Can genomic profiling help predict who will get a second bowel tumour?

Dr Harindra Jayasekara.

Bowel cancer is among the most common of cancers and while survival rates have increased, research is needed into establishing who will develop a second, potentially deadly, tumour. People developing a pre-cancerous polyp in the large bowel are more likely to have a subsequent polyp or bowel cancer. Yet we are unable to accurately identify who will or will not develop a second lesion. By establishing this, high-risk patients can be screened more frequently as necessary while others may be spared unnecessary interventions.

Dr Harindra Jayasekara, a cancer epidemiologist at the Department of Clinical Pathology at The University of Melbourne and at the University of Melbourne Centre for Cancer Research at Victorian Comprehensive Cancer Centre, has been awarded a Victorian State Government Early Career Seed Grant to further his research into developing genomic profiling to accurately discriminate those at high-risk of developing a second bowel neoplasm from those at low-risk.

Using state-of-the-art genetic profiling and clinical methods, as well as 15 years of follow-up data from a large Australian bowel cancer study, Dr Jayasekara hopes his research will take us closer to understanding who is at risk.

“We aim to develop a model that incorporates novel genomic profiling to determine a person’s risk of developing cancer of the large bowel following the diagnosis of a polyp,” Dr Jayasekara said.

“Current determinants of colorectal cancer risk are not personalised, resulting in unnecessarily frequent surveillance colonoscopies (an invasive procedure that scans for polyps, tumours and other lesions in the bowel) for low-risk individuals and insufficient testing for individuals at higher risk.”

Dr Jayasekara said he and Associate Professor Dan Buchanan who leads the Colorectal Oncogenomics Group at the Department of Clinical Pathology hoped the findings of the research will be translated into clinical practice and incorporated into colorectal cancer surveillance guidelines.

The research is supported by a $200,000, two-year grant announced by the State Government in January as part of a $7 million research boost to fight cancer.

Dr Jayasekara started his career in medicine as a physician and now works as a cancer epidemiologist. He is a Research Fellow in the Colorectal Oncogenomics Group at the Department of Clinical Pathology at The University of Melbourne and at the University of Melbourne Centre for Cancer Research. He is also a Post-doctoral Fellow at the Cancer Epidemiology and Research Division at Cancer Council Victoria and is an Adjunct Fellow at La Trobe University.

Dr Jayasekara’s current research focus is working towards achieving personalised risk assessment of bowel cancer, and he also leads research that evaluates the role of ethanol in alcoholic beverages as a risk factor for cancer.