Establishing the China–UK Cancer Prevention and Control Alliance

Abstract

Given China's emergent position as one of the global leaders in artificial intelligence, a tremendous opportunity exists to apply it across the spectrum of cancer control, improving patient care by enhancing detection, survival prediction, and treatment efficacy. Both countries should provide governmental and financial support to extend collaboration between top UK and Chinese medical schools, exemplified by the successful collaboration between the University of Oxford and Sichuan University Joint Centre for Gastrointestinal Cancer in 2020, that has developed a model of one team based across two sites, with an operating and governance system that drives the exchange of ideas, researchers, and clinicians. 4 In terms of governance, we propose a steering group, co-chaired by a senior Chinese and UK oncologist, supported by other leaders in the field from both nations, who would be asked to co-chair working groups, which would address various topics (ie, prevention, early detection and screening, multidisciplinary cancer treatment, research, palliative and survivor care, and governance and systems, including health workforce and information systems) and provide a report capturing current practice and evolved models of care, which can be used as a blueprint or manual for other countries with nascent cancer systems. CS received funding from the Francis Crick Institute that receives its core funding from Cancer Research UK (CC2041), the UK Medical Research Council (CC2041), the Wellcome Trust (CC2041), and the Royal Society (RSRP\R\210001, paid to institution); grants from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Invitae, Ono Pharmaceuticals, Personalis, and Pfizer; consulting fees from Bicycle Therapeutics, Genentech, Medicxi, Novartis, Relay Therapeutics, China Innovation Centre of Roche (CICoR), SAGA Diagnostics, and Sarah Canon Research Institute; honoraria from Amgen, AstraZeneca, Bristol Myers Squibb, Illumina, GlaxoSmithKline, Merck Sharp & Dohme, Roche–Ventana, Pfizer, and AstraZeneca; is on a scientific advisory board for GRAIL; is the Chief Clinician for Cancer Research UK; is the co-founder of Achilles Therapeutics; has patents with; has stock options for Epic Biosciences, Relay Therapeutics, GRAIL, Bicycle Therapeutics, and Achilles Therapeutics; is the Chief Investigator of the MeRmaiD 1 and 2 clinical trials for AstraZeneca; and is the Co-Chief Investigator of the GRAIL–NHS Galleri Trial for GRAIL. TM received grants from AstraZeneca, Bristol Myers Squibb, G1 Therapeutics, Merck Sharp & Dohme, Merck Serono, Novartis, Pfizer, Roche, SFJ, Takeda, and XCovery; consulting fees from AbbVie, ACEA Pharma, Adagene, Alentis Therapeutics, Alpha Biopharma, Amgen, Amoy Diagnostics, AnHeart Therapeutics, AVEO Pharmaceuticals, Bayer, BeiGene, BerGenBio ASA, Berry Oncology, Boehringer Ingelheim, Blueprint Medicines Corporation, Bridge Bio, Bristol Myers Squibb, Bowtie Life Insurance Company, Bridge Biotherapeutics, Covidien LP, C4 Therapeutics, Cirina, CStone Pharmaceuticals, Curio Science, D3 Bio, Da Volterra, Daiichi Sankyo, Eisai, Elevation Oncology, Erasca, F Hoffmann–La Roche/Genentech, Fishawack Facilitate, G1 