Title: Early Diagnosis for Ovarian Cancer using commercial loyalty card data and purchase behaviours
Funder: Cancer Research UK

Abstract: Background: Approximately 7400 new cases of ovarian cancer are diagnosed each year in the UK, and with over 4000 women dying from the disease each year it is a particularly lethal form of cancer. The symptoms are not well known, are vague and non-specific and most women are diagnosed at a late stage when the cancer has already spread around the peritoneum with poor prognosis. Novel methods are needed to improve earlier detection and thereby improve survival from this disease. We hypothesise that a change in purchasing behaviour, primarily an increase in self-medication to treat these vague cancer symptoms, may provide a novel avenue for earlier diagnosis for cancer. Aims: In this study we propose to use loyalty card data from two participating high street retailers (Boots and Tesco) to investigate purchase behaviour as an opportunity for cancer symptom surveillance. We aim to conduct a case-control study of ovarian cancer patients matched with healthy controls. We aim to develop a prospective cohort study of loyalty card holders linked with Cancer Registry to prospectively and independently validate any early diagnosis test. Lastly, we aim to investigate how best to effectively communicate potential risk or cancer symptom alerts back to participants. Methods: We will recruit 500 recently diagnosed ovarian cancer cases and 500 healthy controls and collate 4 years of prior purchase data. We will also collect epidemiological and symptom questionnaire data and clinical information to stratify on risk profiles, stage or histology. Using the retailers email lists and mail outs we will recruit 50,000 loyalty card holders to participate in a prospective cohort and will identify incident cancer cases by linking with Cancer Registry. We will use discreet choice experiments with 600 participants to assess public acceptability and methods of communicating this information. Impact: If successful, this research may identify an “early cancer symptom alert” to aid in earlier diagnosis of ovarian cancer and addresses an important clinical problem of delayed presentation. It may provide direct empirical evidence for when symptoms are occurring prior to diagnosis and improve our understanding of the natural progression of this disease. It will provide a novel national cohort study that might aid in early detection of many cancer types, foster stronger interactions with our commercial partners in cancer research and may promote engagement with other retailers. Lastly, this research may open other opportunities for research such as epidemiology of diet and cancer risk.

Lay abstract: Background: Approximately 7400 new cases of ovarian cancer are diagnosed each year in the UK, and with over 4000 women dying from the disease each year it is a particularly lethal form of cancer. The symptoms are not well known, are vague and non-specific and most women are diagnosed at a late stage when the cancer has already spread around the peritoneum with poor prognosis. Novel methods are needed to improve earlier detection and thereby improve survival from this disease. We hypothesise that a change in purchasing behaviour, primarily an increase in self-medication to treat these vague cancer symptoms, may provide a novel avenue for earlier diagnosis for cancer. Aims: In this study we propose to use loyalty card data from two participating high street retailers (Boots and Tesco) to investigate purchase behaviour as an opportunity for cancer symptom surveillance. We aim to conduct a case-control study of ovarian cancer patients matched with healthy controls. We aim to develop a prospective cohort study of loyalty card holders linked with Cancer Registry to prospectively and independently validate any early diagnosis test. Lastly, we aim to investigate how best to effectively communicate potential risk or cancer symptom alerts back to participants. Methods: We will recruit 500 recently diagnosed ovarian cancer cases and 500 healthy controls and collate 4 years of prior purchase data. We will also collect epidemiological and symptom questionnaire data and clinical information to stratify on risk profiles, stage or histology. Using the retailers email lists and mail outs we will recruit 50,000 loyalty card holders to participate in a prospective cohort and will identify incident cancer cases by linking with Cancer Registry. We will use discreet choice experiments with 600 participants to assess public acceptability and methods of communicating this information. Impact: If successful, this research may identify an “early cancer symptom alert” to aid in earlier diagnosis of ovarian cancer and addresses an important clinical problem of delayed presentation. It may provide direct empirical evidence for when symptoms are occurring prior to diagnosis and improve our understanding of the natural progression of this disease. It will provide a novel national cohort study that might aid in early detection of many cancer types, foster stronger interactions with our commercial partners in cancer research and may promote engagement with other retailers. Lastly, this research may open other opportunities for research such as epidemiology of diet and cancer risk.

Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: CANCER AND NEOPLASMS