Groundbreaking Manchester partnership with Kenyan oesophageal cancer initiative gets £2.6m award

A groundbreaking initiative by Manchester and Kenyan researchers to bring world leading oesophageal cancer early detection and research to Kenya has received £2.6 million funding from the Government through the National Institute for Health Research.

The unique partnership between The University of Manchester, The Christie NHS Foundation Trust, and Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) will raise awareness of squamous cell carcinoma of the oesophagus (OSCC) in Kenya and increase engagement in public screening opportunities using mobile detection units that travel across the country.

It will link the early detection of cancer using a digital transformation in cancer detection and outcome data through a “hub and spoke” system linking cancer hospitals and local healthcare authorities.

The funding will help establish a central cancer specialist “hub” at KUTRRH in the capital Nairobi which will support local cancer care delivery ’spokes’ in five regional counties: Meru, Kiambu, Kisii, Nakuru, and Nyeri.

According to the International Agency for Research in Cancer, OSCC is the third most common cancer in Kenya and the most lethal: 99% of patients die from their disease within 5 years.

The poor prognosis is directly related to OSCC patients being diagnosed too late when they have advanced, incurable disease. Instead, this initiative will establish early detection as a part of the Kenyan healthcare system by training healthcare workers to recognise early symptoms of OSCC.

The NIHR Global Health Research award will co-train Kenyan clinicians and healthcare workers in NHS Trusts. It will provide continuous, bespoke training in state of the art cancer diagnosis and molecular pathology where the initial trainees from Kenya travel to Manchester and subsequently return to Kenya to become the trainers future cancer researchers and carers.

The award will also use molecular assays to help identify Kenyans at greatest risk of OSCC.

Using next generation genetic and cell biology approaches, tissue samples taken for patient diagnosis will undergo sophisticated molecular pathology studies to document the abnormal cancer genes and proteins which drives the initial growth, unique biology and aggression of Kenyan OSCC cancers.

The genetic results will be obtained from all 5 Kenyan counties and matched with clinical data and county level information to try to understand the differences which cause the variable rates of OSCC seen across Kenya.

Robert Bristow is the study’s UK Co-Lead, Professor of Cancer Studies at The University of Manchester, Chief Academic Officer at the Christie NHS Foundation Trust  and Director of the Manchester Cancer Research Centre (MCRC).

He said: “We are excited to be working side by side with our Kenyan partners to optimise a national Kenyan Cancer Early Detection network to diagnose and understand the biology squamous cell carcinoma of the oesophagus at an early stage and design new strategies to improve survival.

“Our joint study is designed to increase accuracy of data across the diverse geography of Kenya to use to develop early detection intervention strategies for Kenyans living in rural areas with very low incomes.

“Many are cut off from cancer care since around 80% of cancer treatment centres are in the capital city Nairobi and a hub and spoke model will benefit both rural and urban populations.

“The project also is an example of inclusive cancer research as the data from the molecular research in OSCC and other Kenyan cancers will improve our understanding and appropriate individualised treatment of cancers in Africa and UK patients who come from Africa. Despite Africa being between 15-20% of the world’s population, only 2% of the genetic sequencing and information have been completed on African cancers”

Professor Keith Brennan, Vice Dean for Internationalisation at The University of Manchester said: “This work is about helping to meet the UN Sustainable Development Goals by supporting the provision of Universal Health Coverage within Kenya.

“As the world’s number one university in the Times Higher Education (THE) Impact Rankings last year, we take this responsibility very seriously.”

Professor F. George Njoroge is study’s Kenyan  co-principal investigator,  Chief Scientific Officer at  Kenyatta University Teaching, Referral and Research Hospital (KUTRRH),  Board director at Kenya Medical Research Institute(KEMRI) and chairman of the council at Daystar University

 He commented: “The unique collaboration between  Kenya and  United Kingdom in this oesophageal cancer study will go a long way in establishing ways  that would tilt the balance whereby oesophageal cancer could be detected at the potentially curative stages 1 and 2 rather than the late stages 3 and 4. This will be a game changer in diagnosis and management of that disease”