Therapeutics, geneDecode, Gilead Sciences, GLG's Healthcare, Gritstone Oncology, Guardant Health, Hengrui Therapeutics, HiberCell, HutchMed, Ignyta, Illumina Imagene AI, Incyte, Inivata, InxMed, IQVIA, Janssen, Lakeshore Biotech, Lilly, Lunit USA, Loxo-Oncology, Lucence Health, Medscape/WebMD, Medtronic, Merck Serono, Merck Sharp & Dohme, Mirati Therapeutics, MiRXES, MoreHealth, Novartis, Novocure, Ningbo NewBay Technology Development, Omega Therapeutics, OrigiMed, OSE Immunotherapeutics, PeerVoice, Phanes Therapeutics, Pfizer, PrIME Oncology, Prenetics Global, Puma Biotechnology, Qiming Development, Regen Medtech Holdings, Regeneron Pharmaceuticals, Roche Pharmaceuticals/Diagnostics/Foundation One, Sanofi Aventis, Schrödinger, Seagen International, SFJ, Simcere of America, Synergy Research, Summit Therapeutics Sub, Takeda Pharmaceuticals, Tigermed, Vertex Pharmaceuticals, Virtus Medical Group, XENCOR, and Yuhan Corporation; honoraria from ACEA Pharma, Alpha Biopharma, Amgen, Amoy Diagnostics, AstraZeneca (before Jan 1, 2019), BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Daz Group, Fishawack Facilitate, InMed Medical Communication, Janssen Pharmaceutica NV, Jiahui Holdings, LiangYiHui Healthcare, Lilly, Lucence Health, MD Health Brazil, Medscape, Merck Pharmaceuticals, Merck Sharp & Dohme, MiRXES, Novartis, OrigiMed, P Permanyer SL, PeerVoice, Physicians’ Education Resource, Pfizer, PrIME Oncology, Research to Practice, Roche Pharmaceuticals/Diagnostics/Foundation One, Sanofi Aventis, Shanghai BeBirds Translation & Consulting, Taiho Pharmaceutical, Takeda Oncology, and Touch Independent Medical Education; support for attending meetings or travel from Novartis, Roche, Pfizer (personal and to institution), AstraZeneca, Daiichi Sankyo, Takeda, MiRXES, AbbVie, Zai Lab, Liangyihui, Lu Ye Pharma, Beigene, and Merck Sharp & Dohme; participated on a data safety monitoring board or advisory board for AbbVie, ACEA Pharma, Amgen, AstraZeneca, Alentis Therapeutics AG, BerGenBio ASA, Berry Oncology, Blueprint Medicines Corporation, Boehringer Ingelheim, Bowtie Life Insurance, Bristol Myers Squibb, C4 Therapeutics, Covidien LP, CStone Pharmaceuticals, Curio Science, D3 Bio Ltd, Daiichi Sankyo, Eisai, Erasca, Fishawack Facilitate, G1 Therapeutics, Gilead Sciences, Gritstone Oncology, Guardant Health, geneDecode (unpaid), Hengrui Therapeutics, HutchMed, Ignyta, Incyte, Imagene AI, Inivata, IQVIA, Janssen, Lakeshore Biotech, Lilly, Loxo-Oncology, Lunit, Merck Serono, Merck Sharp & Dohme, Mirati Therapeutics, MiRXES, Novartis, OrigiMed, Phanes Therapeutics, Pfizer, Prenetics Global, Puma Biotechnology, Roche/Genentech, Regeneron Pharmaceuticals, Sanofi Aventis, SFJ, Simcere of America, Simcere Zaiming, Takeda, Vertex Pharmaceuticals, Virtus Medical Group, XENCOR, and Yuhan Corporation; has a leadership or fiduciary role with EPOCH BIOSCIENCES (unpaid), AstraZeneca, HutchMed, Aurora, and Insighta; and has stock or stock options with AstraZeneca, Aurora Tele-Oncology, Biolidics, HutchMed, Prenetics Global, D3 Bio, Lunit, Bowtie Life Insurance, Lakeshore Biotech, Loxo-Oncology, Virtus Medical Group, Yinson Capital, Phanes Therapeutics, Insighta, Alentis Therapeutics AG, and EPOCH BIOSCIENCES.

