuro-protective property of the compounds. © 2012 Elsevier Inc.


Young K.,Royal Surrey County Hospital | Rowe-Jones J.,Surrey Research Park
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2011

Purpose of review: To describe the contemporary techniques used for septal saddle nose and, based on these, present our approaches for correction of a spectrum of deformity severities. Recent findings: A review of different techniques currently in practice. These reflect greater emphasis on nasal structural framework repair rather than disguise and the use of autografts rather than allografts. Summary: We present our classification of septal saddle deformity, demonstrating that this condition requires a flexible surgical approach with different techniques required depending on the extent of the defect. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Halloran S.P.,Surrey Research Park
Nature reviews. Gastroenterology & hepatology | Year: 2014

Colorectal cancer (CRC) screening, the decade's most promising cancer-related public health development, is evolving. Faecal immunochemical tests (FIT) will be the primary population-based CRC screening biomarker for the next 10-15 years. Will the international community exploit the full potential of FIT and other CRC risk indicators to enable a revolution in the effectiveness of screening?

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