Due to the COVID-19 pandemic, the collection of oral cancer samples in India has been on hold for almost a year. Now, Aqsens Health’s research collaboration to detect oral cancer from saliva with the Public Health Foundation of India continues. The next step in the project is to collect an extensive sample data set in India and move on to laboratory analysis of the samples.
A challenging year
The year 2020 was an unusual year everywhere in the world. The COVID-19 pandemic had an effect on almost every aspect of our societies, research projects included. As countries began to implement lockdowns and focus health care resources on managing the pandemic, many less time-sensitive research projects, and especially projects that required human saliva samples, had to be put on hold.
This was also the case with Aqsens Health’s research collaboration with the Public Health Foundation of India (PHFI). Now, as the world slowly starts to return towards a new kind of normalcy, the many research projects that have been on pause also slowly continue right where they left off.
Oral cancer burden in India
India accounts for almost a third of the world’s oral cancer cases. In 2020, the estimated number of new oral cancer cases in India was over 135 000, while mortality was estimated at over 75 000. The oral cancer burden in India is largely driven by young men and women during productive years.
Low-income populations in India have the highest risk of developing oral cancer due to constant exposure to several risk factors, like tobacco and chewing Betel-quid. The low- and middle-income populations also have limited access to health care services, and the delayed diagnoses have been associated with the high oral cancer morbidity and mortality. The Indian government is taking steps to lower the incidence of oral cancer by raising awareness about risk factors, implementing policy recommendations for tobacco control and downstaging by establishing population level cancer screening and early detection programmes for oral cancer.
Detection of oral cancer from saliva –project
Aqsens Health’s collaboration with PHFI started through a proof of concept –project for the detection of oral cancer Aqsens had conducted in India earlier. When the time came to move into the research validation phase of the project in 2018, Aqsens wanted to find a partner with more widely spread operations and a high reputation in research and health technology validation. This led to the collaboration with the Public Health Foundation of India, and the first cooperation agreement was signed in May of 2018. The collaboration officially began later in 2018.
In 2021, the project’s main aims remain the same as they were in the beginning – to establish E-TRF’s functionality in the Indian context and to validate its functionality as a screening tool for oral cancer. Improving early detection has the potential to directly affect oral cancer mortality, and Aqsens Health’s portable and affordable screening solution could also be deployed in remote, low-income areas with limited access to healthcare services.
The next steps
After a year of not being able to collect sample data, PHFI is now able to continue the data collection safely in a controlled hospital environment in the southern city of Chennai. Leading the project in India is Dr. Krithiga Shridhar, who is an Epidemiologist at the Public Health Foundation of India. Dr. Shridhar recounts the past year’s challenges:
“We had to retain the well-trained staff during this one year period, where we could not do much in terms of data collection, but we had to retain them, motivate them, and assure them that this project would go forward” Dr. Shridhar explains.
Making sure that the project would continue after the pandemic was the result of close cooperation and mutual trust between Aqsens Health and PHFI. The team kept in close contact during 2020 even though the project could not move forward. Open and honest communication played a significant part in keeping the project going despite the delay.
“Our project was due to end somewhere early this year, but it got extended until early next year. That was one thing we could do, you know, mutually agreeing and extending the timeline, which really played a huge role in terms of taking this project forward” Dr. Shridhar continues.
Now after a year’s pause both parties are extremely excited to continue the project. The next objective is to collect a representative number of samples and ensure the quality of sample collection with a good collection infrastructure. Dr. Shridhar outlines the research project’s next steps:
“Our number one goal is to ramp up the data collection as much as possible in hospital settings. For example, the Southern unit where we are collecting data for oral cancer is a hospital unit. So there are well-set protocols and adequate protective measures can be followed, and the patients’ entry and exit are well monitored.”
After the sample collection is complete, the next goal is to facilitate laboratory analysis in India by making sure that the infrastructure and laboratory conditions comply with Aqsens Health’s standards.
Both Aqsens Health and PHFI are excited about the prospect of new research collaborations. The current project establishes a platform for future cooperation between Aqsens Health and PHFI and after its successful completion, the two teams will move on to look for future projects together.
“We are delighted to continue our work with the Public Health Foundation of India. Their commitment to this project underlines the importance of having methods that can offer accurate remote diagnostics tests for preventive health, at a required price point,” says Riikka Erkkilä, the COO of Aqsens Health Oy.
“This is an important stepping stone for our company in extending the use of our E-TRF method towards developing economies,” Riikka continues.
The data collection in Chennai has already begun, and the Detection of oral cancer from saliva –project will continue until 2022.