Advances in medicine and technology are creating new opportunities to detect, manage, and cure cancer. Nowadays, accelerated access programmes can bring novel health-care approaches to patients faster than ever before; however, new technologies and advances cannot be developed in isolation. To successfully help a population, these advances need to be integrated into the infrastructure of a country's health-care system across the spectrum of cancer control and encompass awareness raising, prevention, early detection, and treatment that is supported by education and research. This is an exciting challenge facing both the UK and China that is best tackled with greater collaboration.

The global cancer burden hardly needs restating, as it is currently responsible for more than 7 million deaths per year, and will likely increase to 15 million new cases per annum by 2030. It has been estimated that one in two people face a lifetime risk of developing cancer, of whom one in four will die. ¹

With more than 20% of its population aged 60 years and older and a growing public focus on health, China has committed to a health-first strategy that highlights disease prevention and health management. ² This strategy was outlined in a key reform resolution recently adopted at the third plenary session of the 20th Communist Party of China Central Committee. With solid progress in health care, the country is transitioning from primarily treating diseases to maintaining overall health. To ensure the overall health for its huge population, the country needs to boost capacities for disease monitoring and early warning, risk assessment, epidemiological investigation, testing and inspection, emergency response, and medical treatment, according to the resolution.

The UK published its first national cancer plan in 2000, ³ the basis of which encompassed tumour-site specialisation, multidisciplinary team working, implementation of treatment guidelines, and improved referral pathways linking district and major hospitals in a so-called hub and spoke model that is supported by targeted funding. Subsequent iterations of the plan have sought to embrace innovative technologies.

In a January, 2025 meeting between Premier Li Qiang of the State Council in the Great Hall of the People and one of the authors of this Comment (DK), and following a discussion with the Chinese Ministry of Social Affairs, a proposition arose suggesting that China and the UK should work together to improve cancer control by forming a China–UK Cancer Prevention and Control Alliance (CCPCA).

At the Lancet Summit on cancer control in Shanghai, China (Feb 21–23, 2025), several leading oncologists in China met with UK representatives to discuss how to take this initiative forward. The broad philosophy would be to establish multidisciplinary teams drawing from both nations to enable scientists and clinicians to learn from each other and apply their expertise for the benefit of cancer patients globally. The CCPCA will be driven by the exchange of young scientists, cooperation between group leaders, joint symposia, and a management framework that encompasses communication, joint publications, shared intellectual property, and the genesis of additional, competitive governmental funding.

Several topics of specific interest were proposed that an alliance with this potential could address. Large-scale randomised clinical trials linked to well-curated digital, genomic, and tissue biobanks would make an invaluable contribution to precision cancer medicine and meet Doug Laney's definition of big data, namely the three V's of volume, velocity, and variety. This sort of trial activity could serve as a precursor for aligning the UK's Medicines and Healthcare Regulatory Agency and China's National Medical Products Administration, boosting cooperation between the biotechnology, pharmaceutical, and medical devices sectors. Given China's emergent position as one of the global leaders in artificial intelligence, a tremendous opportunity exists to apply it across the spectrum of cancer control, improving patient care by enhancing detection, survival prediction, and treatment efficacy.

The first steps for establishing the CCPCA should involve creating an intergovernmental forum with leading health-care and policy experts from both countries working together to compare and then explore new and improved models of cancer control, to the benefit of citizens of both countries and the global cancer community ( ^figure ). Both countries should provide governmental and financial support to extend collaboration between top UK and Chinese medical schools, exemplified by the successful collaboration between the University of Oxford and Sichuan University Joint Centre for Gastrointestinal Cancer in 2020, that has developed a model of one team based across two sites, with an operating and governance system that drives the exchange of ideas, researchers, and clinicians. ⁴

In terms of governance, we propose a steering group, co-chaired by a senior Chinese and UK oncologist, supported by other leaders in the field from both nations, who would be asked to co-chair working groups, which would address various topics (ie, prevention, early detection and screening, multidisciplinary cancer treatment, research, palliative and survivor care, and governance and systems, including health workforce and information systems) and provide a report capturing current practice and evolved models of care, which can be used as a blueprint or manual for other countries with nascent cancer systems.

