How City of Hope is leading the way in early cancer detection, prevention

City of Hope prioritizes finding ways to detect cancer earlier, advance personalized treatments and promote screening

The White House recently proclaimed April National Cancer Prevention and Early Detection Month. This announcement comes at a pivotal time, as rates for many common cancers are on the rise. In 2024, for the first time ever, the number of new cancer cases is projected to surpass 2 million.

Cancer will soon become the greatest cause of mortality in the world. And although oncologists often say “the best treatment is prevention,” less than 10% of oncology funding is currently spent on prevention efforts.

Underserved communities often bear the brunt of cancer's impact. This is due, in large part, to lower cancer screening and early detection rates in these communities.

City of Hope Chief Scientific Officer John D. Carpten, Ph.D.
John Carpten, Ph.D., chief scientific officer

“Historically in America, opportunities and health care innovations have not been made available equitably. Educating communities about the importance of screening and making cancer screening more accessible to all communities are ways to close the health equity gap,” said John D. Carpten, Ph.D., City of Hope chief scientific officer, Irell & Manella Cancer Center Director's Distinguished Chair and Morgan & Helen Chu Director's Chair of the Beckman Research Institute. “As an example, Black Americans are 20% more likely to be diagnosed with colon cancer and 40% more likely to die from it.  And since colon cancer screening can detect these cancers early, we can intervene earlier and, in many cases, provide curative treatment. Getting the word out about screening can significantly reduce colon cancer death rates and could reduce the horrible burden of this disease in underserved communities.”

'Early detection and prevention are currently the biggest unmet needs in cancer.'
Marcel van den Brink, president of City of Hope Los Angeles and City of Hope National Medical Center

Disparities also exist based on education level and geographic location. Those with more education are less likely to die prematurely from colorectal cancer than those with less education, and those living in rural areas face higher cancer mortality rates than those living in urban areas. If socioeconomic disparities like these were eliminated, up to 34% of cancer deaths could be prevented.

Additionally, a report released by the American Cancer Society earlier this year showed that the rate of cancer incidence in people under 50 has increased significantly in recent years. Colorectal cancer, for example, is now the leading cause of cancer death in men under 50 and the second leading cause of cancer death in women of the same age group.

These sobering statistics underscore the urgent need for increased awareness, access to screenings and investment in research to address the growing burden of cancer and improve outcomes for individuals and communities affected by this disease.

City of Hope Los Angeles President Marcel van den Brink, M.D., Ph.D.
Marcel van den Brink, M.D., Ph.D., City of Hope president

City of Hope is at the forefront of this endeavor, offering comprehensive screening programs tailored to individual risk factors, leading-edge diagnostic technology and community outreach initiatives that empower individuals to take control of their health and well-being. It is also committed to ensuring that all people, regardless of race, age, gender, socioeconomic status or geographic location, are able to receive quality preventive health services.

“Early detection and prevention are currently the biggest unmet needs in cancer,” said Marcel van den Brink, M.D., Ph.D., president of City of Hope Los Angeles and City of Hope National Medical Center and Deana and Steve Campbell Chief Physician Executive Distinguished Chair in Honor of Alexandra Levine, M.D. “Everyone talks about how important they are, but few institutions devote adequate resources. At City of Hope we have made early detection and prevention a top priority. Finding cancers early or preventing them in the first place can literally mean the difference between life and death.”

Aiming for Earlier Cancer Detection

City of Hope is home to the Center for Cancer Prevention and Early Detection, which is dedicated to accelerating the advancement of new technologies in cancer risk prediction, early detection and monitoring. The center’s goals are to prevent cancer from occurring or detecting it at the earliest stages and to deploy methods to reach diverse, rural and underserved populations. It is comprised of City of Hope’s Division of Mathematics for Cancer Evolution and Early Detection, Translational Genomics Research Institute's (TGen) Center for Early Detection Technologies and City of Hope’s clinical research branch for early detection.

Led by Director Cristian Tomasetti, Ph.D., professor and director in the Division of Mathematics for Cancer Evolution and Early Detection in the Department of Computational and Quantitative Medicine, the center unites investigators from all academic disciplines across City of Hope, including mathematicians, bioinformaticians, molecular biologists and clinicians. This multidisciplinary team is poised to pioneer groundbreaking approaches in detecting cancer when it is most treatable and preventing the disease before it starts. One key research initiative in the works is a blood test for detection of multiple cancers (including lung, ovarian, breast and colorectal), slated to launch next year.

Cristian Tomasetti, Ph.D.
Cristian Tomasetti, Ph.D., director of the Center for Prevention and Early Detection.

"A huge body of evidence shows that cancer isn't what kills us. It is cancer caught at later stages that kills people,” Tomasetti said. “New technology developed at TGen and City of Hope gets us closer to a world where people will receive a blood test annually to detect cancer earlier, when it's more treatable and possibly curable."

