One project is about finding a screening method for colorectal cancer based on a new blood sample using new technology, and the other project is about anaemia during pregnancy and its consequences for the child’s risk of developing diabetes in early adulthood.
“The screening project may have far-reaching consequences for Denmark and other western countries, while results from the anaemia project which includes field studies in Tanzania may give a much better understanding of why obesity and diabetes are developing so fast in Africa and other developing countries", says the coming chairman of the commission, director Kim Krogsgaard.
He regrets that resources this year have been very limited and that the success rate is less that 4 %: “To choose between so many highly qualified applications was extremely difficult. But I am happy with the two exciting project, each of them with far-reaching possibilities”, he says.
NOCRC : Novel CRC Screening Tools Improve Survival and Cost-effectiveness
(1309-00006B)
Danish title: NOCRC: Nye CRC screenings tests forbedre overlevelse og omkostningseffektivitet
Grant holder: Torben Falck Ørntoft
E-mail: orntoft@ki.au.dk
Grant: DKK 20 million
Total budget: DKK 35,2 million
Funding period: 2014-2018
Research training: two PhDs
Partners: Aarhus University Hospital, Department of Molecular Medicine; Aarhus University Hospital, Department of Clinical Epidemiology; Hvidovre Hospital; University College London; John Hopkins University School of Medicine; Exiqon A/S
Every year, approximately 2 000 Danes die from colorectal cancer (CRC). To reduce the mortality, a screening program based on analysis for feces occult blood (FOBT) and colonoscopy will be initiated in DK January 2014 at a cost of 200 mill DKK/year. This screening strategy has been documented to reduce mortality by 15 %. Nevertheless, the FOBT has two major weaknesses: low patient compliance (about 50 %) and mediocre sensitivity (about 60 %), which results in around 30 % clinical sensitivity. Consequently, 70% of the CRC cases in the screening cohort will go undetected. From a societal perspective there is great potential in replacing the FOBT with a better test, thereby reducing mortality further and improving cost-effectiveness. Blood based tests have much better patient acceptance than feces tests, and well performing blood markers have been reported. However, they have not been validated in the context of operational screening programs, so the necessary evidence to justify their use has not yet been generated. With the present interdisciplinary cancer research alliance, bringing together experts from Denmark, UK, and USA, we aim to develop and validate a high performance blood based test. We will test the most promising existing markers, but also develop novel markers and ultra-sensitive and cost-efficient methods to quantify these. We include a thorough health economic analysis of the cost/benefit of the new markers. The company Exiqon will be instrumental in designing, validating, and providing market access for the test.
FOETALforNCD – Foetal Exposure and Epidemiological Transition: the role of Anaemia in early Life for Non-Communicable Diseases in later life
(1309-00003B)
Danish title: FOETALforNCD - føtal eksponering og epidemiologisk transition: betydningen af anæmi i fosterlivet for livsstilsygdomme i voksenlivet.
Grant holder: Ib Christian Bygbjerg
E-mail: iby@sund.ku.dk
Grant: DKK 17,9 million
Total budget: DKK 22,2 million
Funding period: 2014-2017
Research training: two PhDs
Partners: University of Copenhagen, Institute of International Health, Immunology and Microbiology; Rigshospitalet, Department for Endocrinology; Lund University, Department of Clinical Research; Aarhus University Hospital, Department of Obstetrics and Gynecology
Globally, anaemia and non-communicable diseases (NCDs), including diabetes and hypertension, are major health problems. In Denmark, 12 % of pregnant women are anaemic, in low- and middle-income countries (LMIC) 40-60%. Anaemia in pregnancy decreases birth weight (BW) and susceptibility to NCDs may partially be determined by low BW and foetal programming. How anaemia affects foetal growth is not well established; poor placental development in early pregnancy may play a pivotal role. While 1st and 2nd trimesters are possible key time points for foetal programming, maternal health before conception could play a role in programming of NCDs. The alarmingly high prevalence of anaemia in LMIC is a threat, but also an opportunity to reveal the role of anaemia in the global epidemic of NCDs. Tanzania is in fast epidemiological transition: from anaemia and infectious diseases towards NCDs within one generation. We will conduct a case-control study of 1894 non-pregnant women, which will form the basis and a recruitment platform for a subsequent case-control study of 568 of these women during pregnancy. Foetal growth and placental development will be evaluated as well as blood markers throughout pregnancy. Causes of anaemia, nutritional status and general health will be characterized before and during pregnancy, and the newborns’ health and body composition measured at delivery. Women, foetal, newborn, and placental health will be linked to epigenetic markers of foetal programming for NCDs in cord blood and placental tissue. This project will shed light on the role of anaemia before and during pregnancy on placental development, intrauterine growth and foetal programming, including epigenetic changes.