CS received funding from the Francis Crick Institute that receives its core funding from Cancer Research UK (CC2041), the UK Medical Research Council (CC2041), the Wellcome Trust (CC2041), and the Royal Society (RSRP\R\210001, paid to institution); grants from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Invitae, Ono Pharmaceuticals, Personalis, and Pfizer; consulting fees from Bicycle Therapeutics, Genentech, Medicxi, Novartis, Relay Therapeutics, China Innovation Centre of Roche (CICoR), SAGA Diagnostics, and Sarah Canon Research Institute; honoraria from Amgen, AstraZeneca, Bristol Myers Squibb, Illumina, GlaxoSmithKline, Merck Sharp & Dohme, Roche–Ventana, Pfizer, and AstraZeneca; is on a scientific advisory board for GRAIL; is the Chief Clinician for Cancer Research UK; is the co-founder of Achilles Therapeutics; has patents with; has stock options for Epic Biosciences, Relay Therapeutics, GRAIL, Bicycle Therapeutics, and Achilles Therapeutics; is the Chief Investigator of the MeRmaiD 1 and 2 clinical trials for AstraZeneca; and is the Co-Chief Investigator of the GRAIL–NHS Galleri Trial for GRAIL. TM received grants from AstraZeneca, Bristol Myers Squibb, G1 Therapeutics, Merck Sharp & Dohme, Merck Serono, Novartis, Pfizer, Roche, SFJ, Takeda, and XCovery; consulting fees from AbbVie, ACEA Pharma, Adagene, Alentis Therapeutics, Alpha Biopharma, Amgen, Amoy Diagnostics, AnHeart Therapeutics, AVEO Pharmaceuticals, Bayer, BeiGene, BerGenBio ASA, Berry Oncology, Boehringer Ingelheim, Blueprint Medicines Corporation, Bridge Bio, Bristol Myers Squibb, Bowtie Life Insurance Company, Bridge Biotherapeutics, Covidien LP, C4 Therapeutics, Cirina, CStone Pharmaceuticals, Curio Science, D3 Bio, Da Volterra, Daiichi Sankyo, Eisai, Elevation Oncology, Erasca, F Hoffmann–La Roche/Genentech, Fishawack Facilitate, G1 Therapeutics, geneDecode, Gilead Sciences, GLG's Healthcare, Gritstone Oncology, Guardant Health, Hengrui Therapeutics, HiberCell, HutchMed, Ignyta, Illumina Imagene AI, Incyte, Inivata, InxMed, IQVIA, Janssen, Lakeshore Biotech, Lilly, Lunit USA, Loxo-Oncology, Lucence Health, Medscape/WebMD, Medtronic, Merck Serono, Merck Sharp & Dohme, Mirati Therapeutics, MiRXES, MoreHealth, Novartis, Novocure, Ningbo NewBay Technology Development, Omega Therapeutics, OrigiMed, OSE Immunotherapeutics, PeerVoice, Phanes Therapeutics, Pfizer, PrIME Oncology, Prenetics Global, Puma Biotechnology, Qiming Development, Regen Medtech Holdings, Regeneron Pharmaceuticals, Roche Pharmaceuticals/Diagnostics/Foundation One, Sanofi Aventis, Schrödinger, Seagen International, SFJ, Simcere of America, Synergy Research, Summit Therapeutics Sub, Takeda Pharmaceuticals, Tigermed, Vertex Pharmaceuticals, Virtus Medical Group, XENCOR, and Yuhan Corporation; honoraria from ACEA Pharma, Alpha Biopharma, Amgen, Amoy Diagnostics, AstraZeneca (before Jan 1, 2019), BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Daz Group, Fishawack Facilitate, InMed Medical Communication, Janssen Pharmaceutica NV, Jiahui Holdings, LiangYiHui Healthcare, Lilly, Lucence Health, MD Health Brazil, Medscape, Merck Pharmaceuticals, Merck Sharp & Dohme, MiRXES, Novartis, OrigiMed, P Permanyer SL, PeerVoice, Physicians’ Education Resource, Pfizer, PrIME Oncology, Research to Practice, Roche Pharmaceuticals/Diagnostics/Foundation One, Sanofi Aventis, Shanghai BeBirds Translation & Consulting, Taiho Pharmaceutical, Takeda Oncology, and Touch Independent Medical Education; support for attending meetings or travel from Novartis, Roche, Pfizer (personal and to institution), AstraZeneca, Daiichi Sankyo, Takeda, MiRXES, AbbVie, Zai Lab, Liangyihui, Lu Ye Pharma, Beigene, and Merck Sharp & Dohme; participated on a data safety monitoring board or advisory board for AbbVie, ACEA Pharma, Amgen, AstraZeneca, Alentis Therapeutics AG, BerGenBio ASA, Berry Oncology, Blueprint Medicines Corporation, Boehringer Ingelheim, Bowtie Life Insurance, Bristol Myers Squibb, C4 Therapeutics, Covidien LP, CStone Pharmaceuticals, Curio Science, D3 Bio Ltd, Daiichi Sankyo, Eisai, Erasca, Fishawack