In addition, in 2020, City of Hope’s Center for Precision Medicine launched the INSPIRE (Implementing Next-generation Sequencing for Precision Intervention and Risk Evaluation) study to offer comprehensive genetic testing at no cost to patients. A person who elects to participate is offered the option to undergo germline genetic tests for 189 genes related to risk of cancer and other medically actionable disease-causing variants. Genetic tests for inherited susceptibility have been shown to save lives for patients and their family members, and City of Hope's panel of cancer genes is the most comprehensive test for cancer risk. Since its inception, over 20,000 patients have participated, with about 20% testing positive for a disease-causing gene variant.

The vision of the center is to harness genomic insights, clinical expertise and advanced analytics to pioneer personalized treatment and prevention, improving quality of life for patients and their families. The multidisciplinary team includes experts in medical oncology, genetics, genetic counseling, epidemiology, gastroenterology, surgery and other specialty services.

“City of Hope has one of the largest cancer genetic counseling teams in the United States, and we are focused on treating the whole family, since [some of] these gene changes are heritable,” said Heather Hampel, M.S., CGC , professor in the Department of Medical Oncology & Therapeutics Research and associate director of the Center for Precision Medicine.

Researching Cancer Screening and Treatment Options

Clinical research is another key area of focus. For example, Enrique Velazquez Villarreal, M.D., Ph.D., M.P.H., M.S., recently joined City of Hope as an assistant professor in the Department of Integrative Translational Sciences and is leading research on Latinos and precision medicine. Among other research, his lab is focused on molecularly characterizing colorectal cancer tissues of Latinos with the goal of creating targeted therapies for this population. Velazquez Villarreal is also a co-investigator on the National Institutes of Health's National Cancer Institute Colorectal Cancer Disparities Moonshot project.

Doctor Dan Raz
Dan Raz, M.D.

One promising method for early cancer detection and prevention is so-called “liquid biopsy.” Dan Raz, M.D., M.A.S., co-director of City of Hope’s Lung Cancer and Thoracic Oncology Program, is leading a clinical trial to determine the feasibility of lung cancer screening using liquid biopsy in a community setting. Currently, a low-dose computed tomography (CT) scan is used to screen for lung cancer, a procedure that can be intimidating and hard to access for high-risk patients, particularly those in underserved communities. The hope is that a blood-based screening test will be more accessible but still accurate for those who need it most.

Additionally, a City of Hope team led by Ajay Goel, Ph.D., M.S., City of Hope professor and chair of the Department of Molecular Diagnostics and Experimental Therapeutics, and Caiming Xu, Ph.D., a postdoctoral fellow in Goel’s lab, developed an exome-based liquid biopsy test that detected 97% of early-stage pancreatic cancers when combined with screening for the biomarker CA 19-9 in people enrolled in the study. Pancreatic cancer is highly untreatable after it spreads beyond the pancreas, making early detection crucial to survivorship. This investigational screening technique, which garnered national attention after Goel presented his findings at the annual American Association of Cancer Researchers meeting in April, has the potential to enable clinicians to find and treat the disease before it spreads, saving countless lives.

Promoting Mobile Cancer Screening

Recently, City of Hope initiated an innovative mobile cancer screening and prevention program in Southern California, furthering its commitment to eliminating health disparities and meeting the cancer screening needs of local communities. The first-of-its-kind mobile clinic assesses risk and screens for at least 15 different types of cancer and offers state-of-the-art mammography technology.

April - Minority Month - Ashing White BG
Kimlin Ashing, Ph.D.

The program features two highly advanced mobile clinics with a full staff, including nurse practitioners, nurses, mammography technologists and support staff. Mobile clinic clients are able to receive personalized screening recommendations based on a novel risk assessment, along with any necessary lab tests, genetic testing for mutations associated with increased risk for developing cancer, and vaccines for viruses, which may be linked to multiple types of cancer.

"Our comprehensive mobile cancer prevention and screening program is the next step in our mission to expand access to optimal cancer care, bringing our expertise outside the walls of our campus and into the communities we serve,” said Harlan Levine, M.D., president of health innovation and policy at City of Hope. “We know that identifying and addressing cancers early saves lives, and we want to do our part to ensure every person has access to these services and help create a healthier, more equitable future for all.”

Kimlin Tam Ashing, Ph.D., associate director of City of Hope’s Community Outreach and Engagement (COE), has long targeted underserved communities by spearheading a broad initiative to reduce and eliminate health inequities, including access to cancer screenings. COE provides free education, training and screening and partners with community leaders to spread the word. To date, more than 10,000 community members have been screened for colorectal, prostate and breast cancer through the program.

“We can clearly see the relationship between poverty and poor health outcomes,” Ashing said. “And although we don’t always understand the exact mechanism of that relationship, that doesn’t mean we can’t act.”