Metabolomics makes colorectal cancer detection easier

A made-in-Alberta solution for the prevention and early detection of colorectal cancer is one step closer to mass adoption.

In October 2018, Metabolomics Technologies Inc. announced the launch of a $1.4-million project to evaluate a new colorectal cancer screening program using its flagship product, PolypDx.

PolypDx is the first and only urine test for the detection of precancerous polyps in the colon. The current screening method involves completing a home stool (poop) test.

It is believed that the adoption of this new diagnostic tool will help increase screening compliance rates, which are currently 33 percentage points behind the provincial goal of 70 per cent. (That means only 3.7 out of 10 Albertans complete the recommended stool test when prescribed by a doctor.)

Colorectal cancer is the third deadliest cancer for both men and women in Canada — accounting for an estimated 9,400 deaths in 2017 alone. When detected early, however, this type of cancer is preventable. According to the Canadian Cancer Society, the five-year survival rate at stage I diagnosis is 92 per cent.

Unfortunately, despite the availability of organized screening programs in most provinces and territories, nearly half of all colorectal cancer cases in Canada are diagnosed at stages III or IV — when they are mostly untreatable.

The high percentage of late-stage diagnoses likely reflects suboptimal screening rates. Recognizing this, MTI founder founders Dr. Richard Fedorak and Dr. Haili Wang set out to create a more user-friendly test.

“[They decide to] use urine as a biomarker because people give urine samples all the time,” MTI CEO David Chang explains.

In 2008, Fedorak and Wang discovered a way to identify the presence of polyps in the colon using an emerging field known as metabolomics (the study of molecules generated by metabolism.) A year later, they used artificial intelligence to turn the data-heavy findings into an agile and cost-effective test. MTI partnered with the Alberta Machine Intelligence Institute to establish the A.I. and machine learning protocols in their product.

The resulting test is not only more convenient (patients can give a sample at the clinic, rather than wait for a bowel movement at home), but also leads to earlier detection of precancerous cells in the colon.

PolypDx is three times better at detecting adenomatous polyps — a precursor to colorectal cancer — than the current fecal immunochemical test (FIT). Proper screening can lead to removal of the polyps, stopping the progression of cancer before it begins.

Though ease of use isn’t generally a factor when adopting new health innovations, PolypDX was an exception. The Alberta Colorectal Cancer Screening Program is hoping the urine-based test will help increase screening compliance rates, especially in remote and rural areas.

The project marks a significant milestone for the University of Alberta spin-off; it is meant to serve as a launching pad for the rest of Canada.

“The problem of [low] screening rates is not just an Alberta problem,” Chang says.

PolypDx is currently in use in parts of the United States.