Aim:

The PROLIFICA-NT project – Prevention of Liver Fibrosis and Cancer Australia – Northern Territory aims to  provide initial validation and demonstrate the feasibility of using a urinary metabolite screening assay for hepatocellular carcinoma in remote Aboriginal communities.

Objectives:


To validate and adapt if necessary a metabolite panel for use in a urinary screening test within the Australian population.  Participants will provide a urine and blood sample and dietary information and undergo ultrasound and fibroscan.  There will be a mix of healthy controls, patients with hepatocellular carcinoma and Hep B infected individuals with and without cirrhosis (scarring) fo the liver .

Summary:


We have determined that Aboriginal populations have a six times higher incidence of hepatocellular carcinoma (HCC) compared to non-Aboriginal Australians in the Northern Territory (NT). Screening for HCC currently consists of a liver ultrasound and a blood test for a tumour marker every 6 months.  Picking up HCC early when curative treatments are available is logistically challenging in the NT setting. This study will establish if a urine test, looking for specific urinary metabolites to screen for HCC is possible and can provide clinically useful results in Aboriginal people living in remote communities. The collaborating Imperial college has already successfully pioneered the use of urinary metabolomics for this purpose in the Gambia. 

Implications for policy and practice:


This project will find an enduring solution to a health problem that matters – i.e. enable Aboriginal Australians living in the remote NT setting to have access to regular HCC screening which is part of internationally recommended evidence based guidelines.  It will eliminate some of the logistical challenges faced in a remote tropical setting for a common problem that has significant mortality associated with it. 

Our research has found:


Preliminary results show that it is logistically possible to collect urine samples in a remote NT community and transport firstly to Darwin and then to London. Early results suggest the models being used are predictive.  

Chief Investigator:
Project manager:
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Project dates:

The project commenced in 2016 and is ongoing.