Sanome identifies biomarkers from routine blood tests that can aid in the early detection of colorectal cancer (bowel, colon). This finding could lead to better and/or earlier detection of cancer.

Sanome, a digital health company, have had their research published in the peer reviewed Journal Nature’s Scientific Reports. Using the UK Biobank dataset, Sanome used its AI tool to identify blood-based biomarkers that are often collected in routine health check-ups and can indicate the presence of colorectal cancers.

The costs of and getting people to do additional tests is often a barrier for many diagnostic tests, leading to poor adoption and therefore not realising the full potential of the technologies we have to identify diseases earlier. Leveraging routinely collected blood tests for the early detection of diseases such as colorectal cancer has the potential to reach more people, enable earlier intervention, and potentially save healthcare systems billions.

Using machine learning is a powerful new approach to identify signals from existing tests and can lead to novel scientific and clinical insights, as shown in this paper.

The paper, titled: ‘Additive pre-diagnostic and diagnostic value of routine blood-based biomarkers in the detection of colorectal cancer in the UK Biobank cohort’, has been published in Volume 13 of the Journal. It is available for public access.

In this paper, machine learning techniques were used to identify correlations. The data analysed a cohort of over 500,000 participants, aged 40–69 years, recruited between 2006 and 2010 across 22 UK-based assessment centres. The dataset, supplied by the UK BioBank, comprises sociodemographic, psychosocial, lifestyle, family history, clinical, physical, cognitive, activity monitoring, biochemical, imaging, health linkage to a wide range of electronic healthcare records, and genomics data.

Stool based blood tests (e.g. FIT) are the current gold standard for detecting colorectal cancers. These tests show good diagnostic performance, are non-invasive, safe and simple to perform. However, patient acceptability and uptake remain low.

Blood collected from routine check-ups for other disease detections, provide a more acceptable, potentially cheaper alternative to stool-based tests. Longer term, these could even be developed into at-home blood tests.

There has been a lot of research to identify cancer specific blood-based markers such as genomic and epigenomic markers, circulating tumour cells, or specific protein markers such as carcinoembryonic antigen (CEA). Whilst it has now been shown that these biomarkers show diagnostic potential for CRC, they are not yet part of routine blood panels.

The problem that Sanome is ultimately solving is both economic and personal to people before they become patients – can diseases be detected earlier through routine check-ups without initially requiring expensive or invasive procedure, before patients develop un-ignorable symptoms. If we can detect treatable diseases earlier, we are not only saving the healthcare system a lot of money, but we are also improving quality of life and healthy lifespan – this is a core part of our mission.

The health economics of using routine blood tests for the earlier detection of CRC are potentially substantial.

  • There are around 42,900 new bowel cancer cases in the UK every year (Source: CRUK 2016-2018).
  • Stage 1 survival rates = 90%, costs NHS £15k per person
  • Stage 3 survival rates = 20-30%, costs NHS £65k per person.
  • Earlier detection therefore not only saves the NHS potentially thousands a year but also significantly improves survival rates.

Introducing regular stool screening (FIT) and a colonoscopy every 10 years [NICE – National Institute for Health and Care Excellence] has had a big impact on reducing CRC detection from stage 3 to stage 2.

Professor Chris Lowe, University of Cambridge, remarked that, “Data-driven diagnostics represents a new approach to combine diverse data sets to form a more definitive early diagnosis and thereby accelerate treatment options. Such a system will assist the development of “hospital-at-home” approaches and alleviate pressure on the NHS.”

Professor Carole Longson, Founding Member and ex-Director of NICE – National Institute for Health and Care Excellence added, “The work that Sanome is doing is at the forefront a new generation of big data driven diagnostics. By identifying biomarker combinations collected through routine check-ups, Sanome’s approach has the potential to drive cheaper and more useful point of care diagnostics. I am very excited by the work that Benedikt and his team are doing. This new way of thinking about diagnostics could help accelerate the pace of change towards prevention-based healthcare.”

Specialist Dietitian at University Hospital Southampton, Karyn Buckland commented: “Innovations in early-detection for colorectal cancers, such as Sanome’s, may offer an acceleration in diagnosis and treatment, leading to possible improved patient outcomes. Often symptoms for these cancers such as blood in the stool; persistent changes in bowel habits; abdominal pain and/or bloating on eating, or weight loss, are ignored by patients as they are uncertain of how to proceed or can be embarrassed by the nature of the symptom. The opportunity to include these biomarker tests in routine health screening means that even if these symptoms are ignored or omitted from consultation conversation, the presence of disease can still be picked up.”

Dr Ece Kocagoncu, one of the paper’s co-authors, and Data Scientist at Sanome said, “We are excited about our findings because they show the potential of routinely collected blood tests in earlier detection of colorectal cancer, at no additional cost to the healthcare system. If these early blood-based markers used together with other common cancer tests like CEA or faecal immunochemical test, they can provide additive value by increasing the accuracy of the diagnostic test.”

Founder and CEO of Sanome, Benedikt von Thüngen, commented: “This is a great validation of our approach to using ML tools to identify powerful biomarker combinations that can be translated into diagnostic tools for the early detection of health changes. We are already translating this work into clinical practice, and I am super excited by some of the work we have in our pipeline.”

This work wouldn’t have been possible without the support of the UK BioBank, and the wider team at Sanome. We are very excited for the next steps as our research continues to build momentum and we move closer to changing healthcare.

Sanome is building early-warning systems to detect health changes as early as possible, using AI to combine biomarkers into diagnostics. Sanome, Benedikt’s von Thüngen’s digital health venture, is his fifth successful start-up; with previous ventures including Speechmatics.

Colorectal Cancers Statistics

  • There are around 42,900 new bowel cancer cases in the UK every year, that’s nearly 120 every day (2016-2018).
  • Bowel cancer is the 4th most common cancer in the UK, accounting for 11% of all new cancer cases (2016-2018).
    [For more Bowel Cancer statistics, see Cancer Research UK source here.]

Colorectal Cancers Symptoms

  • There are around 42,900 new bowel cancer cases in the UK every year, that’s nearly 120 every day (2016-2018).
  • A persistent change in your bowel habits, including diarrhoea or constipation or a change in the consistency of your stool
  • Rectal bleeding or blood in your stool
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that your bowel doesn’t empty completely – Weakness or fatigue
  • Unexplained weight loss  


Read the paper via Nature’s Scientific Reports here

Download the paper here

Press Release available to download here

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