Facilitate, G1 Therapeutics, Gilead Sciences, Gritstone Oncology, Guardant Health, geneDecode (unpaid), Hengrui Therapeutics, HutchMed, Ignyta, Incyte, Imagene AI, Inivata, IQVIA, Janssen, Lakeshore Biotech, Lilly, Loxo-Oncology, Lunit, Merck Serono, Merck Sharp & Dohme, Mirati Therapeutics, MiRXES, Novartis, OrigiMed, Phanes Therapeutics, Pfizer, Prenetics Global, Puma Biotechnology, Roche/Genentech, Regeneron Pharmaceuticals, Sanofi Aventis, SFJ, Simcere of America, Simcere Zaiming, Takeda, Vertex Pharmaceuticals, Virtus Medical Group, XENCOR, and Yuhan Corporation; has a leadership or fiduciary role with EPOCH BIOSCIENCES (unpaid), AstraZeneca, HutchMed, Aurora, and Insighta; and has stock or stock options with AstraZeneca, Aurora Tele-Oncology, Biolidics, HutchMed, Prenetics Global, D3 Bio, Lunit, Bowtie Life Insurance, Lakeshore Biotech, Loxo-Oncology, Virtus Medical Group, Yinson Capital, Phanes Therapeutics, Insighta, Alentis Therapeutics AG, and EPOCH BIOSCIENCES. RF received royalties and is named on patents related to the capsule sponge device and associated biomarkers that were licensed by the Medical Research Council UK to Covidien (now Medtronic) and is named on new patents related to biomarkers but not relevant to this Comment; is Chair for the Sarong Trial; is on the advisory boards for 23andMe; is a scientific advisory board member for AstraZeneca and the Cancer Research UK Functional genomics core; is a Trustee for Heartburn Cancer UK (unpaid); and is a shareholder for Cyted Health. R-HX received consulting fees from Hutchison, Hengrui, Junshi, Qilu, CPPC, Roche, and Merck Serono; and participates on data safety monitoring board or advisory boards for Astellas, Merck Sharp & Dohme, AstraZeneca, Junshi, Hengrui, BeiGene, Innovent, CPPC, and Keymed Biosience. RC received funding from The UK and Ireland Global Cancer Network and The Christie Hospital and University of Manchester. G-JT is the President of the Chinese College of Interventionalists (unpaid); is the President of International Society of Multidisciplinary Interventional Oncology (unpaid); is the Dean of Southeast University Department of Medicine and Life Sciences (unpaid); is the Academician of the Chinese Academy of Sciences (unpaid); and is a Fellow of the Chinese Academy of Medical sciences (unpaid). TE is the non-executive Director of Cambridge University Health Partners; is the Director of DeviceChooser; is employed as the Vice President of the GU and GI Oncology Late Clin Dev section for Roche; and has stock options for Roche and AstraZeneca. ML received grants from AstraZeneca, Gilead, Merck Sharp & Dohme, Takeda (all to institution), and Johnson & Johnson (personal); honoraria from AstraZeneca, Novartis, Amgen, Pfizer, Takeda, ACE Oncology, Gilead, Guardant Health, Johnson & Johnson, Merck, Merck Sharp & Dohme, Bristol Myers Squibb, and Roche; support for travel from AstraZeneca, Pfizer, Daiichi Sankyo, Merck Sharp & Dohme, Roche, Johnson & Johnson, and Amgen; and served on data safety monitoring boards or advisory boards for AstraZeneca, Pfizer, Takeda, Amgen, AnHeart Therapeutics, Yuhan, Blossomhill Therapeutics, and Johnson & Johnson. FWSK was Supported by Sanofi to attend the European Respiratory Society 2024 Congress (paid via CHEST Delegation Hong Kong and Macau) and was supported by GlaxoSmithKline to attend the European Respiratory Congress 2023 (paid via CHEST Delegation Hong Kong and Macau). BX received consulting fees from AstraZeneca and Novartis. Y-LW received honoraria from AstraZeneca, Roche, Pfizer, Boehringer Ingelheim, Merck Sharp & Dohme Oncology, Bristol Myers Squibb, Hengrui Pharmaceutical, and BeiGene Beijing; and is the President of the Chinese Thoracic Oncology Group (unpaid). DF is the President of China Anti-Cancer Association, the President of Asia Oncology Society, and the President of the World Association for Integrative Oncology (all unpaid). JM, DK, YS, RL, ML, MM, EA, DX, AP, MK, and LY declare no competing interests.

We acknowledge the support of Sir Muir Gray and Dr Ruoting Men in the preparation of this manuscript.