The research
Led by Clinical Associate Professor Brian Nicholson at the Nuffield Department of Primary Care Health Sciences, the new AcceleRated coMmunity Multi-cAncer DIagnostic evaLuatiOn (ARMADILO) platform will explore whether multi-cancer tests can help GPs identify cancer earlier in people with these non-specific symptoms.
The innovative tests, including blood tests, are a new type of technology that aim to detect signals of multiple cancer types at once. They look for tiny bits of material released by cancer cells into the blood or other biological samples such as urine.
While early research shows promise, these tests are not yet used routinely in the NHS as their accuracy and usefulness in real-world settings need to be better understood.
The recently published National Cancer Plan and the James Lind Alliance – which brings together patients, carers and clinicians to identify shared research priorities – have highlighted the need to evaluate these tests in real-world settings, particularly in general practice. The new research will assess how accurate and useful the tests are in a real NHS primary care setting and whether they can be used to support decision-making around urgent referrals.
How it will work?
Over five years, the research team behind the new ARMADILO platform will work with up to 132 GP practices and invite nearly 10,000 patients aged 50 and over to take part. Participants will be asked to provide a sample and permission to access their health records. Tracking their health outcomes through linked NHS records, the researchers will then monitor who is diagnosed with cancer over the following year to evaluate how well the different tests perform in detecting cancer.
The study will also assess how to recruit participants fairly, efficiently, and in an inclusive way. It will compare patients identified by their GP with those identified using electronic health records to see whether digital tools could help make the recruitment process less burdensome for practices. It will work with patient communities to ensure the platform is inclusive of patients from all backgrounds so that they may benefit from the research findings.
Professor Brian Nicholson, the lead for the ARMADILO platform, said:
“We urgently need better tools to help GPs identify cancer earlier, especially when patients come in with vague symptoms that don’t immediately point to a specific diagnosis. This study is the first in the world that will help us understand whether multi-cancer tests can be a useful part of a GP’s toolkit. By working closely with patients, GP practices, and the wider NHS, we hope to find practical ways to improve how and when cancer is detected.”
Professor Sir Aziz Sheikh, Head of the Nuffield Department of Primary Care Health Sciences, said:
“Multi-cancer testing has the potential to revolutionise early diagnosis, and this study is a critical step in understanding how that potential could be realised in GP practices. Strengthening community-based healthcare will be a crucial part of delivering the ambitions set out in the NHS Long Term Plan and the National Cancer Plan, and innovations like this could play an important role in supporting earlier diagnosis closer to home.”
Patient involvement and inclusion
A central focus of the study is ensuring that the research is inclusive and reflects the diversity of the communities it aims to serve. Patient and Public Involvement and Engagement (PPIE) has played a central role in shaping the study from the start. A dedicated advisory group will continue to guide the study throughout, helping to design participant materials, improve accessibility, and ensure the research reflects the needs of diverse communities.
Joanne Lloyd, a PPIE contributor, said: “From a patient and public perspective, this study is incredibly important. Having seen how cancer affects families, I know how much earlier diagnosis matters. It’s been vital to help shape the research, so it is clear, reassuring, and accessible for everyone”
Patrick McGuire, also a PPIE contributor said: ‘Early diagnosis saves lives. Currently far too many people are being diagnosed far too late. A simple blood test that would help GPs diagnose cancer early could hugely improve cancer care, saving lives and providing a big step forward to a world where people live longer, better lives free from the fear of cancer.’
Potential impact
The study could lead to earlier diagnoses and better outcomes for people with cancer, as well as inform how multi-cancer tests might be used in NHS primary care in the future. The results will help inform NHS decisions on whether and how multi-cancer tests might be introduced into routine general practice. If successful, the tests could help GPs make quicker, better-informed decisions about who should be referred for further cancer investigation - leading to earlier diagnoses and potentially better outcomes for patients.
Findings from the study will be published in open access journals and shared through presentations and materials designed with patients and the public in mind.
Take part
The ARMADILO study offers a unique opportunity for developers of multi-cancer detection tests to evaluate their technologies in a real-world NHS primary care setting. Organisations interested in taking part are encouraged to contact the research team via cancer@phc.ox.ac.uk to discuss collaboration.