Point of Care Technologies for Gastrointestinal Cancer Prevention and Early Detection

Fast-Track proposals will be accepted. Direct-to-Phase II proposals will NOT be accepted. Number of anticipated awards: 3-5 Budget (total costs, per award): Phase I: up to $400,000 for up to 12 months Phase II: up to $2,250,000 for up to 2 years PROPOSALS THAT EXCEED THE BUDGET OR PROJECT DURATION LISTED ABOVE MAY NOT BE FUNDED. Summary Gastrointestinal (GI) tract (esophagus, stomach, small and large intestine, rectum, anus) cancers account for approximately 19% and 23% of global cancer incidence and mortality. While the burden predominately lies in high and upper-middleincome countries, an epidemiologic shift is leading to increased incidence in low- and middle-income countries (LMIC). Apart from colorectal cancer (CRC), where there have been advances in early detection and treatment, prognosis in other GI tract cancers tends to be poor due to the late stage of most diagnoses. Within the United States (US), disparities are largely attributed to late presentation of CRC, and African Americans and Hispanics as well as rural populations face increased CRC mortality. Similarly, while gastric cancer is less common in the US, incidence in Asians, Blacks, and Hispanics is significantly higher than in Whites. For esophageal cancer, although early detection increases treatment options, the burden is greater in minorities, immigrants, and lower socioeconomic groups, who present at more advanced stage. Finally, while risk-stratified early detection approaches have been implemented for esophageal adenocarcinoma (EAC), there are no recommended screening approaches for average-risk individuals or for esophageal squamous cell carcinoma (ESCC), which is seen more commonly in LMICs and accounts for 90% of global esophageal cancers. For all these cancers, there is a need for affordable and scalable point-of-care tests (POCTs) that can effectively screen for precancerous conditions and early cancers, while intervention is still possible. Moreover, the parallel needs in high-income countries (HICs) and LMICs call for a reciprocal innovation approach based on bidirectional, mutually beneficial research, where the resultant tests are designed for broad applicability across both the HICs and LMICs.